Prognosis is a clinical term describes how a disease condition develops, the signs and symptoms of the disease, how soon an affected individual is expected to recover, and how will be the quality of life of the affected individual over a period of time post treatment like ability to carry out activities of daily living; the chances of any complications and other health concerns, and the chances of overall survival in cases of rare or incurable disease. In short, prognosis is referred to as the expected length of the disease, course of the disease, chances of any expected or unforeseen adverse events.
Factors For Prognosis
Prognosis of metastases to the liver include the success of any surgical procedure to remove the tumor that must have been performed. What is the status of the lymph node tumor around the portal veins, how much it has spread outside the liver; and the overall stage of the primary malignancy.
What Is The Prognosis For Liver Metastases?
Liver metastases often referred to as “secondary liver cancer” which occurs in the breast, colon, pancreas, lungs, or GI tract of the person with metastasis to the liver. The overall survival rate for individuals with secondary liver cancer or liver metastasis is dependent on how much the cancer has spread, age of the patient, and overall immunity status. Without treatment, patients who develop liver metastases live an average of 8.7 months.
Metastatic Breast Cancer
Liver metastases are found in 6 to 25% of patients with metastatic breast cancer. Median survival noted in breast cancer liver metastasis i.e. only a few months and rarely 5-year survival. Median survival was 4.23 months (range 0.16–51), with a 27.6% 1-year survival. The factors that significantly affect the patients include jaundice, an elevated level of liver enzymes, the incidence of ascites, histological grade 3 disease at primary presentation, advanced age, estrogen receptor (ER) negative tumors, the carcinoembryonic antigen of over 1000 ng ml−1 and multiple liver metastases.
Colorectal Cancer Liver Metastases
Liver metastasis from colorectal cancer has a maximum survival rate of an average of 6 months to 1.5 years, if left untreated. A two-year survival rate is not common and five-year survival rate is very rare. Factors associated with a significant disadvantage in the unresected group include the extent of liver disease, the presence of extrahepatic disease, the age of the patient, and carcinoembryonic antigen (CEA) level. Though most patients with colorectal liver metastases have a poor prognosis, some patients can still benefit from radical surgery and possibly even avoid recurrence.
Neuroendocrine Liver Metastases
In neuroendocrine liver metastases, the excess hormone production, the multitude of hepatic lesions, and ultimate liver disease has made the condition poor prognosis. Patients with liver metastases have a significantly worse prognosis and 5-year survival of patients with neuroendocrine liver metastases on supportive care is 0% to 20%.
Some Example For Dismal Prognosis
The prognosis of patients with liver metastases from gastric cancer is depressing, and little is known about prognostic factors in these patients; so the justification for surgical resection is still controversial. Liver metastases develop in approximately 10% of patients with renal tumors, and they have a dismal prognosis:
Forms of Prognostic Scoring
Another way to predict overall outcomes for cancers is through prognostic Scoring. The prognosis for small-cell lung cancer can be done through Manchester score.
International Prognostic Index is used for prognosis of a condition like Non-Hodgkin lymphoma. There are also certain other conditions where prognostic indicators are used like Drug mediated Liver Dysfunctions and exercise stress test after myocardial infarction. Prognostic indicators are also used to predict the overall outcome of patients with multiple myeloma.
Conclusion
Liver metastases are observed in patients with breast, lung, and pancreatic cancers. However, liver metastases are most commonly found in patients with metastatic colorectal cancer followed by neuroendocrine liver metastases. Liver metastases historically confer a poor prognosis, often less than a year. However, there is significant variability based on tumor type, treatment options, and comorbid disease.
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