The prognostic utility of the “Tumor Burden Score” based on preoperative radiographic features of colorectal liver metastases

Sasaki, Kazunari; Margonis, Georgios Antonios; Andreatos, Nikolaos; Zhang, Xu Feng; Buettner, Stefan; Wang, Jane; Deshwar, Amar; He, Jin; Wolfgang, Christopher L.; Weiss, Matthew J.; Pawlik, Timothy M.

doi:10.1002/jso.24678

Cited by 53 publications

(44 citation statements)

References 33 publications

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“…Of note, TBS was calculated using pathological data, rather than preoperative radiographic imaging. However, the authors recently demonstrated that TBS values estimated by either imaging or pathology are equivalent in prognostic terms. As such, although pathological data were used to estimate TBS and consequently the GAME score in the present study, it is probable that the GAME score can also be calculated with the aid of imaging, supporting the decision to classify TBS as a value available before surgery.…”

Section: Discussionmentioning

confidence: 99%

Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases

Margonis

Sasaki

Gholami

et al. 2018

British Journal of Surgery

134

110

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Section: Discussionmentioning

confidence: 99%

Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases

Margonis

Sasaki

Gholami

et al. 2018

British Journal of Surgery

134

110

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“…In solid tumors, such as melanoma, breast cancer, and lung cancer, tumor burden is always represented as the tumor size assessed using a CT scan [17]. However, as a hematopoietic and lymphoid disease, CT scan is not always performed to assess the tumor burden in DLBCL due to the large number of lymph nodes involved, as well as tumors in extra-nodal tissues.…”

Section: Introductionmentioning

confidence: 99%

“…Tumor burden is thought to be an important risk factor in multiple malignancies, usually reflecting the degree of tumor damage to the body [17, 18]. In solid tumors, such as melanoma, breast cancer, and lung cancer, tumor burden is always represented as the tumor size assessed using a CT scan [17].…”

Section: Introductionmentioning

confidence: 99%

Ratio of Immune Response to Tumor Burden Predicts Survival Via Regulating Functions of Lymphocytes and Monocytes in Diffuse Large B-Cell Lymphoma

Niu

Yin

et al. 2018

Cell Physiol Biochem

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Background/Aims: Diffuse large B-cell lymphoma (DLBCL) is an aggressive disease, and is the most common type of lymphoma in adults. Although significant progress in treatment has been made using chemotherapy combinations, there exist a large amount of relapse or refractory cases. Thus, effective clinical biomarkers for DLBCL are urgently needed. Our study aims to explore the predictive significance of using the immune response to tumor burden ratio [defined as the lymphocyte to monocyte ratio (LMR)/lactate dehydrogenase (LDH) levels] in 184 DLBCL patients and the potential mechanism underlying the use of the LMR to tumor burden ratio in predicting patient survival. Methods: The correlation between serum LDH levels and tumor levels assessed by PET-CT was determined using Spearman’s correlation analysis. Clinical data from 184 DLBCL patients was assessed using receiver operating characteristic curve analysis and survival analysis. The potential correlation between tumor burden and lymphocytes or monocytes was analyzed by immunohistochemical staining, flow cytometry, and ELISA analysis of patient samples. In addition, we performed in vitro studies to further determine the effects of tumor burden on the anti-tumor activity of T lymphocytes. Results: We observed that serum LDH was an excellent surrogate marker of tumor burden in DLBCL patients, and that the ratio of LMR to LDH was an independent prognostic biomarker capable of predicting survival in DLBCL patients. Further analysis showed that a high tumor burden was correlated with decreased Ki67 expression in T cells, either in the solid tumor tissue or in the circulating blood. In addition, based on an in vitro co-culture study, a higher tumor burden led to the suppression of the anti-tumor response of T cells. Furthermore, we found that a higher tumor burden was correlated with the differentiation of monocytes to tumor associated macrophages in the tumor micro-environment. Both results demonstrate the importance of considering both the immune system and tumor burden for prognostic analysis. Conclusion: Our study has identified a novel clinical biomarker, namely, the immune response to tumor burden ratio, that can be used to distinguish survival outcomes in DLBCL patients, and demonstrated the potential mechanism underlying the use of this biomarker, that incorporates both the immune system and tumor burden, for use in future clinical applications.

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“…Specifically, the TB score was defined as the distance from the origin on a Cartesian plane that incorporated 2 variables: maximum tumor size ( x -axis) and the number of liver lesions ( y -axis). The Pythagorean theorem was then used to calculate the distance of any given point from the origin of the plane (0, 0), whereby [TBS 2 = (maximum tumor diameter) 2 + (number of liver lesions) 2 ] [7, 8].…”

Section: Methodsmentioning

confidence: 99%

“…Mazzaferro et al [5, 6] demonstrated that the tumor size and number criteria for HCC have undergone numerous iterations culminating in a predictive tool termed the “metro-ticket” system. Furthermore, Sasaki et al [7, 8] showed that the “metro-ticket” concept was applicable to patients undergoing liver resection for colorectal liver metastases, and they established a novel scoring system (i.e., Tumor Burden (TB) score).…”

Section: Introductionmentioning

confidence: 99%

Preoperative Controlling Nutritional Status plus Tumor Burden Score for the Assessment of Prognosis after Curative Liver Resection for Hepatocellular Carcinoma

et al. 2020

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Objective: There is no prior study analyzing the prognostic predictive value of adding the tumor factor (i.e., tumor burden score) to the Controlling Nutritional Status (CONUT) score for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the value of the CONUT plus Tumor Burden (CONUT-TB) score as a prognostic predictor in patients with HCC undergoing liver resection. Methods: Between 2015 and 2018, 96 consecutive patients with HCC underwent liver resection at our institution. Patients undergoing repeated liver resection and combined resection of a metastatic lesion were excluded. Patients were divided into two groups according to their CONUT-TB scores according to a cutoff value. Clinicopathological prognostic factors for survival were analyzed using a database containing the medical records. Results: The optimal cutoff value of the CONUT-TB score determined by using a minimum p value approach was 13 points. Among the 81 patients included in the analytic cohort, 71 patients had low (<13) and 10 patients had high (>13) CONUT-TB scores. The overall 3-year survival rate of patients following liver resection for HCC in the high CONUT-TB group was significantly worse than that of patients in the low CONUT-TB group (62.5% vs. 89.3%, p=0.003). Multivariate analysis indicated that a high CONUT-TB score was independently associated with overall survival after liver resection (p=0.010). Conclusions: The CONUT-TB score is a valuable predictor of survival in patients with HCC after liver resection.

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The prognostic utility of the “Tumor Burden Score” based on preoperative radiographic features of colorectal liver metastases

Abstract: Imaging-based TBS was superior to traditional tumor size and number and was comparable to pathology-based TBS. Imaging-based TBS may have the potential to facilitate improved preoperative risk stratification of patients with CRLM.

Cited by 53 publications

References 33 publications

Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases

Genetic And Morphological Evaluation (GAME) score for patients with colorectal liver metastases

Ratio of Immune Response to Tumor Burden Predicts Survival Via Regulating Functions of Lymphocytes and Monocytes in Diffuse Large B-Cell Lymphoma

Preoperative Controlling Nutritional Status plus Tumor Burden Score for the Assessment of Prognosis after Curative Liver Resection for Hepatocellular Carcinoma

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