Korean J Hepatobiliary Pancreat Surg.  2011 Aug;15(3):146-151. 10.14701/kjhbps.2011.15.3.146.

Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer

• Ahn SW
• Na AS
• Yang JD
• Hwang HP
• Yu HC
• Cho BH

• KMID: 2130985
• DOI: http://doi.org/10.14701/kjhbps.2011.15.3.146

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.

Keyword

Colorectal cancer; Hepatic metastasis; Hepatic resection; Clinical risk scoring system

MeSH Terms

Colorectal Neoplasms
Humans
Multivariate Analysis
Neoplasm Metastasis
Risk Factors
Survival Rate

Figure

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  Fig. 1 Cumulative survival curves of the groups as related to the stages. 1-, 3-, and 5-year survival rate was all 100% in stage I (n=2). 1-, 3-, and 5-year survival rate was 100%, 79.6%, and 42.6% each in stage II (n=27). 1-, 3-, and 5-year survival rate was 93.8%, 71.8%, and 57.1% each in stage III (n=32). 1-, 3-, and 5-year survival rate was 72.7%, 46.3%, and 29.4% each in stage IV (n=89) (p<0.001).

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  Fig. 2 Cumulative survival curves of the groups between synchronous and metachronous metastasis. The 1-, 3-, and 5-year survival rate was 78.8%, 49.4%, and 23.3% each in synchronous (n=122) and 1-, 3-, and 5-year survival rate was 100%, 96%, and 77.5% each in metachronous (n=28), respectively (p<0.001).

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