Impact of overweight on postoperative complications and oncological outcome after radical hepatectomy for metastatic colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between overweight and postoperative complications and prognosis after radical hepatectomy for colorectal liver metastasis (CRLM).</p><p><b>METHODS</b>A total of 192 patients who underwent hepatectomy for colorectal liver metastases between January 2000 and March 2012 were eligible for the study. We retrospectively summarized their clinicopathological data, BMI index and postoperative complications, and investigated the relation between these data and complications and prognosis.</p><p><b>RESULTS</b>Of the 192 patients, 109 cases were classified as overweight with a BMI ≥24 and 83 patients were classified as non-overweight with a BMI <24. Seventy-five complications occurred in 68 of the 192 patients (35.4%) who underwent hepatectomy. Surgical complications (P=0.428), operation time (P=0.837), and blood loss (P=0.272) were not statistically significantly associated with BMI. 173 patients were included to analyze the influence of overweight on oncologic outcome. The median survival for the overweight patients was 59 months, while that of non-overweight patients was 31 months (P=0.016). The overweight patients had a longer OS assessed by both univariate analysis (P=0.016) and multivariate analysis (P=0.031). However, no statistical differences in disease-free survival (DFS) were detected between the overweight and non-overweight groups (P=0.058).</p><p><b>CONCLUSIONS</b>Overweight is not independently associated with an increasing complication rate. BMI does not significantly affect the CRLM-DFS, and high BMI patients might have a better overall survival.</p>

Prognostic significance of clinical risk score system after resection of hepatic metastases from colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To validate the prognostic significance of Clinical Risk Score (CRS) system proposed by Fong et al. after hepatectomy of liver metastasis from colorectal cancer.</p><p><b>METHODS</b>The clinicopathological data were collected retrospectively from 294 patients with hepatic metastases from colorectal cancer who received liver resection between January 2000 and August 2014 in Peking University Cancer Hospital. Routine follow-up was done by outpatient interview or telephone. Statistical analysis was conducted to compare the survival of different CRS patients.</p><p><b>RESULTS</b>After a median follow-up of 19 months (2-129 months) for all the 294 patients, the median overall survival and disease-free survival were 35 months and 11 months, respectively. The postoperative 1-, 3- and 5-year overall survival rates were 89.0%, 49.0%, and 35.7%, and the disease-free survival rates were 47.2%, 22.2%, and 18.2%, respectively. For the six different groups with CRS of 0, 1, 2, 3, 4, 5 accordingly, the median overall survival was 64, 59, 33, 35, 17 and 15 months, respectively, showing a significant difference (P=0.002), and the median disease-free survival was 16, 19, 13, 10, 4 and 6 months, respectively, showing also a significant difference (P<0.001). For patients whose CRS were 0-2 and 3-5, the median overall survival was 44 and 33 months, respectively, with a significant difference between them (P=0.022), and the median disease-free survival was 15 and 8 months, respectively, with also a significant difference (P<0.001).</p><p><b>CONCLUSION</b>This CRS system may predict the prognosis for patients with hepatic metastasis from colorectal cancer after hepatectomy, therefore to provide useful reference for making treatment plan for those patients.</p>