Even though surgery remains the only potentially curative option for patients with neuroendocrine liver metastases, the factors determining a patient’s prognosis following hepatectomy are poorly understood. Using a multicentric database including patients who underwent hepatectomy for NELMs at seven tertiary referral hepato-biliary-pancreatic centers between January 1990 and December 2014, we sought to identify the predictors of survival and develop a clinical tool to predict patient’s prognosis after liver resection for NELMs. The median age of the 238 patients included in the study was 61.9 years (interquartile range 51.5–70.1) and 55.9 % (n = 133) of patients were men. The number of NELMs (hazard ratio = 1.05), tumor size (HR = 1.01), and Ki-67 index (HR = 1.07) were the predictors of overall survival. These variables were used to develop a nomogram able to predict survival. According to the predicted 5-year OS, patients were divided into three different risk classes: 19.3, 55.5, and 25.2 % of patients were in low (>80 % predicted 5-year OS), medium (40–80 % predicted 5-year OS), and high (<40 % predicted 5-year OS) risk classes. The 10-year OS was 97.0, 55.9, and 20.0 % in the low, medium, and high-risk classes, respectively (p < 0.001). We developed a novel nomogram that accurately (c-index >70 %) staged and predicted the prognosis of patients undergoing liver resection for NELMs.

Ruzzenente, A., Bagante, F., Bertuzzo, F., Aldrighetti, L., Ercolani, G., Giuliante, F., Ferrero, A., Torzilli, G., Grazi, G. L., Ratti, F., Cucchetti, A., De Rose, A. M., Russolillo, N., Cimino, M., Perri, P., Cataldo, I., Scarpa, A., Guglielmi, A., Iacono, C., A Novel Nomogram to Predict the Prognosis of Patients Undergoing Liver Resection for Neuroendocrine Liver Metastasis: an Analysis of the Italian Neuroendocrine Liver Metastasis Database, <<JOURNAL OF GASTROINTESTINAL SURGERY>>, 2017; 21 (1): 41-48. [doi:10.1007/s11605-016-3228-6] [http://hdl.handle.net/10807/94274]

A Novel Nomogram to Predict the Prognosis of Patients Undergoing Liver Resection for Neuroendocrine Liver Metastasis: an Analysis of the Italian Neuroendocrine Liver Metastasis Database

Giuliante, Felice;Torzilli, Guido;De Rose, Agostino Maria;
2017

Abstract

Even though surgery remains the only potentially curative option for patients with neuroendocrine liver metastases, the factors determining a patient’s prognosis following hepatectomy are poorly understood. Using a multicentric database including patients who underwent hepatectomy for NELMs at seven tertiary referral hepato-biliary-pancreatic centers between January 1990 and December 2014, we sought to identify the predictors of survival and develop a clinical tool to predict patient’s prognosis after liver resection for NELMs. The median age of the 238 patients included in the study was 61.9 years (interquartile range 51.5–70.1) and 55.9 % (n = 133) of patients were men. The number of NELMs (hazard ratio = 1.05), tumor size (HR = 1.01), and Ki-67 index (HR = 1.07) were the predictors of overall survival. These variables were used to develop a nomogram able to predict survival. According to the predicted 5-year OS, patients were divided into three different risk classes: 19.3, 55.5, and 25.2 % of patients were in low (>80 % predicted 5-year OS), medium (40–80 % predicted 5-year OS), and high (<40 % predicted 5-year OS) risk classes. The 10-year OS was 97.0, 55.9, and 20.0 % in the low, medium, and high-risk classes, respectively (p < 0.001). We developed a novel nomogram that accurately (c-index >70 %) staged and predicted the prognosis of patients undergoing liver resection for NELMs.
Inglese
Ruzzenente, A., Bagante, F., Bertuzzo, F., Aldrighetti, L., Ercolani, G., Giuliante, F., Ferrero, A., Torzilli, G., Grazi, G. L., Ratti, F., Cucchetti, A., De Rose, A. M., Russolillo, N., Cimino, M., Perri, P., Cataldo, I., Scarpa, A., Guglielmi, A., Iacono, C., A Novel Nomogram to Predict the Prognosis of Patients Undergoing Liver Resection for Neuroendocrine Liver Metastasis: an Analysis of the Italian Neuroendocrine Liver Metastasis Database, <<JOURNAL OF GASTROINTESTINAL SURGERY>>, 2017; 21 (1): 41-48. [doi:10.1007/s11605-016-3228-6] [http://hdl.handle.net/10807/94274]
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