Total Metastases Volume and Relative Volume Reduction After Neoadjuvant Therapy Predict Outcome After Liver Resection of Colorectal Liver Metastases.

IF 3.4 2区医学 Q2 ONCOLOGY

Annals of Surgical Oncology Pub Date : 2025-08-01 Epub Date: 2025-04-24 DOI:10.1245/s10434-025-17295-9

Florian Lindenlaub, Ulrika Asenbaum, Christoph Schwarz, Jessica Makolli, Martina Mittlböck, Stefan Stremitzer, Klaus Kaczirek

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引用次数: 0

Abstract

Background: Established clinical risk scores (CRSs) can estimate the prognosis of patients with colorectal liver metastases (CLM) after hepatic resection. However, their ability to predict outcome for patients undergoing neoadjuvant chemotherapy is limited, mainly because most included variables do not reflect a biologic response to neoadjuvant chemotherapy (NAC). This study aimed to evaluate the prognostic value of total metastases volume (TMV) and relative volume reduction (RVR) for patients with CLM undergoing perioperative chemotherapy and surgery.

Methods: Liver metastases volume was semi-automatically measured on computed tomography images in 69 patients before and after NAC and compared to established CRS regarding progression-free survival (PFS) and overall survival (OS).

Results: Patients with a TMV smaller than 29.5 ml before NAC and 7.5 ml after NAC showed a significantly longer PFS than those with a larger TMV (median, 31.0 vs. 13.7 months [p = 0.005] and 22.6 vs. 9.1 months [p = 0.013], respectively). An RVR after NAC of at least 73% was a positive predictor of PFS (median, 38.0 vs. 9.4 months; p = 0.004) and OS (mean, 59.5 vs. 92.5 months; p = 0.002).

Conclusions: Total tumor volume and RVR of CLM seem to be superior to established CRS for patients undergoing neoadjuvant chemotherapy and surgery.

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新辅助治疗后总转移灶体积和相对体积减少预测结直肠肝转移灶肝切除术后的预后。

背景：已建立的临床风险评分（CRSs）可以评估结肠直肠肝转移（CLM）患者肝切除术后的预后。然而，它们预测接受新辅助化疗的患者预后的能力有限，主要是因为大多数纳入的变量不能反映对新辅助化疗（NAC）的生物学反应。本研究旨在评估总转移体积（TMV）和相对体积缩小（RVR）对围手术期化疗和手术的CLM患者的预后价值。方法：对69例NAC前后患者的计算机断层扫描图像半自动测量肝转移体积，并与已建立的无进展生存期（PFS）和总生存期（OS）进行比较。结果：NAC前TMV小于29.5 ml和NAC后TMV小于7.5 ml的患者的PFS明显长于TMV较大的患者（中位数分别为31.0 vs. 13.7个月[p = 0.005]和22.6 vs. 9.1个月[p = 0.013]）。NAC后RVR至少为73%是PFS的积极预测因子(中位数，38.0 vs. 9.4个月；p = 0.004)和OS(平均59.5 vs. 92.5个月；P = 0.002)。结论：在接受新辅助化疗和手术的患者中，CLM的总肿瘤体积和RVR似乎优于已建立的CRS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Oncology 医学-外科

CiteScore

5.90

自引率

10.80%

发文量

1698

审稿时长

2.8 months

期刊介绍： The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.