{"title":"Validation of tumor burden score as a prognostic factor in colorectal cancer liver metastases patients: a retrospective analysis.","authors":"Anton Burlaka, Serhii Zemskov, Volodymyr Bezverkhnyi, Veronika Rozhkova, Vitalii Zvirych, Dupyk Mykhailo, Artem Mykytyuk, Romanna Pavliuk, Volodymyr Skyba","doi":"10.1007/s12029-025-01220-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The assessment of resectability in patients with colorectal cancer (CRC) and multiple liver metastases is primarily a technical decision. However, in cases with unfavourable tumor biology, the clinical benefit of surgery remains limited. Further research is needed to identify additional factors influencing oncological outcomes in these patients to better guide the decision-making process. The aim of this study was to investigate the association of tumor burden score (TBS) and oncological outcome in CRC patients with multiple bilobar metastases.</p><p><strong>Methods: </strong>Five hundred twenty-one consecutive patients who underwent liver resections for CRC liver metastases between January 2002 and January 2024 were identified from the National Cancer Institute (Kyiv, Ukraine) prospective database and analysed retrospectively.</p><p><strong>Results: </strong>The median and 5-year overall survival in cohorts with TBS clusters < 3, ≥ 3-9 and ≥ 9 was 116.2 months, 50.3 months and 29.7 months; and 75.7%, 42.4% and 41.6%, respectively (P < 0.001). TBS index has shown high prognostic specificity and sensitivity for postoperative morbidity with AUC 0.97 on the ROC curve. The multivariate Cox regression model has shown that the TBS clusters have a significant negative impact on overall survival particularly in cohorts with TBS ≥ 3-9 (HR: 2.8, 95% CI: 1.7-4.8, P = 0.0001) and TBS ≥ 9 (HR: 1.4, 95% CI: 1.31-1.46, P = 0.005).</p><p><strong>Conclusion: </strong>In this Ukranian population-based study of patients with resectable CRC liver metastases, high TBS was associated with poorer overall survival.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"119"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01220-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The assessment of resectability in patients with colorectal cancer (CRC) and multiple liver metastases is primarily a technical decision. However, in cases with unfavourable tumor biology, the clinical benefit of surgery remains limited. Further research is needed to identify additional factors influencing oncological outcomes in these patients to better guide the decision-making process. The aim of this study was to investigate the association of tumor burden score (TBS) and oncological outcome in CRC patients with multiple bilobar metastases.
Methods: Five hundred twenty-one consecutive patients who underwent liver resections for CRC liver metastases between January 2002 and January 2024 were identified from the National Cancer Institute (Kyiv, Ukraine) prospective database and analysed retrospectively.
Results: The median and 5-year overall survival in cohorts with TBS clusters < 3, ≥ 3-9 and ≥ 9 was 116.2 months, 50.3 months and 29.7 months; and 75.7%, 42.4% and 41.6%, respectively (P < 0.001). TBS index has shown high prognostic specificity and sensitivity for postoperative morbidity with AUC 0.97 on the ROC curve. The multivariate Cox regression model has shown that the TBS clusters have a significant negative impact on overall survival particularly in cohorts with TBS ≥ 3-9 (HR: 2.8, 95% CI: 1.7-4.8, P = 0.0001) and TBS ≥ 9 (HR: 1.4, 95% CI: 1.31-1.46, P = 0.005).
Conclusion: In this Ukranian population-based study of patients with resectable CRC liver metastases, high TBS was associated with poorer overall survival.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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