• Andrea Ruzzenente, Fabio Bagante, Francesca Bertuzzo, Luca Aldrighetti, Giorgio Ercolani, Felice Giuliante, Alessandro Ferrero, Guido Torzilli, Gian Luca Grazi, Francesca Ratti, Alessandro Cucchetti, Agostino M De Rose, Nadia Russolillo, Matteo Cimino, Pasquale Perri, Ivana Cataldo, Aldo Scarpa, Alfredo Guglielmi, and Calogero Iacono.
• General and Hepatobiliary Surgery, Department of Surgery and Oncology, University of Verona, School of Medicine, Verona, Italy.
• J. Gastrointest. Surg. 2017 Jan 1; 21 (1): 41-48.

AbstractEven 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.

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