title: External validation of two nomograms for predicting patient survival after hepatic resection for metastatic colorectal cancer.
abstract: BACKGROUND
  Two nomograms are available for predicting patient survival after hepatic resection for metastatic colorectal cancer (CRC). However, they have not been externally validated using other databases, and so their universal applicability has not been established. We aimed to examine the validity of these nomograms for predicting patient survival after hepatic resection for metastatic CRC in different institutions.
  
  
  METHODS
  We analyzed the cases of 113 patients who underwent hepatic resection for metastatic CRC at Hiroshima University Hospital between 1995 and 2006. In this patient set, we assessed the predictive value of the Kattan nomogram of the Memorial Sloan-Kettering Cancer Center (MSKCC) (United States) and the Kanemitsu nomogram from the Aichi Cancer Center (Japan). The concordance index was used as an accuracy measure for comparing these two nomograms. The predictive accuracy of these nomograms was compared with that of conventional predictive models.
  
  
  RESULTS
  The 3-, 5-, and 10-year overall survival rates in our cohort were 66.3%, 52.4%, and 42.7%, respectively. The concordance indexes of the pre- and postoperative Kanemitsu nomogram and that of the Kattan nomogram were 0.70, 0.69, and 0.68, respectively. These values were higher than those obtained using other models for hepatic metastatic CRC, including the clinical risk score of the MSKCC and the grading system of the Japanese Society for Cancer of the Colon and Rectum.
  
  
  CONCLUSIONS
  The high predictive accuracy of both nomograms shows that these predictive tools can be used in different institutions. Patient counseling and adjuvant therapy decision-making should benefit from use of these nomograms.
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. ytaka0621@aol.com
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takakura
authors.forename: Masazumi
authors.initials: M
authors.lastname: Okajima
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kuroda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Egi
authors.forename: Takao
authors.initials: T
authors.lastname: Hinoi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D015233:Models, Statistical