Novel Methods for Clinical Risk Stratification in Patients with Colorectal Liver Metastases

作者：Kim Ki Yeol; Kim Nam Kyu; Cha In Ho; Ahn Joong Bae; Choi Jin Sub; Choi Gi Hong; Lim Joon Suk; Lee Kang Young; Baik Seung Hyuk; Min Byung Soh; Hur Hyuk; Roh Jae Kyung; Shin Sang Joon^*

来源：Cancer Research and Treatment, 2015, 47(2): 242-250.

DOI：10.4143/crt.2014.066

• Risk calculation
• Patient stratification
• Colorectal neoplasms
• Liver metastasis

Purpose
Colorectal cancer patients with liver-confined metastases are classified as stage IV, but their prognoses can differ from metastases at other sites. In this study, we suggest a novel method for risk stratification using clinically effective factors.
Materials and Methods
Data on 566 consecutive patients with colorectal liver metastasis (CLM) between 1989 and 2010 were analyzed. This analysis was based on principal component analysis (PCA).
Results
The survival rate was affected by carcinoembryonic antigen (CEA) level (p < 0.001; risk ratio, 1.90), distribution of liver metastasis (p=0.014; risk ratio, 1.46), and disease-free interval (DFI; p < 0.001; risk ratio, 1.98). When patients were divided into three groups according to PCA score using significantly affected factors, they showed significantly different survival patterns (p < 0.001).
Conclusion
The PCA scoring system based on CEA level, distribution of liver metastasis, and DFI may be useful for preoperatively determining prognoses in order to assist in clinical decision-making and designing future clinical trials for CLM treatment.

• 出版日期2015-4