Dai et al reported a predictive model for early recurrence following curative surgery for colorectal cancer with liver metastases. This can help to identify a patient who may benefit from more aggressive management. The authors are from Zhejiang University and the Cancer Institute of the Second Affiliated Hospital in Hangzhou.
Patient selection: curative surgery for colorectal cancer surgery (primary and liver metastases)
Parameters:
(1) number of hepatic metastases
(2) suspicion of lymph node metastases
(3) neurovascular invasion
(4) location of the primary
(5) CEA level after surgery in ng/mL
(6) CA19-9 level after surgery in U/mL
(7) serum albumin in g/L
Parameter
Finding
Points
number of hepatic lesions
1 to 4
0
> 4
1.424
lymph node metastases
no
0
yes
1.349
neurovascular invasion
no
0
yes
1.014
location of the primary
rectum
-1.196
other
0
CEA after surgery
<= 6 ng/mL
0
> 6 ng/mL
1.287
CA19-9 after surgery
<= 13 U/mL
0
> 13 U/mL
1.656
serum albumin
<= 40 g/L
0
> 40 g/L
-1.074
value of X =
= SUM(points for all of the parameters) - 2.879
percent of patients with these findings who have early recurrence =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.87.
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