Nomogram for prediction of prognosis in patients with initially unresectable colorectal liver metastases

The British Journal of Surgery
K ImaiRené Adam

Abstract

Although recent advances in surgery and chemotherapy have increasingly enabled hepatectomy in patients with initially unresectable colorectal liver metastases (CRLM), not all such patients benefit from surgery. The aim of this study was to develop a nomogram to predict survival after hepatectomy for initially unresectable CRLM. Patients with initially unresectable CRLM treated with chemotherapy followed by hepatectomy between 1990 and 2012 were included in the study. A nomogram to predict survival was developed based on a multivariable Cox model. The predictive performance of the model was assessed according to the C-statistic, Kaplan-Meier curve and calibration plots. Of a total of 439 patients, liver and globally completed surgery was achieved in 380 (86·6 per cent) and 335 (76·3 per cent) patients respectively. The 5-year overall and disease-free survival rates were 39·9 and 10·0 per cent respectively. Based on the Cox model, the following five factors were selected for the nomogram and assigned specific scores: node-positive primary, 5; more than six metastases at hepatectomy, 7; carbohydrate antigen 19-9 level at hepatectomy above 37 units/ml, 10; disease progression during first-line chemotherapy, 9; and presence of extra...Continue Reading

References

Nov 1, 1990·The British Journal of Surgery·J ScheeleA Altendorf-Hofmann
Jun 18, 2003·Annals of Oncology : Official Journal of the European Society for Medical Oncology·R Adam
Jun 2, 2006·The British Journal of Surgery·L CapussottiM Aglietta
Jul 22, 2006·Annals of Surgery·Sylvain ManfrediAnne-Marie Bouvier
Jul 26, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Cora N Sternberg
Jul 4, 2007·Surgical Oncology Clinics of North America·René AdamThomas Aloia
Mar 8, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Alexia IasonosKatherine S Panageas
Mar 11, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·René AdamDenis Castaing
Sep 11, 2012·The Oncologist·René AdamUNKNOWN Jean-Nicolas Vauthey of the EGOSLIM (Expert Group on OncoSurgery management of LIver Metastases) group
Feb 13, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shinichiro TakahashiTakayuki Yoshino

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