title: Impact of Neoadjuvant Chemotherapy on Clinical Risk Scores and Survival in Patients with Colorectal Liver Metastases.
abstract: BACKGROUND
  Several clinical risk scores for patients with colorectal liver metastases (CLM) were established in cohorts of patients undergoing liver resection (LR) without neoadjuvant chemotherapy (NAC). The purpose of the study was to evaluate the predictive values of four common risk scores in the setting of NAC and the impact of score changes during NAC.
  
  
  METHODS
  Risk scores (Fong, Nordlinger, Nagashima, and Konopke) were retrospectively calculated for 336 patients undergoing LR for CLM, including 109 patients without and 227 patients with NAC. In patients with NAC, the scores were calculated before and after NAC.
  
  
  RESULTS
  In patients without NAC (n = 109), all risk scores except the Konopke score showed a significant correlation with disease-free survival (DFS). Only the Nagashima score also was predictive for overall survival (OS). In patients with NAC (n = 227), all scores except the Konopke score were predictive for DFS and OS before and after NAC. Score changes in the Fong and the Nagashima score showed a significant correlation with DFS and OS.
  
  
  CONCLUSIONS
  Nagashima score was the most universally applicable score and predicted prognosis in all tested scenarios.
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wimmer
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schwarz
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Carmen
authors.initials: C
authors.lastname: Szabo
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Bodingbauer
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Tamandl
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.affiliation: Department of General Surgery, Medical University of Vienna, Vienna, Austria. klaus.kaczirek@meduniwien.ac.at.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kaczirek
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate