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Value of prognostic scoring systems in the era of multimodal therapy for recurrent colorectal liver metastases. | LitMetric

Value of prognostic scoring systems in the era of multimodal therapy for recurrent colorectal liver metastases.

HPB (Oxford)

Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52074, Aachen, Germany; Center for Integrated Oncology Aachen, Boon, Cologne and Duesseldorf (CIO ABCD), Site, Aachen, Germany. Electronic address:

Published: November 2023

AI Article Synopsis

  • The study examined the effectiveness of various predictive scoring systems for estimating outcomes in patients with recurrent colorectal liver metastases (recCRLM) who underwent repeat surgery.
  • Nine different scoring systems were evaluated for their predictive value on overall survival (OS) and recurrence-free survival (RFS) among 150 patients treated at a German hospital from 2010 to 2021.
  • Results indicated that the Nagashima score was the most effective in predicting both OS and RFS, suggesting its potential utility in clinical evaluations for patients with recCRLM.

Article Abstract

Background: Various predictive scoring systems have been developed to estimate outcomes of patients undergoing surgery for colorectal liver metastases (CRLM). However, data regarding their effectiveness in recurrent CRLM (recCRLM) are very limited.

Methods: Patients who underwent repeat hepatectomy for recCRLM at the University Hospital RWTH Aachen, Germany from 2010 to 2021 were included. Nine predictive scoring systems (Fong's, Nordlinger, Nagashima, RAS mutation, Tumor Burden, GAME, CERR, and Glasgow Prognostic score, Basingstoke Index) were evaluated by likelihood ratio (LR) χ, linear trend (LT) χ and Akaike Information Criterion (AIC) for their predictive value regarding overall survival (OS) and recurrence free survival (RFS).

Results: Among 150 patients, median RFS was 9 (2-124) months with a 5-year RFS rate of 10%. Median OS was 39 (4-131) months with a 5-year OS rate of 32%. For RFS and OS, the Nagashima score showed the best prognostic ability (LT χ 3.00, LR χ 9.39, AIC 266.66 and LT χ 2.91, LR χ 20.91, 290.36).

Discussion: The Nagashima score showed the best prognostic stratification to predict recurrence as well as survival, and therefore might be considered when evaluating patients with recCRLM for repeat hepatectomy.

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Source
http://dx.doi.org/10.1016/j.hpb.2023.06.016DOI Listing

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