Multicentre validation of a clinical prognostic score integrating the systemic inflammatory response to the host for patients treated with curative-intent for colorectal liver metastases: The Liverpool score

被引：9

作者：

Dupre, A. ^{[1
]}

Berhane, S. ^{[2
]}

Chan, A. W. H. ^{[3
]}

Rivoire, M. ^{[1
]}

Chong, C. C. N. ^{[4
]}

Lai, P. B. S. ^{[4
,5
]}

Cucchetti, A. ^{[6
]}

Poston, Graeme J. ^{[7
]}

Malik, H. Z. ^{[7
]}

Johnson, P. J. ^{[8
]}

机构：

[1] Ctr Leon Berard, Dept Surg Oncol, F-69008 Lyon, France

[2] Univ Liverpool, Dept Biostat, Liverpool L69 3BX, Merseyside, England

[3] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Anat & Cellular Pathol, State Key Lab Oncol South China, Hong Kong, Peoples R China

[4] Chinese Univ Hong Kong, Dept Surg, Div Hepatobiliary & Pancreat Surg, Hong Kong, Peoples R China

[5] Chinese Univ Hong Kong, Inst Digest Dis, Partner State Key Lab Digest Dis, Hong Kong, Peoples R China

[6] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci DIMEC, Morgagni Pierantoni Hosp, Forli, Italy

[7] Aintree Univ Hosp NHS Fdn Trust, Liverpool Hepatobiliary Ctr, Longmoor Lane, Liverpool L9 7AL, Merseyside, England

[8] Univ Liverpool, Dept Mol & Clin Canc Med, Liverpool L69 3BX, Merseyside, England

来源：

EJSO | 2019年 / 45卷 / 06期

关键词：

Colorectal liver metastases; Liver surgery; Recurrence; Clinical risk score; Staging; Inflammation; PRIMARY TUMOR LOCATION; HEPATIC RESECTION; CANCER; SURVIVAL; SURGERY;

D O I：

10.1016/j.ejso.2019.02.022

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: This study aimed to create a new prognostic score integrating the systemic inflammatory response to predict survival in patients treated with curative intent for colorectal liver metastases (CLM). Methods: We identified independent prognostic factors in patients who underwent liver surgery for CLM in a tertiary centre in the United Kingdom (UK) between 2010 and 2015. A pre- and a postoperative score (Liverpool score) were created by combining these factors to stratify patients into different risk groups. These new scores were validated in an international cohort of 219 patients from China and France. Results: Multivariate cox regression analysis of the 364 patients of the UK cohort identified 6 preoperative and 1 postoperative prognostic factors for overall survival (OS): American society of anaesthesiologists (ASA) score, location and node status of the primary tumour, number and size of CLM, neutrophil-to-lymphocyte ratio (NLR) and resection margin. Both pre- and postoperative scores can be calculated with an online calculator at https://jscalc.io/calc/PXatrmjfrEFpYy2t . Using the pre-operative model on the UK cohort, median OS was 61.22 (50.23, not reached) months in the low-risk group (n = 162) and 30.36 (23.68, 35.95) months in the high-risk group (n = 162, p < 0.0001). The same difference was observed in the validation cohort. The Liverpool score outperformed previously published scoring system with a c-index of 0.619 pre-operatively and of 0.637 post-operatively. Conclusion: We developed a new prognostic score based on clinicopathologic characteristics including the site of the primary tumour location and on measurement of the systemic inflammatory response which could help to tailor patients' management. (C) 2019 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：999 / 1004

页数：6

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