Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 21:2018:5618581.
doi: 10.1155/2018/5618581. eCollection 2018.

Proposal of Two Prognostic Models for the Prediction of 10-Year Survival after Liver Resection for Colorectal Metastases

Ulf Kulik  1 , Mareike Plohmann-Meyer  2 , Jill Gwiasda  2 , Joline Kolb  1 , Daniel Meyer  2 , Alexander Kaltenborn  2 , Frank Lehner  1 , Jürgen Klempnauer  1 , Harald Schrem  1   2
Affiliations

Proposal of Two Prognostic Models for the Prediction of 10-Year Survival after Liver Resection for Colorectal Metastases

Ulf Kulik et al. HPB Surg. .

Abstract

Background: One-third of 5-year survivors after liver resection for colorectal liver metastases (CLM) develop recurrence or tumor-related death. Therefore 10-year survival appears more adequate in defining permanent cure. The aim of this study was to develop prognostic models for the prediction of 10-year survival after liver resection for colorectal liver metastases.

Methods: N=965 cases of liver resection for CLM were retrospectively analyzed using univariable and multivariable regression analyses. Receiver operating curve analyses were used to assess the sensitivity and specificity of developed prognostic models and their potential clinical usefulness.

Results: The 10-year survival rate was 15.2%. Age at liver resection, application of chemotherapies of the primary tumor, preoperative Quick's value, hemoglobin level, and grading of the primary colorectal tumor were independent significant predictors for 10-year patient survival. The generated formula to predict 10-year survival based on these preoperative factors displayed an area under the receiver operating curve (AUROC) of 0.716. In regard to perioperative variables, the distance of resection margins and performance of right segmental liver resection were additional independent predictors for 10-year survival. The logit link formula generated with pre- and perioperative variables showed an AUROC of 0.761.

Conclusion: Both prognostic models are potentially clinically useful (AUROCs >0.700) for the prediction of 10-year survival. External validation is required prior to the introduction of these models in clinical patient counselling.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Depicted is the study flow chart of analyzed patients.
Figure 2
Figure 2
(a) Shown is the result of ROC-curve analysis of the final multivariable regression model with preoperative risk factors for 10-year survival (AUROC = 0.716). (b) Shown is the result of ROC-curve analysis of the final multivariable regression model with preoperative and perioperative risk factors for 10-year survival (AUROC = 0.761).
See this image and copyright information in PMC

References

    1. Primrose J. N. Treatment of colorectal metastases: Surgery, cryotherapy, or radiofrequency ablation. Gut. 2002;50(1):1–5. doi: 10.1136/gut.0500001... doi: 10.1136/gut.50.1.1. - DOI - DOI - PMC - PubMed
    1. Simmonds P. C., Primrose J. N., Colquitt J. L., Garden O. J., Poston G. J., Rees M. Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies. British Journal of Cancer. 2006;94(7):982–999. doi: 10.1038/sj.bjc.6603033. - DOI - PMC - PubMed
    1. Malik H. Z., Prasad K. R., Halazun K. J., et al. Preoperative prognostic score for predicting survival after hepatic resection for colorectal liver metastases. Annals of Surgery. 2007;246(5):806–814. doi: 10.1097/SLA.0b013e318142d964. - DOI - PubMed
    1. Pulitanó C., Castillo F., Aldrighetti L., et al. What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up. HPB. 2010;12(4):244–249. doi: 10.1111/j.1477-2574.2010.00155.x. - DOI - PMC - PubMed
    1. Roberts K. J., White A., Cockbain A., et al. Performance of prognostic scores in predicting long-term outcome following resection of colorectal liver metastases. British Journal of Surgery. 2014;101(7):856–866. doi: 10.1002/bjs.9471. - DOI - PubMed

LinkOut - more resources