Prognostic significance of early recurrence: a conditional survival analysis in patients with resected colorectal liver metastasis
Prognostic significance of early recurrence: a conditional survival analysis in patients with resected colorectal liver metastasis
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DOI：
10.1111/hpb.12136
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发表时间：
2013-10-01
期刊：
影响因子：
2.9
通讯作者：
D'Angelica, Michael I.
中科院分区：
文献类型：
--
作者：
Tan, Marcus C. B.;Butte, Jean M.;D'Angelica, Michael I.
背景：对于因结直肠转移而行肝切除术的患者，特定的临床病理变量已被证明是预测预后的基线。这项研究分析了这些变量在条件生存模型中的预后能力是如何变化的。方法：回顾1994-2004年间在单一机构接受R0切除结直肠肝转移患者的前瞻性数据库。结果：总共确定了807名患者，存活患者的中位随访期为87个月。5年和10年疾病特异性生存率(DSS)分别为68%和55%。进一步存活的概率随着生存时间的延长而增加。对于3年生存者(n=504)，临床危险评分低(0-2)和高(3-5)的患者之间的DSS差异无统计学意义(CRS，P=0.19)。多变量分析显示，肝切除后前3年内复发、术前癌胚抗原(CEA)200 ng/ml和无病间隔是3年存活者DSS的独立预测因素。
Background: For patients undergoing liver resection for colorectal metastases, specific clinicopathological variables have been shown to be prognostic at baseline. This study analyses how the prognostic capability of these variables changes in a conditional survival model.Methods: Retrospective review of a prospectively maintained database of patients who underwent an R0 resection of colorectal liver metastases from 1994 to 2004 at a single institution.Results: In total, 807 patients were identified, with an 87-month median follow-up for survivors. Five- and 10-year disease-specific survivals (DSS) were 68% and 55%, respectively. The probability of further survival increased as the survival time increased. For 3-year survivors (n = 504), DSS were no longer significantly different between patients with a low (0-2) or high (3-5) clinical risk score (CRS, P = 0.19). On multivariate analysis, independent predictors of DSS for 3-year survivors were recurrence within the first 3 years after a liver resection, a pre-operative carcinoembryonic antigen (CEA) >200 ng/ml and disease-free interval