A nomogram predicting disease-free survival in patients with colorectal liver metastases treated with hepatic resection: multicenter data collection as a Project Study for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery

作者:Beppu Toru; Sakamoto Yoshihiro; Hasegawa Kiyoshi; Honda Goro; Tanaka Kuniya; Kotera Yoshihito; Nitta Hiroyuki; Yoshidome Hiroyuki; Hatano Etsuro; Ueno Masaki; Takamura Hiroyuki; Baba Hideo; Kosuge Tomoo; Kokudo Norihiro; Takahashi Keiichi; Endo Itaru; Wakabayashi Go; Miyazaki Masaru; Uemoto Shinji; Ohta Tetsuo; Kikuchi Ken; Yamaue Hiroki; Yamamoto Masakazu*; Takada Tadahiro
来源:Journal of Hepato-Biliary-Pancreatic Sciences, 2012, 19(1): 72-84.
DOI:10.1007/s00534-011-0460-z

摘要

The aim of this study was to create a nomogram to predict the disease-free survival of patients with colorectal liver metastases treated with hepatic resection. %26lt;br%26gt;Perioperative factors were assessed in 727 hepatectomized patients with colorectal liver metastases between 2000 and 2004 at the 11 institutions of the %26quot;Project Committee of the Liver%26quot; in the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A nomogram was developed as a graphical representation of a stepwise Cox proportional hazards regression model. %26lt;br%26gt;Perioperative mortality was 0.55%. Disease-free and overall survival rates were 31.2 and 63.8% at 3 years, 27.2 and 47.7% at 5 years, and 24.7 and 38.5% at 10 years, respectively. Six preoperative factors were selected to create the nomogram for disease-free survival: synchronous metastases, 3 points; primary lymph node positive, 3 points; number of tumors 2-4, 4 points and a parts per thousand yen5, 9 points; largest tumor diameter %26gt; 5 cm, 2 points; extrahepatic metastasis at hepatectomy, 4 points, and preoperative carbohydrate antigen 19-9 level %26gt; 100, 4 points. The estimated median disease-free survival time was easily calculated by the nomogram: %26gt; 8.4 years for patients with 0 points, 1.9 years for 5 points, 1.0 years for 10 points, and the rates were lower than 0.6 years for patients with more than 10 points. %26lt;br%26gt;This nomogram can easily calculate the median and yearly disease-free survival rates from only 6 preoperative variables. This is a very useful tool to determine the likelihood of early recurrence and the necessity for perioperative chemotherapy in patients with colorectal liver metastases after hepatic resection.

  • 出版日期2012-1