A model containing 15 tumor, treatment, and patient characteristics accurately predicts 10-year overall survival following resection of colorectal liver metastasis (CRLM), according to study results published in the European Journal of Cancer.
For the study, researchers included 4112 individuals (median age, 61 years; IQR, 52-69 years) who underwent CRLM surgery at 2 centers: Memorial Sloan Kettering Cancer Center (MSKCC) and Erasmus Medical Center Cancer Institute (Erasmus MC). Those with borderline resectable or unresectable CRLM were treated with systemic chemotherapy before operation, while those at MSKCC received neoadjuvant systemic chemotherapy and adjuvant systemic and/or hepatic arterial infusion pump (HAIP) chemotherapy as deemed appropriate by physicians. Cox regression was used to develop a predictive model for 10-year overall survival probabilities, with cross-validation used to assess discrimination and calibration. This model was developed into a web-based predictive calculator.
Among the study population, estimated 10-year overall survival was 30% (95% CI, 29%-32%), and estimated median overall survival was 59 months (95% CI, 57-62 months). Predictors for 10-year overall survival included 15 independent predictors: sex, age, nodal status of colorectal cancer (CRC), location of CRC, disease-free interval, quantity of CRLM, diameter of largest CRLM, resection margin, preoperative carcinoembryonic antigen (CEA) levels, extrahepatic disease, BRAF and KRAS mutation statuses, histopathological growth pattern, and perioperative systemic and HAIP chemotherapies. At 10 years, the discrimination for both centers was 0.73. A simplified risk score was used to identify 4 risk groups with 10-year overall survival rates of 57%, 38%, 24%, and 12%.
Limitations to this study included changes in participant selection and treatment over the inclusion period, differences in perioperative treatment between the 2 centers, a limited application of the model to centers offering HAIP chemotherapy, and missing data for many participants.
The study researchers concluded that “this model with web-based calculator accurately predicts a 10-year [overall survival] after resection of CRLM based on 15 patient, tumor, genomic, and treatment factors.” Furthermore, they indicated that “it serves as a benchmark for the evaluation of future prognostic biomarkers.”
Buisman FE, Giardiello D, Kemeny NE, et al. Predicting 10-year survival after resection of colorectal liver metastases; an international study including biomarkers and perioperative treatment. Eur J Cancer. Published online April 14, 2022. doi:10.1016/j.ejca.2022.01.012