新辅助化疗后手术切除结直肠肝转移瘤的生存预测:肿瘤反应结合基因和形态学评估评分。

IF 3.5 2区 医学 Q2 ONCOLOGY
Ejso Pub Date : 2024-10-21 DOI:10.1016/j.ejso.2024.108777
Yu-Ming Su, Ke-Min Jin, Hong-Wei Wang, Yan-Yan Wang, Xiao-Luan Yan, Kun Wang, Juan Li, Da Xu, Bao-Cai Xing
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引用次数: 0

摘要

简介:对于复发风险高或切除困难的结直肠肝转移(CRLM)患者,新辅助化疗已成为常规治疗方法。这项回顾性研究旨在为接受新辅助化疗后进行肝切除术的 CRLM 患者建立一个改良的生存预测模型:纳入2006年至2021年期间接受新辅助化疗后进行肝切除术的619例患者,按2:1的比例分为训练组和验证组。模型在训练组建立,在验证组验证。将化疗反应纳入基因和形态学评价(GAME)评分,作为一个新的NeoGAME模型,并根据多变量Cox回归的危险比进行赋分。用X-tile划分NeoGAME评分分组,并与传统模型的预测能力进行比较:结果:NeoGAME低风险组(0-2分)、中风险组(3-4分)和高风险组(≥5分)的5年总生存率均有明显差异(训练组,P 结论:NeoGAME评分的预测能力与传统模型的预测能力相近:新建立的 NeoGAME 评分能更准确地预测接受新辅助化疗的 CRLM 患者的生存率。此外,该模型还是评估肿瘤行为和选择肝切除术受益人群的有用工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Survival prediction of colorectal liver metastases underwent surgical resection after neoadjuvant chemotherapy: Tumor response combined with the genetic and morphological evaluation score.

Introduction: Neoadjuvant chemotherapy is becoming routine for colorectal liver metastasis (CRLM) in patients with high risks of recurrence or in whom resection is difficult. This retrospective study aimed to establish a modified survival prediction model for patients with CRLM who underwent hepatectomy after neoadjuvant chemotherapy.

Materials and methods: A total of 619 patients who received neoadjuvant chemotherapy followed by hepatectomy between 2006 and 2021 were included and divided into training and validation groups at a ratio of 2:1. The model was established in training group and validated in validation group. Chemotherapy response was integrated into the genetic and morphological evaluation (GAME) score as a new NeoGAME model, with assigned points based on the hazard ratio in the multivariate Cox regression. The NeoGAME score grouping cutoff was divided using X-tile, and the predictive power was compared with that of traditional models.

Results: The 5-year overall survival were significantly different in the NeoGAME low-risk (0-2 points), medium-risk (3-4 points) and high-risk (≥5 points) groups (training group, P < 0.001; validation group, P = 0.0012). The area under the curve in predicting 5-year survival was 0.67 and 0.66 for the training and validation groups, respectively. Time-dependent receiver operating characteristic curve showed better discrimination ability of NeoGAME than the GAME score in predicting 5-year survival.

Conclusions: The newly established NeoGAME score can predict survival more precisely for patients with CRLM receiving neoadjuvant chemotherapy. Moreover, the model offers a useful tool for assessing tumor behavior and selecting a benefiting population for liver resection.

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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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