Pulmonary Emphysema Assessed by the Goddard Score Predicts Outcomes After Hepatic Resection for Colorectal Liver Metastases.

BACKGROUND/AIM: Pulmonary emphysema, a key component of chronic obstructive pulmonary disease, is closely linked to frailty and systemic inflammation. While its prognostic significance has been explored in lung cancer, its impact in gastrointestinal malignancies, including colorectal liver metastases (CRLM), remains unclear.

PATIENTS AND

METHODS

This retrospective study included 107 patients who underwent hepatic resection for CRLM. Preoperative emphysema was assessed using the Goddard score on computed tomography, with a cutoff of ≥7 defining as pulmonary emphysema. Clinical outcomes, including disease-free survival (DFS) and cancer specific survival, were analyzed.

RESULTS

Pulmonary emphysema was observed in 26 (24%) patients. Those with high Goddard score had significantly worse DFS (3-year: 12.9% vs. 40.9%, p<0.01) and cancer specific survival (5-year: 42.8% vs. 76.8%, p=0.02). Multivariate analysis confirmed high Goddard score as an independent predictor of poor DFS (HR=1.49, p<0.01) and cancer specific survival (HR=1.63, p=0.02).

CONCLUSION

Pulmonary emphysema, as measured by the Goddard score, is independently associated with unfavorable oncologic outcomes in CRLM.