Predictive preoperative clinical score for patients with liver-only oligometastatic colorectal cancer

ESMO Open

article

G. Filippini Velázquez¹  S. Schiele²  M. Gerken³  S. Neumaier⁴  C. Hackl⁵  P. Mayr¹  M. Klinkhammer-Schalke³  G. Illerhaus⁴  H.J. Schlitt⁵  M. Anthuber¹  T. Kröncke¹  H. Messmann¹  B. Märkl¹  C. Schmid¹  M. Trepel¹  G. Müller²  R. Claus¹  B. Hackanson¹ 

[1] Comprehensive Cancer Center Augsburg ,(CCCA), University Medical Center Augsburg;Faculty of Applied Mathematics and Statistics, University of Augsburg;Tumor Center Regensburg, Institute for Quality Assurance and Health Service Research, University of Regensburg;Department of Haematology and Oncology, Katharinen Hospital Stuttgart;Department of Surgery, University Medical Center Regensburg;General Pathology and Molecular Diagnostics, Faculty of Medicine, University of Augsburg;Faculty of Medicine, University of Freiburg

关键词: colorectal cancer;    oligometastases;    clinical score;    predictive score;    surgical resection;    liver metastases;    overall survival;   

DOI  :  10.1016/j.esmoop.2022.100470

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Resection of liver metastases from colorectal cancer (CRC) in the oligometastatic stage improves survival and is a potentially curative treatment. Thus, predictive scores that reliably identify those patients who especially benefit from surgery are essential.Patients and methods In this multicenter analysis, 512 patients had undergone surgery for liver metastases from CRC. We investigated distinct cancer-specific risk factors that are routinely available in clinical practice and developed a predictive preoperative score using a training cohort (TC), which was thereafter tested in a validation cohort (VC).Results Inflammatory response to the tumor, a right-sided primary tumor, multiple liver metastases, and node-positive primary tumor were significant adverse variables for overall survival (OS). Patients were stratified in five groups according to the cumulative score given by the presence of these risk factors. Median OS for patients without risk factors was 133.8 months [95% confidence interval (CI) 81.2-not reached (nr)] in the TC and was not reached in the VC. OS decreased significantly for each subsequent group with increasing number of risk factors. Median OS was significantly shorter (P < 0.0001) for patients presenting all four risk factors: 14.3 months (95% CI 10.5 months-nr) in the TC and 16.6 months (95% CI 14.6 months-nr) in the VC.Conclusions Including easily obtainable variables, this preoperative score identifies oligometastatic CRC patients with prolonged survival rates that may be cured, and harbors potential to be implemented in daily clinical practice.

【 授权许可】

CC BY|CC BY-NC-ND