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Contour prognostic model for predicting survival after resection of colorectal liver metastases: development and multicentre validation study using largest diameter and number of metastases with RAS mutation status.
Kawaguchi, Y; Kopetz, S; Tran Cao, H S; Panettieri, E; De Bellis, M; Nishioka, Y; Hwang, H; Wang, X; Tzeng, C-W D; Chun, Y S; Aloia, T A; Hasegawa, K; Guglielmi, A; Giuliante, F; Vauthey, J-N.
Afiliación
  • Kawaguchi Y; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Kopetz S; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
  • Tran Cao HS; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Panettieri E; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • De Bellis M; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Nishioka Y; Hepatobiliary Surgery Unit, Foundation and Teaching Hospital IRCCS A. Gemelli, Rome, Italy.
  • Hwang H; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Wang X; Department of Surgery, Division of General and Hepatobiliary Surgery, G. B. Rossi University Hospital, University of Verona, Verona, Italy.
  • Tzeng CD; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
  • Chun YS; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Aloia TA; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Hasegawa K; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Guglielmi A; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Giuliante F; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Vauthey JN; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
Br J Surg ; 108(8): 968-975, 2021 08 19.
Article en En | MEDLINE | ID: mdl-33829254
BACKGROUND: Most current models for predicting survival after resection of colorectal liver metastasis include largest diameter and number of colorectal liver metastases as dichotomous variables, resulting in underestimation of the extent of risk variation and substantial loss of statistical power. The aim of this study was to develop and validate a new prognostic model for patients undergoing liver resection including largest diameter and number of colorectal liver metastases as continuous variables. METHODS: A prognostic model was developed using data from patients who underwent liver resection for colorectal liver metastases at MD Anderson Cancer Center and had RAS mutational data. A Cox proportional hazards model analysis was used to develop a model based on largest colorectal liver metastasis diameter and number of metastases as continuous variables. The model results were shown using contour plots, and validated externally in an international multi-institutional cohort. RESULTS: A total of 810 patients met the inclusion criteria. Largest colorectal liver metastasis diameter (hazard ratio (HR) 1.11, 95 per cent confidence interval 1.06 to 1.16; P < 0.001), number of colorectal liver metastases (HR 1.06, 1.03 to 1.09; P < 0.001), and RAS mutation status (HR 1.76, 1.42 to 2.18; P < 0.001) were significantly associated with overall survival, together with age, primary lymph node metastasis, and prehepatectomy chemotherapy. The model performed well in the external validation cohort, with predicted overall survival values almost lying within 10 per cent of observed values. Wild-type RAS was associated with better overall survival than RAS mutation even when liver resection was performed for larger and/or multiple colorectal liver metastases. CONCLUSION: The contour prognostic model, based on diameter and number of lesions considered as continuous variables along with RAS mutation, predicts overall survival after resection of colorectal liver metastasis.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Hepatectomía / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Br J Surg Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Hepatectomía / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Br J Surg Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido