TY - JOUR
T1 - Prognostic value of total tumor volume in patients with colorectal liver metastases
T2 - A secondary analysis of the randomized CAIRO5 trial with external cohort validation
AU - Michiel Zeeuw, J.
AU - Wesdorp, Nina J.
AU - Ali, Mahsoem
AU - Bakker, Anne Joëlle J.J.
AU - Voigt, Kelly R.
AU - Starmans, Martijn P.A.
AU - Roor, Joran
AU - Kemna, Ruby
AU - van Waesberghe, Jan Hein T.M.
AU - van den Bergh, Janneke E.
AU - Nota, Irene M.G.C.
AU - Moos, Shira I.
AU - van Dieren, Susan
AU - van Amerongen, Martinus J.
AU - Bond, Marinde J.G.
AU - Chapelle, Thiery
AU - van Dam, Ronald M.
AU - Engelbrecht, Marc R.W.
AU - Gerhards, Michael F.
AU - van Gulik, Thomas M.
AU - Hermans, John J.
AU - de Jong, Koert P.
AU - Klaase, Joost M.
AU - Kok, Niels F.M.
AU - Leclercq, Wouter K.G.
AU - Liem, Mike S.L.
AU - van Lienden, Krijn P.
AU - Quintus Molenaar, I.
AU - Patijn, Gijs A.
AU - Rijken, Arjen M.
AU - Ruers, Theo M.
AU - de Wilt, Johannes H.W.
AU - Verpalen, Inez M.
AU - Stoker, Jaap
AU - Grunhagen, Dirk J.
AU - Swijnenburg, Rutger Jan
AU - Punt, Cornelis J.A.
AU - Huiskens, Joost
AU - Verhoef, Cornelis
AU - Kazemier, Geert
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/8
Y1 - 2024/8
N2 - Background:This study aimed to assess the prognostic value of total tumor volume (TTV) for early recurrence (within 6 months) and overall survival (OS) in patients with colorectal liver metastases (CRLM), treated with induction systemic therapy followed by complete local treatment.Methods: Patients with initially unresectable CRLM from the multicenter randomized phase 3 CAIRO5 trial (NCT02162563) who received induction systemic therapy followed by local treatment were included. Baseline TTV and change in TTV as response to systemic therapy were calculated using the CT scan before and the first after systemic treatment, and were assessed for their added prognostic value. The findings were validated in an external cohort of patients treated at a tertiary center. Results:In total, 215 CAIRO5 patients were included. Baseline TTV and absolute change in TTV were significantly associated with early recurrence (P = 0.005 and P = 0.040, respectively) and OS in multivariable analyses (P = 0.024 and P = 0.006, respectively), whereas RECIST1.1 was not prognostic for early recurrence (P = 0.88) and OS (P = 0.35). In the validation cohort (n = 85), baseline TTV and absolute change in TTV remained prognostic for early recurrence (P = 0.041 and P = 0.021, respectively) and OS in multivariable analyses (P < 0.0001 and P = 0.012, respectively), and showed added prognostic value over conventional clinicopathological variables (increase C-statistic, 0.06; 95 % CI, 0.02 to 0.14; P = 0.008). Conclusion: Total tumor volume is strongly prognostic for early recurrence and OS in patients who underwent complete local treatment of initially unresectable CRLM, both in the CAIRO5 trial and the validation cohort. In contrast, RECIST1.1 did not show prognostic value for neither early recurrence nor OS.
AB - Background:This study aimed to assess the prognostic value of total tumor volume (TTV) for early recurrence (within 6 months) and overall survival (OS) in patients with colorectal liver metastases (CRLM), treated with induction systemic therapy followed by complete local treatment.Methods: Patients with initially unresectable CRLM from the multicenter randomized phase 3 CAIRO5 trial (NCT02162563) who received induction systemic therapy followed by local treatment were included. Baseline TTV and change in TTV as response to systemic therapy were calculated using the CT scan before and the first after systemic treatment, and were assessed for their added prognostic value. The findings were validated in an external cohort of patients treated at a tertiary center. Results:In total, 215 CAIRO5 patients were included. Baseline TTV and absolute change in TTV were significantly associated with early recurrence (P = 0.005 and P = 0.040, respectively) and OS in multivariable analyses (P = 0.024 and P = 0.006, respectively), whereas RECIST1.1 was not prognostic for early recurrence (P = 0.88) and OS (P = 0.35). In the validation cohort (n = 85), baseline TTV and absolute change in TTV remained prognostic for early recurrence (P = 0.041 and P = 0.021, respectively) and OS in multivariable analyses (P < 0.0001 and P = 0.012, respectively), and showed added prognostic value over conventional clinicopathological variables (increase C-statistic, 0.06; 95 % CI, 0.02 to 0.14; P = 0.008). Conclusion: Total tumor volume is strongly prognostic for early recurrence and OS in patients who underwent complete local treatment of initially unresectable CRLM, both in the CAIRO5 trial and the validation cohort. In contrast, RECIST1.1 did not show prognostic value for neither early recurrence nor OS.
UR - https://www.scopus.com/pages/publications/85196830712
U2 - 10.1016/j.ejca.2024.114185
DO - 10.1016/j.ejca.2024.114185
M3 - Article
C2 - 38924855
AN - SCOPUS:85196830712
SN - 0959-8049
VL - 207
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 114185
ER -
SDG 3 Good Health and Well-being