Is the Clinical Risk Score for Patients with Colorectal Liver Metastases Still Useable in the Era of Effective Neoadjuvant Chemotherapy?
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.
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.
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.
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.
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- Is the Clinical Risk Score for Patients with Colorectal Liver Metastases Still Useable in the Era of Effective Neoadjuvant Chemotherapy?
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Annals of Surgical Oncology
Volume 18, Issue 10 , pp 2757-2763
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- 1. Division of Surgical Oncology, Erasmus University MC, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
- 2. Division of Transplantation and Hepatobiliary Surgery, Erasmus University MC, Rotterdam, The Netherlands
- 3. Division of Public Health, Center for Medical Decision Making, Rotterdam, The Netherlands
- 4. Division of Biostatistics, Erasmus University MC, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
- 5. Institut de cancérologie Gustav Roussy, Villejuif, France