The validity of clinical risk score for patients undergoing liver resection for colorectal metastases.
OBJECTIVE
The purpose of this study was to examine the validity of the clinical risk score (CRS) for a selection of patients for surgery.


METHODS
In the period of January 1996 to June 2007, 169 patients underwent their first surgical and/or local ablative therapy for CRLM. This study assesses five preoperative prognostic criteria which define the CRS (nodal status of the primary tumor, the disease-free interval, the number of hepatic metastases, the preoperative CEA level, and the size of the largest metastasis). In the present study was analyzed the calculated CRS with respect to patient's postoperative survival.


RESULTS
An individual CRS was found to be predictive of survival. CRS stratified into two groups (CRS scores 0-2 and 3-5) were also found to be predictive of survival, with 5-year survival rates of 41% and 13%, respectively. CRS stratified into three groups (CRS scores 0-1; 2-3 and 4-5) were found predictive of survival as well, with 5-year survival rates of 72.7%, 21% and 4.6%, respectively.


CONCLUSIONS
Immediate hepatic resection is reasonable in patients with CRS 0 to 1. In patients with CRS 2 to 3, chemotherapy may be required in addition to hepatic resection. In patients with CRS 4 to 5, hepatic resection is probably reasonable only if there is a response to chemotherapy.
Ivanecz
Arpad
A
Department of Abdominal and General Surgery, University Medical Center-Maribor, Ljubljanska 5, 2000 Maribor, Slovenia. arpad.ivanecz@ukc-mb
Potrc
Stojan
S
Horvat
Matjaz
M
Jagric
Tomaz
T
Gadzijev
Eldar
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D002272:Carcinoembryonic Antigen