Long-term postoperative survival prediction in patients with colorectal liver metastasis

// Kun Wang 1, * , Wei Liu 1, * , Xiao-Luan Yan 1 , Juan Li 1 and Bao-Cai Xing 1 1 Hepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, PR China * These authors contributed equally to this work Correspondence to: Bao-Cai Xing, email: xingbaocai88@sina.com Keywords: colorectal cancer, KRAS mutation, colorectal liver metastasis, chemotherapy, survival Received: May 24, 2017 Accepted: August 05, 2017 Published: August 18, 2017 ABSTRACT Numerous factors affect the prognosis of colorectal liver metastasis (CRLM) patients after hepatic resection. We investigated several factors related to overall survival in patients with CRLM to identify those most likely to benefit from hepatic resection, and produced a rational tumor biology score system. Three hundred CRLM patients treated with preoperative chemotherapy followed by hepatic resection between 2006 and 2016 were enrolled in our study. Clinicopathologic and long-term survival data were collected and assessed. Patient 1-, 3-, and 5-year overall survival rates were 92.7%, 58.3%, and 45.8%, respectively, while 1-, 3-, and 5-year disease-free survival rates were 44.7%, 28.6%, and 24.2%, respectively. Multivariate Cox regression analysis revealed poor preoperative chemotherapy response, Fong clinical risk score > 2, and KRAS mutation to be independent prognostic indicators in CRLM patients. As part of a preoperative staging system in which one point was assigned for each factor, a total score (out of 3) was predictive of long-term survival following surgery. These factors facilitate personalized prognostic assessments in CRLM patients planning for resection.