This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Nomogram for prediction of prognosis in patients with initially unresectable colorectal liver metastases. BJS 2016; 103: 590-599.
Published: 18th January 2016
Authors: K. Imai, M.‐A. Allard, C. Castro Benitez, E. Vibert, A. Sa Cunha, D. Cherqui et al.
Background
Although recent advances in surgery and chemotherapy have increasingly enabled hepatectomy in patients with initially unresectable colorectal liver metastases (
Method
Patients with initially unresectable
Results
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 extrahepatic disease, 4. The model achieved relatively good discrimination and calibration, with a C‐statistic of 0·66. The overall survival rate for patients with a score greater than 16 was significantly worse than that for patients with a score of 16 or less (5‐year survival rate 4
Conclusion
The nomogram facilitates personalized assessment of prognosis for patients with initially unresectable
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