Gervaz et al identified prognostic factors for a patient with cirrhosis and a colorectal adenocarcinoma. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Mayo Clinic.
Parameters:
(1) Child status
(2) serum albumin concentration
(3) prothrombin time (PT, INR)
Parameter
Finding
Points
Child status
A
0
B or C
1
serum albumin
normal
0
hypoalbuminemia
1
prothrombin time
normal
0
prolonged
1
number of adverse prognostic factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of poor prognostic factors: 0
• maximum number of poor prognostic factors: 3
• Survival is worse as the number of risk factors increase.
Interestingly liver metastases are less common in a cirrhotic patient with colorectal cancer than in a patient without cirrhosis.
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