Validation of tumor burden score as a prognostic factor in colorectal cancer liver metastases patients: a retrospective analysis.

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.