Is the Clinical Risk Score for Patients with Colorectal Liver Metastases Still Useable in the Era of Effective Neoadjuvant Chemotherapy?
| Autor: | Alexander M.M. Eggermont, Cornelis Verhoef, Ninos Ayez, Kees van Montfort, Yvonne Vergouwe, Jan N. M. IJzermans, Zarina S. Lalmahomed, Jeroen de Jonge, Anne E. M. van der Pool |
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| Přispěvatelé: | Surgery, Public Health |
| Rok vydání: | 2011 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Surgical oncology Risk Factors Internal medicine medicine Humans Prospective Studies Prospective cohort study Survival rate Neoadjuvant therapy Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Liver Neoplasms Retrospective cohort study Middle Aged Predictive value Neoadjuvant Therapy Survival Rate Treatment Outcome Hepatobiliary Tumors Chemotherapy Adjuvant Female Surgery business Colorectal Neoplasms Clinical risk factor Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology, 18(10), 2757-2763. Springer New York Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| DOI: | 10.1245/s10434-011-1819-8 |
| Popis: | Background. Several clinical risk scores (CRSs) for the outcome of patients with colorectal liver metastases have been validated, but not in patients undergoing neoadjuvant chemotherapy. Therefore, this study evaluates the predictive value of these CRSs in this specific group. Methods. Between January 2000 and December 2008, all patients undergoing a metastasectomy were analyzed and divided into two groups: 193 patients did not receive neoadjuvant chemotherapy (group A), and 159 patients received neoadjuvant chemotherapy (group B). In group B, the CRSs were calculated before and after administration of neoadjuvant chemotherapy. Results were evaluated by using the CRSs proposed by Nordlinger et al., Fong et al., Nagashima et al., and Konopke et al. Results. In groups A and B, the overall median survival was 43 and 47 months, respectively (P = 0.648). In group A, all CRSs used were of statistically significant predictive value. Before administration of neoadjuvant chemotherapy, only the Nordlinger score was of predictive value. After administration of neoadjuvant chemotherapy, all CRSs were of predictive value again, except for the Konopke score. Conclusions. Traditional CRSs are not a reliable prognostic tool when used in patients before treatment with neoadjuvant chemotherapy. However, CRSs assessed after the administration of neoadjuvant chemotherapy are useful to predict prognosis. |
| Databáze: | OpenAIRE |
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