Mann Chris D, Metcalfe Matthew S, Leopardi Lisa N, Maddern Guy J
University of Adelaide, Department of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Arch Surg. 2004 Nov;139(11):1168-72. doi: 10.1001/archsurg.139.11.1168.
The purpose of this study was to examine the validity of the clinical risk score (CRS), a prognostic tool developed by Fong et al, when translated to another center.
This study assesses 5 independent preoperative prognostic criteria, nodal status of the primary lesion, disease-free interval, number of hepatic metastases, size of the largest metastasis, and preoperative carcinoembryonic antigen level, to determine a preoperative CRS for each patient included in the study.
The hepatobiliary unit of The Queen Elizabeth Hospital, Adelaide, South Australia.
Medical records of patients admitted to The Queen Elizabeth Hospital undergoing potentially curative hepatic resection for colorectal metastases during the period of July 1993 to April 2003 were included in the study. Main Outcome Measure The primary outcome measure of the study was survival. The calculated CRS was analyzed with respect to patient postoperative survival.
During the 10-year period, 77 patients underwent hepatic resection. Overall survival rates for 1, 3, and 5 years were found to be 80.9%, 57.5%, and 42.3%, respectively. One- and 5-year survival rates for CRSs of 0 and 1 were found to be 93.8% and 72.5%, respectively; for scores of 2 and 3, 76.6% and 31.2%, respectively;and for scores of 4 and 5, 75% and 0%, respectively. No patient with a CRS greater than 3 survived more than 2 years.
This study validates the CRS, finding it to be highly predictive of patient outcome and survival.
本研究的目的是检验由方等人开发的临床风险评分（CRS）这一预后工具在应用于另一中心时的有效性。
本研究评估了5个独立的术前预后标准，即原发灶的淋巴结状态、无病间期、肝转移灶数量、最大转移灶大小以及术前癌胚抗原水平，以确定研究中纳入的每位患者的术前CRS。
南澳大利亚阿德莱德伊丽莎白女王医院的肝胆科。
本研究纳入了1993年7月至2003年4月期间入住伊丽莎白女王医院接受可能治愈性肝切除治疗结直肠癌转移的患者的病历。主要观察指标本研究的主要观察指标是生存率。对计算出的CRS与患者术后生存率进行分析。
在这10年期间，77例患者接受了肝切除。发现1年、3年和5年的总生存率分别为80.9%、57.5%和42.3%。CRS为0和1的患者1年和5年生存率分别为93.8%和72.5%；CRS为2和3的患者分别为76.6%和31.2%；CRS为4和5的患者分别为75%和0%。没有CRS大于3的患者存活超过2年。
本研究验证了CRS，发现它对患者的预后和生存具有高度预测性。
