Back to Search Start Over

Patient vulnerability is associated with poor prognosis following upfront hepatectomy for colorectal liver metastasis.

Authors :
Mima, Kosuke
Hayashi, Hiromitsu
Adachi, Yuki
Tajiri, Takuya
Ofuchi, Takashi
Kanemitsu, Kosuke
Ogawa, Daisuke
Yumoto, Shinsei
Matsumoto, Takashi
Itoyama, Rumi
Kitano, Yuki
Nakagawa, Shigeki
Okabe, Hirohisa
Baba, Hideo
Source :
International Journal of Clinical Oncology. Jan2024, Vol. 29 Issue 1, p47-54. 8p.
Publication Year :
2024

Abstract

Background: With the rapid aging of populations worldwide, the number of vulnerable patients with liver metastasis from colorectal cancer has increased. This study aimed to examine the association between vulnerability and clinical outcomes in patients with colorectal liver metastasis (CRLM). Methods: Consecutive 101 patients undergoing upfront hepatectomy for CRLM between 2004 and 2020 were included. The preoperative vulnerability was assessed using the Clinical Frailty Scale (CFS) score ranging from one (very fit) to nine (terminally ill), and frailty was defined as a CFS score of ≥ 4. A multivariable Cox proportional hazard regression model was utilized to investigate associations of frailty with disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). Results: Of the 101 patients, 12 (12%) had frailty. Associations between frailty and surgical outcomes, namely, the incidence of 90-day mortality and postoperative complications, were not statistically significant (P > 0.05). In the multivariable analyses, after adjusting for clinical risk scores calculated using six factors (timing of liver metastasis, primary tumor lymph node status, number of liver tumors, size of the largest tumor, extrahepatic metastatic disease, and carbohydrate antigen 19–9 level) to predict recurrence following hepatectomy for CRLM, preoperative frailty was found to be an independent risk factor for DFS (hazard ratio [HR]:2.37, 95% confidence interval [CI] 1.06–4.72, P = 0.036), OS (HR:4.17, 95% CI 1.43–10.89, P = 0.011), and CSS (HR:3.49, 95% CI 1.09–9.60, P = 0.036). Conclusion: Preoperative frailty was associated with worse DFS, OS, and CSS after upfront hepatectomy for CRLM. Assessment and improvement of patient vulnerability may provide a favorable prognosis for patients with CRLM. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13419625
Volume :
29
Issue :
1
Database :
Academic Search Index
Journal :
International Journal of Clinical Oncology
Publication Type :
Academic Journal
Accession number :
174581747
Full Text :
https://doi.org/10.1007/s10147-023-02429-4