Which of the following statement(s) is/are true concerning the prognosis of patients with hepatic metastases and colorectal carcinoma?

b.Five year survivals following hepatic resection for an isolated metastasis is in excess of 25%

c.Survival beyond five years after resection suggests a high probability of cure

d.Survival rates are improved with a margin of resection greater than 1 cm

e. The size of a liver metastasis is not a significant factor in predicting recurrence if adequate margins can be obtained

Studies consistently report five-year survival rates averaging 25% for hepatic resection for colorectal metastases. Those who survive beyond five years seem to do well with only an additional 5% dying of recurrence within the next five years. Median survival of patients with untreated metastases is on the order of three to 10 months, with only 20% surviving past one year. Overall survival is significantly improved with surgical margins greater than 1 cm with decreased survival in patients with positive margins or margins less than 1 cm in size. The number of metastasis is a less consistent but statistically significant factor. Patients with four or more metastases have a poorer prognosis. As for the size of the metastasis, it is not a significant factor except that a larger total liver volume of metastasis requires a larger hepatic resection. Larger size may preclude adequate margins and indicate longer development of time with an increased likelihood of micrometastases.