BackgroundPurpose of this study was to analyse the surgical management and long-term clinical outcome of patients diagnosed with colorectal liver metastases (CLM) over a period of 10 years using data from a German tumour registry.MethodsRetrospective analysis of 5772 patients diagnosed with colorectal adenocarcinoma between 2002 and 2007. Follow-up was continued until 2012.Results1426 patients (24.7%) had CLM; 1019 patients (71%) had synchronous, 407 patients (29%) developed metachronous CLM. Hepatic resection was performed in 374 of the 1426 CLM patients (26%). A significant increase in liver resection rate from 16.6% for the 2002 cohort to 32% in later cohorts was observed. In centers specialized in liver surgery, CLM resection rates reached 46.6%. However, up to 52% of patients diagnosed with three or less CLM did not undergo liver surgery, although, if resected, patients with 1 CLM show a similar long-time survival as CRC patients who do not develop any CLM. Univariate and multivariate analyses adjusted for age, sex, year of resection, time of CLM diagnosis and number of CLM revealed a significant survival benefit for CLM resection (HR =0.355; CI 0.305-0.414). Furthermore, significant impact on OS was seen for age at diagnosis, perioperative chemotherapy and number of CLM.ConclusionsWe here present the first long-term, population-based analysis of the surgical management of CLM in Germany. Significant increase in hepatic resection rates, translating to a significant benefit in OS, was seen over years. However, we still see a striking potential for further improvements in interdisciplinary CLM management.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-810) contains supplementary material, which is available to authorized users.

Our data provide evidence for a possible role of hormonal factors in the aetiology of lung cancer in women.

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Risk factors for early onset of lung cancer are relatively unknown. In a case-control study, carried out in Germany between 1990 and 1996, the effects of smoking and familial aggregation of cancer were compared in 251 young cases and 280 young controls (< or = 45 years) and in 2,009 older cases and 2,039 older controls (55-69 years). The male/female ratio was 2.6/1 in young patients and 5.6/1 in older patients. Adenocarcinomas were more frequent in young men than in older men (41 % vs. 28%). Duration of smoking and amount smoked showed significantly increased odds ratios for lung cancer in both age groups. Lung cancer in a first degree relative was associated with a 2.6-fold (95% confidence interval (CI) 1.1-6.0) increase in the risk of lung cancer in the young age group, but no elevated risk was seen in the older group (OR = 1.2, 95% CI 0.9-1.6). Smoking-related cancer in relatives with the age at diagnosis under 46 years was associated with an increased risk of lung cancer in the young group (OR = 5.6, 95% CI 0.7-46.9) but not in the older group (OR = 0.7, 95% CI 0.3-1.5). Results indicated that lung cancer risk in young and older age groups shows remarkable differences with respect to sex, histologic type, and genetic predisposition.

In a 1990-1996 case-control study in western Germany, the authors investigated lung cancer risk due to exposure to residential radon. Confirmed lung cancer cases from hospitals and a random sample of community controls were interviewed by trained interviewers regarding different risk factors. For 1 year, alpha track detectors were placed in dwellings to measure radon gas concentrations. The evaluation included 1,449 cases and 2,297 controls recruited from the entire study area and a subsample of 365 cases and 595 controls from radon-prone areas of the basic study region. Rate ratios were estimated by using conditional logistic regression adjusted for smoking and for asbestos exposure. In the entire study area, no rate ratios different from 1.0 were found; in the radon-prone areas, the adjusted rate ratios for exposure in the present dwelling were 1.59 (95% confidence interval (CI): 1.08, 2.27), 1.93 (95% CI: 1.19, 3.13), and 1.93 (95% CI: 0.99, 3.77) for 50-80, 80-140, and>140 Bq/m3, respectively, compared with 0-50 Bq/m3. The excess rate ratio for an increase of 100 Bq/m3 was 0.13 (-0.12 to 0.46). An analysis based on cumulative exposure produced similar results. The results provide additional evidence that residential radon is a risk factor for lung cancer, although a risk was detected in radon-prone areas only, not in the entire study area.