"VSports" Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases
- PMID: 10493478
- PMCID: PMC1420876
- DOI: 10.1097/00000658-199909000-00004
Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases
Abstract
Objective: There is a need for clearly defined and widely applicable clinical criteria for the selection of patients who may benefit from hepatic resection for metastatic colorectal cancer. Such criteria would also be useful for stratification of patients in clinical trials for this disease. VSports手机版.
Methods: Clinical, pathologic, and outcome data for 1001 consecutive patients undergoing liver resection for metastatic colorectal cancer between July 1985 and October 1998 were examined. These resections included 237 trisegmentectomies, 394 lobectomies, and 370 resections encompassing less than a lobe V体育安卓版. The surgical mortality rate was 2. 8%. .
Results: The 5-year survival rate was 37%, and the 10-year survival rate was 22%. Seven factors were found to be significant and independent predictors of poor long-term outcome by multivariate analysis: positive margin (p = 0. 004), extrahepatic disease (p = 0. 003), node-positive primary (p = 0. 02), disease-free interval from primary to metastases <12 months (p = 0. 03), number of hepatic tumors >1 (p = 0. 0004), largest hepatic tumor >5 cm (p = 0. 01), and carcinoembryonic antigen level >200 ng/ml (p = 0. 01) V体育ios版. When the last five of these criteria were used in a preoperative scoring system, assigning one point for each criterion, the total score was highly predictive of outcome (p < 0. 0001). No patient with a score of 5 was a long-term survivor. .
Conclusion: Resection of hepatic colorectal metastases may produce long-term survival and cure. Long-term outcome can be predicted from five criteria that are readily available for all patients considered for resection. Patients with up to two criteria can have a favorable outcome. Patients with three, four, or five criteria should be considered for experimental adjuvant trials VSports最新版本. Studies of preoperative staging techniques or of adjuvant therapies should consider using such a score for stratification of patients. .
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References
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- Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995; 19: 59–71. - PubMed
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- Gayowski TJ, Iwatsuki S, Madariaga JR, et al. Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathological risk factors. Surgery 1994; 116: 703–711. - PMC (VSports最新版本) - PubMed
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- Hughes KS, Simons R, Songhorabodi S, et al. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Surgery 1988; 103: 278–288. - "V体育官网" PMC - PubMed
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