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Predicting early extrahepatic recurrence after local treatment of colorectal liver metastases.
Wensink, G E; Bolhuis, Karen; Elferink, Marloes A G; Fijneman, Remond J A; Kranenburg, Onno; Borel Rinkes, Inne H M; Koopman, Miriam; Swijnenburg, Rutger-Jan; Vink, Geraldine R; Hagendoorn, Jeroen; Punt, Cornelis J A; Roodhart, Jeanine M L; Elias, Sjoerd G.
Afiliación
  • Wensink GE; Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Bolhuis K; Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.
  • Elferink MAG; Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • Fijneman RJA; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
  • Kranenburg O; Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • Borel Rinkes IHM; Department of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Koopman M; Utrecht Platform for Organoid Technology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Swijnenburg RJ; Department of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Vink GR; Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Hagendoorn J; Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.
  • Punt CJA; Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Roodhart JML; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
  • Elias SG; Department of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
Br J Surg ; 110(3): 362-371, 2023 02 15.
Article en En | MEDLINE | ID: mdl-36655278
BACKGROUND: Patients who develop early extrahepatic recurrence (EHR) may not benefit from local treatment of colorectal liver metastases (CRLMs). This study aimed to develop a prediction model for early EHR after local treatment of CRLMs using a national data set. METHODS: A Cox regression prediction model for EHR was developed and validated internally using data on patients who had local treatment for CRLMs with curative intent. Performance assessment included calibration, discrimination, net benefit, and generalizability by internal-external cross-validation. The prognostic relevance of early EHR (within 6 months) was evaluated by landmark analysis. RESULTS: During a median follow-up of 35 months, 557 of the 1077 patients had EHR and 249 died. Median overall survival was 19.5 (95 per cent c.i. 15.6 to 23.0) months in patients with early EHR after CRLM treatment, compared with not reached (45.3 months to not reached) in patients without an early EHR. The EHR prediction model included side and stage of the primary tumour, RAS/BRAFV600E mutational status, and number and size of CRLMs. The range of 6-month EHR predictions was 5.9-56.0 (i.q.r. 12.9-22.0) per cent. The model demonstrated good calibration and discrimination. The C-index through 6 and 12 months was 0.663 (95 per cent c.i. 0.624 to 0.702) and 0.661 (0.632 to 0.689) respectively. The observed 6-month EHR risk was 6.5 per cent for patients in the lowest quartile of predicted risk compared with 32.0 per cent in the highest quartile. CONCLUSION: Early EHR after local treatment of CRLMs can be predicted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Neoplasias Hepáticas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Br J Surg Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Neoplasias Hepáticas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Br J Surg Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido