Evaluation of peri-operative chemotherapy using a prognostic nomogram for survival after resection of colorectal liver metastases
- 1 November 2009
- journal article
- Published by Elsevier BV in HPB
- Vol. 11 (7), 592-599
- https://doi.org/10.1111/j.1477-2574.2009.00106.x
Abstract
Nomograms are statistical tools designed to predict outcomes. This study evaluates the effects of peri-operative chemotherapy on the accuracy of a prognostic nomogram for disease-specific survival (DSS) after resection of colorectal liver metastases (CRLM) established at Memorial-Sloan Kettering Cancer Center (MSKCC). An external cohort of 203 patients who underwent resection of CRLM between 1996 and 2006 was used to assess the nomogram. After median follow-up of 30.4 months (range 0.33-150), Kaplan-Meier (KM) estimates for 3-, 5- and 8-year post-resection DSS were 56%, 41%, and 32%, respectively; similar to nomogram-predicted probabilities for DSS. The concordance index for the nomogram was higher (0.602) than for the Fong colorectal risk score (CRS; 0.533). KM DSS was longer for patients (n= 50) treated with at least 6 months of peri-operative irinotecan or oxaliplatin compared with all other patients (median 66 vs. 40 months, P= 0.06). KM DSS was greater than nomogram predicted DSS for treated patients and less than nomogram predicted DSS for all other patients. The CRLM nomogram was validated by an external cohort and more accurately predicted post-resection survival than the commonly used CRS. Differences in observed and nomogram-predicted survival may reflect the effect of treatment factors, such as peri-operative chemotherapy.Keywords
This publication has 46 references indexed in Scilit:
- Preoperative and postoperative nomograms incorporating surgeon experience for clinically localized prostate cancerCancer, 2009
- Appraisal of 1 cm Hepatectomy Margins for Intrahepatic Micrometastases in Patients with Colorectal Carcinoma Liver MetastasisAnnals of Surgical Oncology, 2008
- A Prognostic System Applicable to Patients with Resectable Liver Metastasis from Colorectal Carcinoma Staged by Positron Emission Tomography with [18F]Fluoro-2-Deoxy-D-Glucose: Role of Primary Tumor VariablesJournal of the American College of Surgeons, 2008
- Influence of surgical margin on type of recurrence after liver resection for colorectal metastases: a single-center experienceSurgery, 2008
- Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trialThe Lancet, 2008
- The Impact of Margins on Outcome After Hepatic Resection for Colorectal MetastasisAnnals of Surgery, 2007
- Hepatic Resection for Colorectal MetastasesAnnals of Surgery, 2007
- Applying Fong's CRS Liver Score in Patients with Colorectal Liver Metastases Treated by CryotherapyAsian Journal of Surgery, 2006
- Tumor Progression While on ChemotherapyAnnals of Surgery, 2004
- Prognostic Nomogram for Patients Undergoing Resection for Adenocarcinoma of the PancreasAnnals of Surgery, 2004