Beppu's Nomogram Score Is an Independent Prognostic Factor for Colorectal Liver Metastasis Receiving Perioperative Chemotherapy and/or Targeted Therapy

Higuchi, Akio; Aoyama, Toru; Kazama, Keisuke; Murakawa, Masaaki; Atsumi, Yoshihito; Katayama, Yusuke; Numata, Koji; Sawazaki, Sho; Numata, Masakatsu; Sato, Sumito; Sugano, Nobuhiro; Mushiake, Hajime; Oshima, Takashi; Yukawa, Norio; Morinaga, Soichiro; Rino, Yasushi; Masuda, Munetaka; Shiozawa, Manabu

doi:10.21873/invivo.11603

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…This study developed and validated a prognosis model to predict the survival of CLM patients under the guidance of both the PROGRESS framework and the TRIPOD prediction research report for the first time. Previously developed nomograms (30)(31)(32)(33) could be more convincing if they expanded their sample size. We included as much population as possible from the SEER database, covering 35% population of the US.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram for Liver Metastatic Colon Cancer Based on Histological Type, Tumor Differentiation, and Tumor Deposit: A TRIPOD Compliant Large-Scale Survival Study

et al. 2021

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ObjectiveA proportional hazard model was applied to develop a large-scale prognostic model and nomogram incorporating clinicopathological characteristics, histological type, tumor differentiation grade, and tumor deposit count to provide clinicians and patients diagnosed with colon cancer liver metastases (CLM) a more comprehensive and practical outcome measure.MethodsUsing the Transparent Reporting of multivariable prediction models for individual Prognosis or Diagnosis (TRIPOD) guidelines, this study identified 14,697 patients diagnosed with CLM from 1975 to 2017 in the Surveillance, Epidemiology, and End Results (SEER) 21 registry database. Patients were divided into a modeling group (n=9800), an internal validation group (n=4897) using computerized randomization. An independent external validation cohort (n=60) was obtained. Univariable and multivariate Cox analyses were performed to identify prognostic predictors for overall survival (OS). Subsequently, the nomogram was constructed, and the verification was undertaken by receiver operating curves (AUC) and calibration curves.ResultsHistological type, tumor differentiation grade, and tumor deposit count were independent prognostic predictors for CLM. The nomogram consisted of age, sex, primary site, T category, N category, metastasis of bone, brain or lung, surgery, and chemotherapy. The model achieved excellent prediction power on both internal (mean AUC=0.811) and external validation (mean AUC=0.727), respectively, which were significantly higher than the American Joint Committee on Cancer (AJCC) TNM system.ConclusionThis study proposes a prognostic nomogram for predicting 1- and 2-year survival based on histopathological and population-based data of CLM patients developed using TRIPOD guidelines. Compared with the TNM stage, our nomogram has better consistency and calibration for predicting the OS of CLM patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram for Liver Metastatic Colon Cancer Based on Histological Type, Tumor Differentiation, and Tumor Deposit: A TRIPOD Compliant Large-Scale Survival Study

et al. 2021

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“…Second, validation studies with internal and external cohorts are needed before the application of these scoring systems in general clinical settings. 9,10,[15][16][17][18] In the recent era, preoperative chemotherapy is often used for resectable and borderline resectable CRLMs. Therefore, the scoring systems developed so far need to be validated separately for patients who undergo upfront hepatectomy and for patients who undergo hepatectomy after neoadjuvant chemotherapy (NAC).…”

Section: Introductionmentioning

confidence: 99%

Validation study of the JSHBPS nomogram for patients with colorectal liver metastases who underwent hepatic resection in the recent era ‐ a nationwide survey in Japan

Beppu¹,

Yamamura²,

Sakamoto

et al. 2022

J Hepato Biliary Pancreat

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Background The Japanese Society of Hepato‐Biliary‐Pancreatic Surgery (JSHBPS) nomogram was developed to predict disease‐free survival in patients with colorectal liver metastases (CRLM) undergoing upfront hepatectomy. However, the utility of the nomogram in patients with resected CRLM remains unknown in the current situation in which treatment strategies are changing with advances in drugs. Methods Patients in the initial nomogram cohort (n = 727) and validation cohort (n = 2225) were divided into the upfront hepatectomy and preoperative chemotherapy groups. The nomogram was validated by measuring calibration and discrimination in the two cohorts. Calibration curves were plotted, and survival probabilities were compared. Finally, to quantify the discrimination power, we estimated the concordance index (C‐index). Results In the upfront hepatectomy group, the C‐index was 0.63, the suitable cutoff value of the Beppu score was 7, and adjuvant chemotherapy was significantly effective limited to high‐risk patients (Beppu score ≥7). The C‐index was 0.56 in the preoperative chemotherapy group. Conclusions The JSHBPS nomogram remains beneficial for patients undergoing upfront hepatectomy in the recent era but is less effective for patients undergoing hepatectomy after chemotherapy. Patients with a Beppu score ≥7 showed high‐risk recurrence, and adjuvant chemotherapy should be recommended for these patients.

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“…Although this nomogram is simple and convenient for clinical use, it is unclear whether it is useful in combination with recent advances in chemotherapy because it is a nomogram analyzed based on cases from 2000 to 2004. Higuchi et al validated this nomogram and demonstrated its efficacy [ 11 ]. However, this was confirmed in patients from 2006 to 2011.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis

et al. 2021

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Background Hepatectomy for resectable colorectal liver metastasis (CRLM) is recommended. However, the efficacy of upfront hepatectomy without neoadjuvant chemotherapy (NAC) is unclear due to the uncertainty of perioperative systemic chemotherapy. Moreover, it is crucial to predict the prognosis when considering perioperative chemotherapy. This study evaluated the impact of neoadjuvant chemotherapy on the prognosis of patients with resectable CRLM and assessed the usefulness of Beppu’s nomogram for predicting prognosis. Methods This retrospective study identified 88 consecutive inpatients who underwent primary hepatic resection for CRLM; 58 received neoadjuvant chemotherapy and 30 underwent upfront surgery. Factors associated with recurrence-free survival were identified via univariate and multivariate analysis. Furthermore, propensity score analysis using inverse probability of treatment weighting (IPTW) was performed. Results On univariate analysis, poor recurrence-free survival was associated with multiple tumors, advanced primary tumor stage, vascular invasion by the primary tumor, a Beppu’s nomogram score ≥ 6, and neoadjuvant chemotherapy. On multivariate analysis, a Beppu’s nomogram score ≥ 6 and neoadjuvant chemotherapy were independent risk factors for recurrence. Neoadjuvant chemotherapy recipients had a higher incidence of lymph node metastasis and vascular invasion than non-recipients. Propensity score analysis revealed no significant difference in the recurrence-free survival rate between these groups. Conclusions Our results show that upfront hepatectomy without neoadjuvant chemotherapy can be considered for resectable CRLM treatment. Beppu’s nomogram score can be a tool for predicting the prognosis of patients with CRLM.

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Beppu's Nomogram Score Is an Independent Prognostic Factor for Colorectal Liver Metastasis Receiving Perioperative Chemotherapy and/or Targeted Therapy

Cited by 8 publications

References 24 publications

Prognostic Nomogram for Liver Metastatic Colon Cancer Based on Histological Type, Tumor Differentiation, and Tumor Deposit: A TRIPOD Compliant Large-Scale Survival Study

Prognostic Nomogram for Liver Metastatic Colon Cancer Based on Histological Type, Tumor Differentiation, and Tumor Deposit: A TRIPOD Compliant Large-Scale Survival Study

Validation study of the JSHBPS nomogram for patients with colorectal liver metastases who underwent hepatic resection in the recent era ‐ a nationwide survey in Japan

Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis

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