Kim et al reported a score for predicting survival and disease recurrence following surgical resection of colorectal liver metastases. The authors are from Korea University Guro Hospital in Seoul.
Patient selection: status post resection of colorectal liver metastases
Parameters:
(1) synchronicity
(2) serum CA19-9 concentration in ng/mL
(3) number of liver metastases
(4) diameter of largest liver metastasis in cm
(5) resection margin of liver metastasis
(6) neutrophil to lymphocyte ratio (NLR)
(7) Prognostic Nutritional Index (PNI) of Onodera et al
PNI =
= (albumin in g/L) + (0.005 * (absolute lymphocyte count per µL))
Parameter
Finding
Points
synchronicity
no
0
yes
2
serum CA19-9
< 70 ng/mL
0
>= 70 ng/mL
2
number of liver metastases
1 to 4
0
>= 5
1
diameter of largest metastases
< 5 cm
0
>= 5 cm
2
resection margin
negative
0
positive
1
NLR
< 2
0
>= 2
2
PNI
< 50
2
>= 50
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
Total Score
Risk Group
5-Year Overall Survival
5-Year Disease Free Survival
0 to 4
low
90.5%
81.3%
5 to 12
high
36.6%
14.2%
Performance:
• The area under the ROC curve is 0.82.
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