Patient outcome after resection of colorectal liver metastases can be predicted by various prognostic factors.
Development of a model for risk stratification based on analysis of prognostic factors.
Dr Ralf Konopke and colleagues from Germany prospectively collected data of 201 patients included in a single-center trial.
A total of 20 factors were analyzed as to their influence on recurrence-free and overall survival.
Independent prognostic factors were entered into a model of a clinical risk score.
Median recurrence-free survival reached 24 months for all patients.
|The medican overall survival was 50 months|
The research team found that the median overall survival was 50 months.
The team noted that a synchronous manifestation of primary colorectal carcinoma and liver metastases influenced recurrence-free and overall survival in the multivariate analysis.
In addition, the presence of 4 or more metastases and a carcino-embryonic antigen level of 200 ng/ml or more significantly influenced recurrence-free and overall survival in the multivariate analysis.
The derived risk stratification grouped the patients according to the various criteria.
The criteria included low risk, zero prognostic factors, intermediate risk, high risk, 2 or more factors.
The median recurrence-free survival for low, intermediate and high risk were 30, 23 and 11 months, respectively.
The team noted that the median overall survival was 94, 40 and 33 months.
Compared with the low-risk group, patients with intermediate risk demonstrated an increased hazard ratio of 1.6-fold for recurrence, and 1.9-fold for mortality.
For the high-risk group, the hazard ratio rose significantly to 3.3 for recurrence, and to 3.1 for mortality.
Dr Konopke’s team concludes, “The presented clinical score may allow for patients with colorectal liver metastases to be stratified appropriately and for optimization of their subsequent therapeutic management.”