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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2011

Open Access 01-10-2011 | Hepatobiliary Tumors

Is the Clinical Risk Score for Patients with Colorectal Liver Metastases Still Useable in the Era of Effective Neoadjuvant Chemotherapy?

Authors: Ninos Ayez, MD, Zarina S. Lalmahomed, MD, Anne E. M. van der Pool, MD, Yvonne Vergouwe, PhD, Kees van Montfort, PhD, Jeroen de Jonge, MD, PhD, Alexander M. M. Eggermont, MD, PhD, Jan N. M. IJzermans, MD, PhD, Cornelis Verhoef, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2011

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Abstract

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.
Literature
1.
Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver. I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy. Cancer. 1969;23:198–202.PubMedCrossRef
2.
van der Pool AE, Lalmahomed ZS, Ozbay Y, et al. “Staged” liver resection in synchronous and metachronous colorectal hepatic metastases; differences in clinicopathological features and outcome. Colorectal Dis. 2009;12:e229–35.
3.
Adam R, Avisar E, Ariche A, et al. Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol. 2001;8:347–53.PubMedCrossRef
4.
Nikfarjam M, Shereef S, Kimchi ET, et al. Survival outcomes of patients with colorectal liver metastases following hepatic resection or ablation in the era of effective chemotherapy. Ann Surg Oncol. 2009;16:1860–7.PubMedCrossRef
5.
Scheele J, Altendorf-Hofmann A. Resection of colorectal liver metastases. Langenbecks Arch Surg. 1999;384:313–27.PubMedCrossRef
6.
Giacchetti S, Itzhaki M, Gruia G, et al. Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol. 1999;10:663–9.PubMedCrossRef
7.
Minagawa M, Yamamoto J, Kosuge T, et al. Simplified staging system for predicting the prognosis of patients with resectable liver metastasis: development and validation. Arch Surg. 2007;142:269–76.PubMedCrossRef
8.
Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer. 1996;77:1254–62.PubMedCrossRef
9.
Fong Y, Fortner J, Sun RL, et al. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230:309–18.PubMedCrossRef
10.
Iwatsuki S, Dvorchik I, Madariaga JR, et al. Hepatic resection for metastatic colorectal adenocarcinoma: a proposal of a prognostic scoring system. J Am Coll Surg. 1999;189:291–9.PubMedCrossRef
11.
Nagashima I, Takada T, Matsuda K, et al. A new scoring system to classify patients with colorectal liver metastases: proposal of criteria to select candidates for hepatic resection. J Hepatobiliary Pancreat Surg. 2004;11:79–83.PubMedCrossRef
12.
Konopke R, Kersting S, Distler M, et al. Prognostic factors and evaluation of a clinical score for predicting survival after resection of colorectal liver metastases. Liver Int. 2009;29:89–102.PubMedCrossRef
13.
Schindl M, Wigmore SJ, Currie EJ, et al. Prognostic scoring in colorectal cancer liver metastases: development and validation. Arch Surg. 2005;140:183–9.PubMedCrossRef
14.
Rees M, Tekkis PP, Welsh FK, et al. Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg. 2008;247:125–35.PubMedCrossRef
15.
Lise M, Bacchetti S, Da Pian P, et al. Patterns of recurrence after resection of colorectal liver metastases: prediction by models of outcome analysis. World J Surg. 2001;25:638–44.PubMedCrossRef
16.
Ueno H, Mochizuki H, Hatsuse K, et al. Indicators for treatment strategies of colorectal liver metastases. Ann Surg. 2000;231:59–66.PubMedCrossRef
17.
Zakaria S, Donohue JH, Que FG, et al. Hepatic resection for colorectal metastases: value for risk scoring systems? Ann Surg. 2007;246:183–91.PubMedCrossRef
18.
Merkel S, Bialecki D, Meyer T, et al. Comparison of clinical risk scores predicting prognosis after resection of colorectal liver metastases. J Surg Oncol. 2009;100:349–57.PubMedCrossRef
19.
Reissfelder C, Rahbari NN, Koch M, et al. Validation of prognostic scoring systems for patients undergoing resection of colorectal cancer liver metastases. Ann Surg Oncol. 2009;16:3279–88.PubMedCrossRef
20.
Small RM, Lubezky N, Shmueli E, et al. Response to chemotherapy predicts survival following resection of hepatic colo-rectal metastases in patients treated with neoadjuvant therapy. J Surg Oncol. 2009;99:93–8.PubMedCrossRef
21.
Arru M, Aldrighetti L, Castoldi R, et al. Analysis of prognostic factors influencing long-term survival after hepatic resection for metastatic colorectal cancer. World J Surg. 2008;32:93–103.PubMedCrossRef
22.
Mann CD, Metcalfe MS, Leopardi LN, et al. The clinical risk score: emerging as a reliable preoperative prognostic index in hepatectomy for colorectal metastases. Arch Surg. 2004;139:1168–72.PubMedCrossRef
23.
Sotiropoulos GC, Lang H. Clinical scoring systems for predicting outcome after surgery for colorectal liver metastases: towards a better multidisciplinary approach. Liver Int. 2009;29:6–9.PubMedCrossRef
24.
Mentha G, Terraz S, Morel P, et al. Dangerous halo after neoadjuvant chemotherapy and two-step hepatectomy for colorectal liver metastases. Br J Surg. 2009;96:95–103.PubMedCrossRef
Metadata
Title
Is the Clinical Risk Score for Patients with Colorectal Liver Metastases Still Useable in the Era of Effective Neoadjuvant Chemotherapy?
Authors
Ninos Ayez, MD
Zarina S. Lalmahomed, MD
Anne E. M. van der Pool, MD
Yvonne Vergouwe, PhD
Kees van Montfort, PhD
Jeroen de Jonge, MD, PhD
Alexander M. M. Eggermont, MD, PhD
Jan N. M. IJzermans, MD, PhD
Cornelis Verhoef, MD, PhD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1819-8

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