Preoperative Prognostic Score for Predicting Survival After Hepatic Resection for Colorectal Liver Metastases

Malik, Hassan; Prasad, Kondapalli Siva; Halazun, Karim J.; Aldoori, Amir Q.; Al-Mukhtar, Ahmed; Gomez, Dhanny; Lodge, J. Peter A.; Toogood, Giles J.

doi:10.1097/sla.0b013e318142d964

Cited by 187 publications

(158 citation statements)

References 46 publications

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“…There were 308 (63.1%) men and 180 (36.9%) women. At index hepatectomy, the median number of tumors on preoperative imaging was two (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Tumor size ranged from 5 to 150 mm, with a median size of 35 mm.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The liver is the organ to which CRC most frequently metastasizes, with 15-25% of patients having synchronous colorectal liver metastases (CRLM) at presentation and a further 25-50% ultimately developing CRLM following resection of the primary tumor [2]. Hepatic resection offers the only hope of cure to patients with CRLM, providing 5-year survival rates of 30-50% depending upon selection criteria [3][4][5]. Unfortunately, cancer recurs in up to 75% of patients following hepatectomy, in the remnant liver and/or other sites [5].…”

Section: Introductionmentioning

confidence: 99%

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Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases

et al. 2017

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Up to three-quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short-and long-term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi-squared test. Variables associated with long-term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer-specific survival following index hepatectomy. Short diseasefree interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short-term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved longterm patient survival. Cancer MedicineOpen Access 332

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Section: Patient Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases

et al. 2017

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“…2,13,20,23,26,31,39 For simplicity, high numbers of cells indicates cell numbers higher than the cut-off levels and low numbers of cells indicates cell numbers lower than the cut-off levels. Carstairs deprivation scores were analysed following allocation into established UK-based score quintiles.…”

Section: Statisticsmentioning

confidence: 99%

“…[1][2][3] Recurrence in the liver remnant and/or extrahepatic sites is common, however, affecting up to two-thirds of patients despite optimal metastasectomy. 3 The ability to predict individual patient prognosis prior to hepatectomy is desirable in order to guide surgical and chemotherapeutic treatment according to individual recurrence risk.…”

Section: Introductionmentioning

confidence: 99%

“…12 Elevated CRP has been shown to predict shortened long-term survival in a range of solid and haematological malignancies [13][14][15][16] and, in CRC, independently predicted decreased survival following both primary tumour and CLM resection. 2,[17][18][19] Cellular components of the SIR have also been shown to have prognostic significance in malignancy, though published data are scarce compared to that relating to CRP. Elevated neutrophil, monocyte and/or total leucocyte counts have been reported to predict adverse outcome in patients with a variety of solid tumours, [20][21][22] including primary CRC.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the prognostic value of systemic inflammation and socioeconomic deprivation in patients with resectable colorectal liver metastases

Neal¹,

Mann²,

Sutton³

et al. 2009

European Journal of Cancer

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Background: There is increasing evidence that the presence of a preoperative systemic inflammatory response (SIR) independently predicts poor long-term outcome in patients with colorectal cancer (CRC).Socioeconomic deprivation was reported to correlate with the presence of the SIR and to itself independently predict poor outcome following primary CRC resection. The aim of this study was to determine the prognostic value of preoperative systemic inflammatory biomarkers and socioeconomic deprivation in patients undergoing resection of colorectal liver metastases (CLM) and to examine correlations between these variables in this context. Results: On multivariable analysis, poor CRS (3-5), high neutrophil count (>6.0 x10 9 /L) and low serum albumin (<40 g/dL) were the only independent predictors of shortened overall survival following metastasectomy, with neutrophil count representing the greatest relative risk of death. These factors were also the only independent predictors of shortened disease-free survival 3 following hepatectomy. Socioeconomic deprivation was associated with neither systemic inflammation nor long-term outcome in this context. Patients and methods: Conclusions:The presence of a preoperative systemic inflammatory response, but not socioeconomic deprivation, independently predicts shortened survival following resection of CLM.4

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Preoperative Systemic Inflammation and Infectious Complications After Resection of Colorectal Liver Metastases

Neal

Mann²,

Garcea³

et al. 2011

Arch Surg

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Background: Postoperative complications are associated with a poor long-term prognosis after resection of colorectal liver metastases via an undetermined mechanism. The preoperative systemic inflammatory response, itself a predictor of poor survival, was recently shown to independently predict postoperative infectious complications after primary colorectal cancer resection. Objective: To examine the association of postoperative infectious complications with preoperative systemic inflammation and survival in patients undergoing resection of colorectal liver metastases. Design: Retrospective study based on a prospectively updated database. Setting: A United Kingdom tertiary referral hepatobiliary unit.

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Preoperative Prognostic Score for Predicting Survival After Hepatic Resection for Colorectal Liver Metastases

Abstract: The preoperative prognostic score is a simple and effective system allowing preoperative stratification.

Cited by 187 publications

References 46 publications

Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases

Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases

Evaluation of the prognostic value of systemic inflammation and socioeconomic deprivation in patients with resectable colorectal liver metastases

Preoperative Systemic Inflammation and Infectious Complications After Resection of Colorectal Liver Metastases

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