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KMID : 0870420110150030146
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011 Volume.15 No. 3 p.146 ~ p.151
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Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer
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Ahn Sung-Woo
Na Ahn-Soo
Yang Jae-Do
Hwang Hong-Pil
Yu Hee-Chul
Cho Baik-Hwan
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Abstract
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Background/Aims : To find independent predictors that affect the survival in patients with hepatic metastasis of colorectal cancer after surgery and to devise a risk scoring system.
Methods: Among 150 patients who underwent hepatic resection after diagnosis of colorectal cancer with hepatic metastasis between March 1994 and February 2009, we analyzed clinical, pathologic and outcome data retrospectively.
Results: The 1-year survival rate was 83%, and the 5-year survival rate was 35%. Nine factors were found to be independent predictors of adverse outcome by univariate analysis: stage of primary tumor, CA19-9 ＞36 U/ml, extrahepatic disease, distribution of the hepatic tumor, number of hepatic tumors ＞3, largest hepatic tumor ＞5 cm, total size ＞10 cm, CEA ＞10 ng/ml, and metachronous cancer. The last two of these criteria were also significant risk factors on multivariate analysis. When these criteria were used as a risk scoring system, assigning one point for each criterion and dividing the cases into A, B and C groups, the total score was highly predictive of outcomes (p＜0.001). No patients in group C (6 to 9 points) were long-term survivors.
Conclusions: Long-term outcome can be predicted from nine criteria that are readily available for all patients. Patients meeting up to two criteria (group A) are more likely to have a favorable outcome compared to the three or over (groups B and C). This scoring system may offer an easy, rapid, and reliable prognostic indicator of survival outcome after hepatic resection in patients with hepatic metastasis from colorectal cancer.
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KEYWORD
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Colorectal cancer, Hepatic metastasis, Hepatic resection, Clinical risk scoring system
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