Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2024 Aug:207:114185.
doi: 10.1016/j.ejca.2024.114185. Epub 2024 Jun 23.

Prognostic value of total tumor volume in patients with colorectal liver metastases: A secondary analysis of the randomized CAIRO5 trial with external cohort validation

J Michiel Zeeuw  1 , Nina J Wesdorp  2 , Mahsoem Ali  2 , Anne-Joëlle J J Bakker  2 , Kelly R Voigt  3 , Martijn P A Starmans  4 , Joran Roor  5 , Ruby Kemna  2 , Jan Hein T M van Waesberghe  6 , Janneke E van den Bergh  6 , Irene M G C Nota  6 , Shira I Moos  6 , Susan van Dieren  7 , Martinus J van Amerongen  8 , Marinde J G Bond  9 , Thiery Chapelle  10 , Ronald M van Dam  11 , Marc R W Engelbrecht  12 , Michael F Gerhards  13 , Thomas M van Gulik  7 , John J Hermans  14 , Koert P de Jong  15 , Joost M Klaase  15 , Niels F M Kok  16 , Wouter K G Leclercq  17 , Mike S L Liem  18 , Krijn P van Lienden  19 , I Quintus Molenaar  20 , Gijs A Patijn  21 , Arjen M Rijken  22 , Theo M Ruers  16 , Johannes H W de Wilt  23 , Inez M Verpalen  24 , Jaap Stoker  24 , Dirk J Grunhagen  3 , Rutger-Jan Swijnenburg  25 , Cornelis J A Punt  26 , Joost Huiskens  27 , Cornelis Verhoef  3 , Geert Kazemier  2
Affiliations
Free article
Clinical Trial

Prognostic value of total tumor volume in patients with colorectal liver metastases: A secondary analysis of the randomized CAIRO5 trial with external cohort validation

J Michiel Zeeuw et al. Eur J Cancer. 2024 Aug.
Free article

Abstract

Background: This study aimed to assess the prognostic value of total tumor volume (TTV) for early recurrence (within 6 months) and overall survival (OS) in patients with colorectal liver metastases (CRLM), treated with induction systemic therapy followed by complete local treatment.

Methods: Patients with initially unresectable CRLM from the multicenter randomized phase 3 CAIRO5 trial (NCT02162563) who received induction systemic therapy followed by local treatment were included. Baseline TTV and change in TTV as response to systemic therapy were calculated using the CT scan before and the first after systemic treatment, and were assessed for their added prognostic value. The findings were validated in an external cohort of patients treated at a tertiary center.

Results: In total, 215 CAIRO5 patients were included. Baseline TTV and absolute change in TTV were significantly associated with early recurrence (P = 0.005 and P = 0.040, respectively) and OS in multivariable analyses (P = 0.024 and P = 0.006, respectively), whereas RECIST1.1 was not prognostic for early recurrence (P = 0.88) and OS (P = 0.35). In the validation cohort (n = 85), baseline TTV and absolute change in TTV remained prognostic for early recurrence (P = 0.041 and P = 0.021, respectively) and OS in multivariable analyses (P < 0.0001 and P = 0.012, respectively), and showed added prognostic value over conventional clinicopathological variables (increase C-statistic, 0.06; 95 % CI, 0.02 to 0.14; P = 0.008).

Conclusion: Total tumor volume is strongly prognostic for early recurrence and OS in patients who underwent complete local treatment of initially unresectable CRLM, both in the CAIRO5 trial and the validation cohort. In contrast, RECIST1.1 did not show prognostic value for neither early recurrence nor OS.

Keywords: Colorectal cancer; Liver metastases; Local treatment tumor volume; Prognostic marker; Systemic therapy.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors of this manuscript declare relationships with the following companies: C.J.A.P. has an advisory role for Nordic Pharma; SAS Analytics paid for traveling expenses G. Kazemier. This funding is not related to the current research. The remaining authors declare no potential conflicts of interest.

LinkOut - more resources