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。
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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.
期刊最新文献
Calendar of events Editorial Board Reply to: “Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy” Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy Letter to the editor: “Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma”
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