Development and validation of a novel risk score to predict overall survival following surgical clearance of bilobar colorectal liver metastases
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd..
BACKGROUND: Bilobar liver metastases from colorectal cancer pose a challenge for obtaining a satisfactory oncological outcome with an adequate future liver remnant. This study aimed to assess the clinical and pathological determinants of overall survival and recurrence-free survival among patients undergoing surgical clearance of bilobar liver metastases from colorectal cancer.
METHODS: A retrospective international multicentre study of patients who underwent surgery for bilobar liver metastases from colorectal cancer between January 2012 and December 2018 was conducted. Overall survival and recurrence-free survival at 1, 2, 3 and 5 years after surgery were the primary outcomes evaluated. The secondary outcomes were duration of postoperative hospital stay, and 90-day major morbidity and mortality rates. A prognostic nomogram was developed using covariates selected from a Cox proportional hazards regression model, and internally validated using a 3:1 random partition into derivation and validation cohorts.
RESULTS: A total of 1236 patients were included from 70 centres. The majority (88 per cent) of the patients had synchronous liver metastases. Overall survival at 1, 2, 3 and 5 years was 86.4 per cent, 67.5 per cent, 52.6 per cent and 33.8 per cent, and the recurrence-free survival rates were 48.7 per cent, 26.6 per cent, 19.2 per cent and 10.5 per cent respectively. A total of 25 per cent of patients had recurrent disease within 6 months. Margin positivity and progressive disease at liver resection were poor prognostic factors, while adjuvant chemotherapy in margin-positive resections improved overall survival. The bilobar liver metastases from colorectal cancer-overall survival nomogram was developed from the derivation cohort based on pre- and postoperative factors. The nomogram's ability to forecast overall survival at 1, 2, 3 and 5 years was subsequently validated on the validation cohort and showed high accuracy (overall C-index = 0.742).
CONCLUSION: Despite the high recurrence rates, overall survival of patients undergoing surgical resection for bilobar liver metastases from colorectal cancer is encouraging. The novel bilobar liver metastases from colorectal cancer-overall survival nomogram helps in counselling and informed decision-making of patients planned for treatment of bilobar liver metastases from colorectal cancer.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
BJS open - 7(2023), 5 vom: 05. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dasari, Bobby V M [VerfasserIn] |
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Journal Article |
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Date Completed 25.09.2023 Date Revised 27.12.2023 published: Print ErratumIn: BJS Open. 2023 Nov 1;7(6):. - PMID 38150332 Citation Status MEDLINE |
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| doi: |
10.1093/bjsopen/zrad085 |
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NLM362351406 |
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| 100 | 1 | |a Dasari, Bobby V M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Development and validation of a novel risk score to predict overall survival following surgical clearance of bilobar colorectal liver metastases |
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| 500 | |a Date Revised 27.12.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a ErratumIn: BJS Open. 2023 Nov 1;7(6):. - PMID 38150332 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. | ||
| 520 | |a BACKGROUND: Bilobar liver metastases from colorectal cancer pose a challenge for obtaining a satisfactory oncological outcome with an adequate future liver remnant. This study aimed to assess the clinical and pathological determinants of overall survival and recurrence-free survival among patients undergoing surgical clearance of bilobar liver metastases from colorectal cancer | ||
| 520 | |a METHODS: A retrospective international multicentre study of patients who underwent surgery for bilobar liver metastases from colorectal cancer between January 2012 and December 2018 was conducted. Overall survival and recurrence-free survival at 1, 2, 3 and 5 years after surgery were the primary outcomes evaluated. The secondary outcomes were duration of postoperative hospital stay, and 90-day major morbidity and mortality rates. A prognostic nomogram was developed using covariates selected from a Cox proportional hazards regression model, and internally validated using a 3:1 random partition into derivation and validation cohorts | ||
| 520 | |a RESULTS: A total of 1236 patients were included from 70 centres. The majority (88 per cent) of the patients had synchronous liver metastases. Overall survival at 1, 2, 3 and 5 years was 86.4 per cent, 67.5 per cent, 52.6 per cent and 33.8 per cent, and the recurrence-free survival rates were 48.7 per cent, 26.6 per cent, 19.2 per cent and 10.5 per cent respectively. A total of 25 per cent of patients had recurrent disease within 6 months. Margin positivity and progressive disease at liver resection were poor prognostic factors, while adjuvant chemotherapy in margin-positive resections improved overall survival. The bilobar liver metastases from colorectal cancer-overall survival nomogram was developed from the derivation cohort based on pre- and postoperative factors. The nomogram's ability to forecast overall survival at 1, 2, 3 and 5 years was subsequently validated on the validation cohort and showed high accuracy (overall C-index = 0.742) | ||
| 520 | |a CONCLUSION: Despite the high recurrence rates, overall survival of patients undergoing surgical resection for bilobar liver metastases from colorectal cancer is encouraging. The novel bilobar liver metastases from colorectal cancer-overall survival nomogram helps in counselling and informed decision-making of patients planned for treatment of bilobar liver metastases from colorectal cancer | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Raptis, Dimitri |e verfasserin |4 aut | |
| 700 | 1 | |a Syn, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a Serrablo, Alejandro |e verfasserin |4 aut | |
| 700 | 1 | |a Ramia, Jose Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Laurenzi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Sturesson, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Pawlik, Timothy M |e verfasserin |4 aut | |
| 700 | 1 | |a Siriwardena, Ajith K |e verfasserin |4 aut | |
| 700 | 1 | |a Lesurtel, Mickael |e verfasserin |4 aut | |
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