A predictive model for early recurrence of colorectal-cancer liver metastases based on clinical parameters

Abstract

Background The prognosis for patients with colorectal-cancer liver metastases (CRLM) after curative surgery remains poor and shows great heterogeneity. Early recurrence, defined as tumor recurrence within 6 months of curative surgery, is associated with poor survival, requiring earlier detection and intervention. This study aimed to develop and validate a bedside model based on clinical parameters to predict early recurrence in CRLM patients and provide insight into post-operative surveillance strategies. Material and methods A total of 202 consecutive CRLM patients undergoing curative surgeries between 2012 and 2019 were retrospectively enrolled and randomly assigned to the training (n = 150) and validation (n = 52) sets. Baseline information and radiological, pathological, and laboratory findings were extracted from medical records. Predictive factors for early recurrence were identified via a multivariate logistic-regression model to develop a predictive nomogram, which was validated for discrimination, calibration, and clinical application. Results Liver-metastases number, lymph-node suspicion, neurovascular invasion, colon/rectum location, albumin and post-operative carcinoembryonic antigen, and carbohydrate antigen 19–9 levels (CA19–9) were independent predictive factors and were used to construct the nomogram for early recurrence after curative surgery. The area under the curve was 0.866 and 0.792 for internal and external validation, respectively. The model significantly outperformed the clinical risk score and Beppu’s model in our data set. In the lift curve, the nomogram boosted the detection rate in post-operative surveillance by two-fold in the top 30% high-risk patients. Conclusion Our model for early recurrence in CRLM patients after curative surgeries showed superior performance and could aid in the decision-making for selective follow-up strategies.

Development and validation of a prognostic scoring system for patients with colorectal cancer hepato-pulmonary metastasis: a retrospective study

“…However, most studies also did not have an external validation cohort and did not predict important prognostic indicators such as CSS. In addition, there are similar results yielded by several studies which are only on OS or single metastases and lack external validation cohort [ 33 – 35 ]. Our model based on clinicopathological characteristic can effectively predict the prognosis of CRCHPM, which has important clinical significance.…”

Predicting metachronous liver metastasis in patients with colorectal cancer: development and assessment of a new nomogram

“…At present, nomogram model has been widely used in clinical medicine, particularly in colorectal surgery [ 26 , 27 ]. In view of the high morbidity and mortality characteristics of colorectal cancer, various predictive models focusing on the prognosis of colorectal cancer have been developed in recent years [ 28 – 30 ], including a prognostic model related to liver metastasis [ 31 – 33 ]. Time-dependent factors can effectively predict patient survival.…”

Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

“…Recurrence-free survival (RFS) was defined as the number of months between the date of achieving NED and the date of recurrence of any organs (overall RFS) or hepatic recurrence (hepatic RFS) evaluated by radiological examinations. The specific inclusion procedure can be found in the previous study (19). This project was approved by the Independent Ethics Committee of SAHZU and informed consent was obtained from all patients.…”