Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer.
10.14701/kjhbps.2011.15.3.146
- Author:
Sung Woo AHN
1
;
Ahn Soo NA
;
Jae Do YANG
;
Hong Pil HWANG
;
Hee Chul YU
;
Baik Hwan CHO
Author Information
1. Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea. hcyu@jbnu.ac.kr
- Publication Type:Original Article
- Keywords:
Colorectal cancer;
Hepatic metastasis;
Hepatic resection;
Clinical risk scoring system
- MeSH:
Colorectal Neoplasms;
Humans;
Multivariate Analysis;
Neoplasm Metastasis;
Risk Factors;
Survival Rate
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011;15(3):146-151
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUNDS/AIMS: To find independent predictors that affect the survival in patients with hepatic metastasis of colorectal cancer after surgery and to devise a risk scoring system. METHODS: Among 150 patients who underwent hepatic resection after diagnosis of colorectal cancer with hepatic metastasis between March 1994 and February 2009, we analyzed clinical, pathologic and outcome data retrospectively. RESULTS: The 1-year survival rate was 83%, and the 5-year survival rate was 35%. Nine factors were found to be independent predictors of adverse outcome by univariate analysis: stage of primary tumor, CA19-9 >36 U/ml, extrahepatic disease, distribution of the hepatic tumor, number of hepatic tumors >3, largest hepatic tumor >5 cm, total size >10 cm, CEA >10 ng/ml, and metachronous cancer. The last two of these criteria were also significant risk factors on multivariate analysis. When these criteria were used as a risk scoring system, assigning one point for each criterion and dividing the cases into A, B and C groups, the total score was highly predictive of outcomes (p<0.001). No patients in group C (6 to 9 points) were long-term survivors. CONCLUSIONS: Long-term outcome can be predicted from nine criteria that are readily available for all patients. Patients meeting up to two criteria (group A) are more likely to have a favorable outcome compared to the three or over (groups B and C). This scoring system may offer an easy, rapid, and reliable prognostic indicator of survival outcome after hepatic resection in patients with hepatic metastasis from colorectal cancer.
