Harris et al identified factors affecting survival after palliative (noncurative) resection of a colorectal carcinoma. This can help to identify a patient who may have a worse prognosis following surgery. The authors are from the Cleveland Clinic.
Patient selection: palliative resection of a colorectal carcinoma
Prognostic factors:
(1) age in years
(2) liver metastases
(3) T status
(4) N status
(5) M status
(6) tumor differentiation
(7) resection margins
|
Parameter |
Finding |
Points |
|
age in years |
< 75 years |
0 |
|
|
>= 75 years |
1 |
|
liver metastases |
absent |
0 |
|
|
present |
1 |
|
T status |
T1 or T2 |
0 |
|
|
T3 or T4 |
1 |
|
N status |
N0 |
0 |
|
|
N1 or N2 |
1 |
|
M status |
M0 |
0 |
|
|
M1 |
1 |
|
tumor differentiation |
low grade (well and moderately differentiated) |
0 |
|
|
high grade (poorly or undifferentiated) |
1 |
|
resection margins |
negative |
0 |
|
|
positive |
1 |
total number of prognostic factors =
= SUM(points for all 7 parameters)
Interpretation:
• minimum number of prognostic factors: 0 (unlikely if a palliative resection)
• maximum number of prognostic factors: 7
• The prognosis tends to get worse as the number of prognostic factors increase.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
