Risk scoring system for recurrence after simultaneous resection of colorectal cancer liver metastasis

Wu, Yuchen; Guo, Tong; Xu, Zhenhong; Liu, Fangqi; Cai, Sanjun; Wang, Lu; Xu, Ye

doi:10.21037/atm-21-2595

Cited by 5 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The advancements in imaging technologies in recent years have enabled on-time detection of early, isolated or small liver metastases [ 53 ]. With the continuous improvements in surgical technologies, anaesthetic approaches, and perinatal treatments, the safety of simultaneous hepatectomy to treat SCLM has been dramatically improved, which has increasingly been recognised by scholars [ 54 , 55 ]. A few authors still argue that a 2–6-month waiting period between the resection of the primary tumour and liver resection is necessary for the presentation of any subclinical metastasis, thereby enabling complete tumour clearance [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and long-term prognosis of simultaneous versus staged resection in synchronous colorectal cancer with liver metastasis: a systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

Purpose The optimal time point for surgical resection of synchronous colorectal liver metastases (SCLMs) is still controversial. This meta-analysis evaluated the safety and long-term prognoses of simultaneous and staged resection of SCLM to provide a reference for clinical selection. Methods A systematic literature search for studies published by October 2022 was performed using PubMed, Web of Science, Embase, Scopus and Cochrane Library. The evaluated outcome parameters were total, gastrointestinal and hepatic complications, as well as perioperative mortality, intraoperative blood loss, total hospital stay, 5-year disease-free survival (DFS) and 5-year overall survival (OS). Results This meta-analysis included 22 nonrandomised and one randomised study comprising 4862 patients. The patients undergoing simultaneous resection of SCLM had similar total (OR = 0.88, 95% CI [0.66–1.19], P = 0.409), gastrointestinal (OR = 1.19, 95% CI [0.89–1.59], P = 0.241) and hepatic (OR = 1.04, 95% CI [0.83–1.31], P = 0.734) complications, as well as perioperative mortality (OR = 1.79, 95% CI [0.88–3.64], P = 0.108), 5-year DFS (HR = 1.26, 95% CI [0.96–1.66], P = 0.098) and 5-year OS (HR = 1.13, 95% CI [0.95–1.34], P = 0.164). Lower intraoperative blood loss (SMD = − 0.39, 95% CI [− 0.60 to − 0.18], P < 0.001) and shorter total hospital stay (WMD = − 5.43, 95% CI [− 7.29 to − 3.58], P < 0.001) were observed in the simultaneous-resection group versus the staged group. Conclusions Simultaneous resection is safe and effective for SCLM patients. The long-term prognosis is equivalent to that of the traditional staged resection. Correct selection of resectable SCLM patients for the simultaneous resection of the primary tumour and liver metastases can be the first choice. Owing to the potential heterogeneity, more RCTs should be included to verify our conclusions.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and long-term prognosis of simultaneous versus staged resection in synchronous colorectal cancer with liver metastasis: a systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Surgical margin (R0 resection or not), extent of liver resection (major resection, or not), and hepatic portal occlusion were the surgical data taken into analysis. Resections ≥three segments of liver metastases were defined as major resection ( 22 ). Preoperative chemotherapy regimens, with or without bevacizumab and cetuximab, mainly including 5-flfluorouracil or capecitabine, and oxaliplatin or irinotecan, the regimens were recommended to CRLM patients with one or more risk factors of recurrence as previously defined ( 17 , 23 ).…”

Section: Methodsmentioning

confidence: 99%

Nomogram predicting early recurrence defined by the minimum P value approach for colorectal liver metastasis patients receiving colorectal cancer resection with simultaneous liver metastasis resection: development and validation

Deng¹,

Chen²,

Liu³

et al. 2023

J Gastrointest Oncol

View full text Add to dashboard Cite

Background Simultaneous resections have been increasingly performed for colorectal liver metastasis patients. However, studies explored risk stratification for these patients are scarce. Among which, a clear definition of early recurrence remains controversial and models for predicting early recurrence in these patients are lacking. Methods Colorectal liver metastasis patients who developed recurrence followed by simultaneous resection were enrolled. Early recurrence was determined by the minimum P value method, and patients were divided into an early recurrence group and late recurrence group. Standard clinical data were collected from each patient including demographics features, preoperative laboratory tests and postoperative regular follow-up results. All the data were accessed by clinicians and recorded accordingly. The nomogram for early recurrence was constructed in the training cohort and validated externally in the test cohort. Results The optimal value of early recurrence by the minimum P value method was 13 months. A total of 323 patients were included in the training cohort, of which 241 (74.6%) experienced early recurrence. Seventy-one patients were included in the test cohort, of which 49 (69.0%) experienced early recurrence. Significantly worse post-recurrence survival (median 27.0 vs. 52.8 months, P=0.00083) and overall survival (median 33.8 vs. 70.9 months, P<0.0001) were observed in patients with early recurrence in the training cohort. Positive lymph node metastases (P=0.003), tumour burden scores ≥4.09 (P=0.001), preoperative neutrophil-to-lymphocyte ratios ≥1.44 (P=0.006), preoperative blood urea nitrogen levels ≥3.55 µmol/L (P=0.017) and postoperative complications (P=0.042) were independently associated with early recurrence, and all these predictors were included in the nomogram. The nomogram for predicting early recurrence had a receiver operating characteristic curve of 0.720 in the training cohort and a receiver operating characteristic curve of 0.740 in the test cohort. The Hosmer-Lemeshow test and calibration curves showed acceptable model calibration in the training set (P=0.7612) and in the test set (P=0.8671). The decision curve analysis results for the training cohort and test cohort also indicated that the nomogram showed good clinical applicability. Conclusions Our findings provide clinicians with new insights into accurate risk stratification for colorectal liver metastasis patients receiving simultaneous resection and contributing to the management of patients.

show abstract

Section: Simultaneous Resectionsmentioning

confidence: 99%

“…Six recent Asian studies focused on patients undergoing simultaneous resections of the primary and metastatic tumours [37,[51][52][53]72,82]. Outcomes studied included OS [53,82], CSS [82], PFS [37,51], recurrence [37,72], serious postoperative complications [52] and presence of lymph node (LN) metastases [51]. The latter was unique as an outcome of choice since a positive primary LN status is a strong predictor of poor outcomes in CRLM patients in many studies.…”

Section: Simultaneous Resectionsmentioning

confidence: 99%

Clinical Prediction Models for Prognosis of Colorectal Liver Metastases: A Comprehensive Review of Regression-Based and Machine Learning Models

Kokkinakis,

Ziogas,

Llaque Salazar

et al. 2024

Cancers

View full text Add to dashboard Cite

Colorectal liver metastasis (CRLM) is a disease entity that warrants special attention due to its high frequency and potential curability. Identification of “high-risk” patients is increasingly popular for risk stratification and personalization of the management pathway. Traditional regression-based methods have been used to derive prediction models for these patients, and lately, focus has shifted to artificial intelligence-based models, with employment of variable supervised and unsupervised techniques. Multiple endpoints, like overall survival (OS), disease-free survival (DFS) and development or recurrence of postoperative complications have all been used as outcomes in these studies. This review provides an extensive overview of available clinical prediction models focusing on the prognosis of CRLM and highlights the different predictor types incorporated in each model. An overview of the modelling strategies and the outcomes chosen is provided. Specific patient and treatment characteristics included in the models are discussed in detail. Model development and validation methods are presented and critically appraised, and model performance is assessed within a proposed framework.

show abstract

Risk scoring system for recurrence after simultaneous resection of colorectal cancer liver metastasis

Cited by 5 publications

References 32 publications

Safety and long-term prognosis of simultaneous versus staged resection in synchronous colorectal cancer with liver metastasis: a systematic review and meta-analysis

Safety and long-term prognosis of simultaneous versus staged resection in synchronous colorectal cancer with liver metastasis: a systematic review and meta-analysis

Nomogram predicting early recurrence defined by the minimum P value approach for colorectal liver metastasis patients receiving colorectal cancer resection with simultaneous liver metastasis resection: development and validation

Clinical Prediction Models for Prognosis of Colorectal Liver Metastases: A Comprehensive Review of Regression-Based and Machine Learning Models

Contact Info

Product

Resources

About