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Proposal of a novel H category‐based classification of colorectal liver metastases based on a Japanese nationwide survey
Author(s) -
Beppu Toru,
Imai Katsunori,
Honda Goro,
Sakamoto Katsunori,
Kobayashi Shin,
Endo Itaru,
Hasegawa Kiyoshi,
Kotake Kenjiro,
Itabashi Michio,
Hashiguchi Yojiro,
Kotera Yoshihito,
Yamaguchi Tatsuro,
Tabuchi Ken,
Kobayashi Hirotoshi,
Yamaguchi Kensei,
Morita Satoshi,
Kikuchi Ken,
Miyazaki Masaru,
Sugihara Kenichi,
Yamamoto Masakazu,
Takahashi Keiichi
Publication year - 2021
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.920
Subject(s) - medicine , cohort , lesion , nomogram , overall survival , colorectal cancer , weighting , radiology , cancer , surgery
Background The conventional H category‐based classification for colorectal liver metastases (CRLM) was created by equal weighting of tumor number and tumor size; however, our previous nomogram to predict postoperative disease‐free survival demonstrated that CRLM ≥5 as a parameter provided 4.5 times greater impact compared with a largest CRLM size >5 cm. Methods A total of 3815 patients newly diagnosed with CRLM between 2005 and 2007, including 2220 resectable cases, were investigated. Six groups were created based on largest lesion size (≤ 5 vs >5 cm) and lesion number (1, 2‐4, and ≥5). Results The novel (n) H1, nH2, and nH3 categories were defined as solitary lesions with a size ≤5 cm; lesions other than nH1 or nH3; and ≥5 lesions with any lesion size, respectively. In the resectable cohort, the 5‐year cumulative overall survival rates were 64.0%, 53.5%, and 42.6% in the nH1, nH2, and nH3 groups, respectively ( P < .001), and no significant differences were observed between the conventional H2 and H3 categories. In the overall cohort, the discrimination ability of the two classifications were comparable. Conclusion The novel H category‐based classification might be beneficial in predicting overall survival in patients with CRLM independent of their resectability.