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. 2022 Jun:168:25-33.
doi: 10.1016/j.ejca.2022.01.012. Epub 2022 Apr 14.

Predicting 10-year survival after resection of colorectal liver metastases; an international study including biomarkers and perioperative treatment

Florian E Buisman  1 , Daniele Giardiello  2 , Nancy E Kemeny  3 , Ewout W Steyerberg  4 , Diederik J Höppener  1 , Boris Galjart  1 , Pieter M H Nierop  1 , Vinod P Balachandran  5 , Andrea Cercek  3 , Jeffrey A Drebin  5 , Mithat Gönen  6 , William R Jarnagin  5 , T P Kingham  5 , Peter B Vermeulen  7 , Alice C Wei  5 , Dirk J Grünhagen  1 , Cornelis Verhoef  1 , Micheal I D'Angelica  5 , Bas Groot Koerkamp  8
Affiliations

Predicting 10-year survival after resection of colorectal liver metastases; an international study including biomarkers and perioperative treatment

Florian E Buisman et al. Eur J Cancer. 2022 Jun.

Abstract

Background: The aim of this study was to develop a prediction model for 10-year overall survival (OS) after resection of colorectal liver metastasis (CRLM) based on patient, tumour and treatment characteristics.

Methods: Consecutive patients after complete resection of CRLM were included from two centres (1992-2019). A prediction model providing 10-year OS probabilities was developed using Cox regression analysis, including KRAS, BRAF and histopathological growth patterns. Discrimination and calibration were assessed using cross-validation. A web-based calculator was built to predict individual 10-year OS probabilities.

Results: A total of 4112 patients were included. The estimated 10-year OS was 30% (95% CI 29-32). Fifteen patient, tumour and treatment characteristics were independent prognostic factors for 10-year OS; age, gender, location and nodal status of the primary tumour, disease-free interval, number and diameter of CRLM, preoperative CEA, resection margin, extrahepatic disease, KRAS and BRAF mutation status, histopathological growth patterns, perioperative systemic chemotherapy and hepatic arterial infusion pump chemotherapy. The discrimination at 10-years was 0.73 for both centres. A simplified risk score identified four risk groups with a 10-year OS of 57%, 38%, 24%, and 12%.

Conclusions: Ten-year OS after resection of CRLM is best predicted with a model including 15 patient, tumour, and treatment characteristics. The web-based calculator can be used to inform patients. This model serves as a benchmark to determine the prognostic value of novel biomarkers.

Keywords: Biomarkers; Colorectal liver metastases; Prediction; Prognostic factors.

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Conflict of interest statement

Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Groot Koerkamp received pumps for intra-arterial chemotherapy for use in clinical trials from Tricumed.

Figures

Figure 1.
Figure 1.. Calibration plots in the Erasmus and MSKCC cohort
A) Full model developed in Erasmus MC and validated in MSKCC B) Full model developed in MSKCC and validated in Erasmus MC The black solid lines represent the predicted and observed mortality. The black dotted lines are the 95% prediction intervals. Perfect calibration would be present if the solid black line would overlap the red dotted line.
Figure 2.
Figure 2.
Kaplan-Meier of 4 groups of the simplified risk score
See this image and copyright information in PMC

Comment in

References

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