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.
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.
Authors: M López-Gómez; J Moreno-Rubio; I Suárez-García; P Cejas; R Madero; E Casado; A Jiménez; M Sereno; C Gómez-Raposo; F Zambrana; M Merino; D Fernández-Luengas; J Feliu Journal: Clin Transl Oncol Date: 2014-07-25 Impact factor: 3.405
Authors: Matteo Cescon; Valentina Rosa Bertuzzo; Giorgio Ercolani; Matteo Ravaioli; Federica Odaldi; Antonio Daniele Pinna Journal: World J Gastroenterol Date: 2013-12-28 Impact factor: 5.742
Authors: Junichi Shindoh; Evelyne M Loyer; Scott Kopetz; Piyaporn Boonsirikamchai; Dipen M Maru; Yun Shin Chun; Giuseppe Zimmitti; Steven A Curley; Chusilp Charnsangavej; Thomas A Aloia; Jean-Nicolas Vauthey Journal: J Clin Oncol Date: 2012-11-13 Impact factor: 44.544
Authors: D J Watkins; I Chau; D Cunningham; S S Mudan; N Karanjia; G Brown; S Ashley; A R Norman; A Gillbanks Journal: Br J Cancer Date: 2010-01-19 Impact factor: 7.640