Prognostic variables in patients with hepatic metastases from colorectal cancer: Importance of medical assessment of liver involvement Journal Article

  

Authors:	Kemeny, N.; Niedzwiecki, D.; Shurgot, B.; Oderman, P.
Article Title:	Prognostic variables in patients with hepatic metastases from colorectal cancer: Importance of medical assessment of liver involvement
Abstract:	Variation in response rates to chemotherapy and survival in patients with hepatic metastases from colorectal carcinoma may be due to patient selection factors. The prognostic importance of 13 factors were analyzed in 112 patients with only hepatic metastases, who were eligible for hepatic artery infusional chemotherapy. When individually analyzed, six factors were found to significantly (<0.001) affect survival: the percentage of tumor involvement of the liver, assessed medically or surgically; initial serum albumin and lactic dehydrogenase; initial Karnofsky performance status; and weight loss. Patients with ≦30% liver involvement had a median survival of 24 months versus 10 months if they had >30% involvement. There was a highly significant agreement between medical and surgical assessment of liver involvement (P = 0.0001). When the variables affecting survival were studied together by multivariable analyses, the most important factor was the medical assessment of liver involvement accomplished by evaluation of radionuclide liver scan and CTT scans. The next two most important factors in the model were the ability of the patient to obtain a tumor response and the presence or absence of weight loss. Only one factor helped predict response to chemotherapy, the type of perfusion seen on a 99Technetium‐macroaggregated albumin (MAA) arterial flow scan. Forty‐five percent of patients with good perfusion had a partial response while 13% of patients with poor perfusion had a tumor response (P = 0.006). We recommend that future studies, dealing with patients who have hepatic metastases from colorectal carcinoma and are eligible for hepatic arterial infusion, document and stratify for the following factors: the percentage of liver involvement, the presence or absence of weight loss, and the type of perfusion seen on MAA scans. Copyright © 1989 American Cancer Society
Keywords:	adult; aged; major clinical study; liver neoplasms; adenocarcinoma; weight reduction; age; colorectal carcinoma; colorectal neoplasms; bilirubin; liver metastasis; scintiscanning; lactate dehydrogenase; leukocyte count; floxuridine; analysis of variance; middle age; serum albumin; aspartate aminotransferases; prognosis; human; male; female; priority journal; technetium tc 99m aggregated albumin
Journal Title:	Cancer
Volume:	63
Issue:	4
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	1989-02-15
Start Page:	742
End Page:	747
Language:	English
DOI:	10.1002/1097-0142(19890215)63:4<742::Aid-cncr2820630423>3.0.Co;2-t
PUBMED:	2521570
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0024552372&doi=10.1002%2f1097-0142%2819890215%2963%3a4%3c742%3a%3aAID-CNCR2820630423%3e3.0.CO%3b2-T&partnerID=40&md5=0744a59588245d51ceff8dc50b055a02
Notes:	Article -- Source: Scopus

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