Novel Methods for Clinical Risk Stratification in Patients with Colorectal Liver Metastases
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Purpose Colorectal cancer patients with liver-confined metastases are classified as stage IV, but theirprognoses can differ from metastases at other sites. In this study, we suggest a novelmethod for risk stratification using clinically effective factors. Materials and MethodsData on 566 consecutive patients with colorectal liver metastasis (CLM) between 1989and 2010 were analyzed. This analysis was based on principal component analysis (PCA). ResultsThe 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 accordingto PCA score using significantly affected factors, they showed significantly different survivalpatterns (p < 0.001). ConclusionThe PCA scoring system based on CEA level, distribution of liver metastasis, and DFI maybe useful for preoperatively determining prognoses in order to assist in clinical decisionmakingand designing future clinical trials for CLM treatment.
Abstract
Purpose Colorectal cancer patients with liver-confined metastases are classified as stage IV, but theirprognoses can differ from metastases at other sites. In this study, we suggest a novelmethod for risk stratification using clinically effective factors. Materials and MethodsData on 566 consecutive patients with colorectal liver metastasis (CLM) between 1989and 2010 were analyzed. This analysis was based on principal component analysis (PCA). ResultsThe 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 accordingto PCA score using significantly affected factors, they showed significantly different survivalpatterns (p < 0.001). ConclusionThe PCA scoring system based on CEA level, distribution of liver metastasis, and DFI maybe useful for preoperatively determining prognoses in order to assist in clinical decisionmakingand designing future clinical trials for CLM treatment.
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