Preoperative prognostic score for predicting survival after hepatic resection for colorectal liver metastases. Ann Surg 2007 Nov;246(5):806-14
Date
10/31/2007Pubmed ID
17968173DOI
10.1097/SLA.0b013e318142d964Scopus ID
2-s2.0-35648969531 (requires institutional sign-in at Scopus site) 178 CitationsAbstract
BACKGROUND: Despite indications for resection of colorectal liver metastases having expanded, debate continues about identifying patients that may benefit from surgery.
METHODS: Clinicopathologic data from a total of 700 patients was gathered between January 1993 and January 2006 from a prospectively maintained dataset. Of these, 687 patients underwent resection for colorectal liver metastases.
RESULTS: The median age of patient was 64 years and 36.8% of patients had synchronous disease. The overall 5-year survival was 45%. The presence of an inflammatory response to tumor (IRT), defined by an elevated C-reactive protein (>10 mg/L) or a neutrophil/lymphocyte ratio of >5:1, was noted in 24.5% of cases. Only the number of metastases and the presence or absence of an IRT influenced both overall and disease-free survival on multivariable analysis. A preoperative prognostic score was derived: 0 = less than 8 metastases and absence of IRT; 1 = 8 or more metastases or IRT, and 2 = 8 or more metastases and IRT-from the results of the multivariable analysis. The 5-year survival of those scoring 0 was 49% compared with 34% for those scoring 1. None of the patients that scored 2 were alive at 5 years.
CONCLUSION: The preoperative prognostic score is a simple and effective system allowing preoperative stratification.
Author List
Malik HZ, Prasad KR, Halazun KJ, Aldoori A, Al-Mukhtar A, Gomez D, Lodge JP, Toogood GJAuthor
Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
C-Reactive Protein
Cohort Studies
Colorectal Neoplasms
Female
Humans
Leukocyte Count
Liver Neoplasms
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome
