1. Prognostic value of total tumor volume in patients with colorectal liver metastases: A secondary analysis of the randomized CAIRO5 trial with external cohort validation.
- Author
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Michiel Zeeuw J, Wesdorp NJ, Ali M, Bakker AJJ, Voigt KR, Starmans MPA, Roor J, Kemna R, van Waesberghe JHTM, van den Bergh JE, Nota IMGC, Moos SI, van Dieren S, van Amerongen MJ, Bond MJG, Chapelle T, van Dam RM, Engelbrecht MRW, Gerhards MF, van Gulik TM, Hermans JJ, de Jong KP, Klaase JM, Kok NFM, Leclercq WKG, Liem MSL, van Lienden KP, Quintus Molenaar I, Patijn GA, Rijken AM, Ruers TM, de Wilt JHW, Verpalen IM, Stoker J, Grunhagen DJ, Swijnenburg RJ, Punt CJA, Huiskens J, Verhoef C, and Kazemier G
- Subjects
- Humans, Male, Female, Middle Aged, Prognosis, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Adult, Liver Neoplasms secondary, Liver Neoplasms drug therapy, Liver Neoplasms diagnostic imaging, Colorectal Neoplasms pathology, Colorectal Neoplasms mortality, Tumor Burden, Neoplasm Recurrence, Local pathology
- 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., Competing Interests: 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., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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