Work

Tumor burden in patients with colorectal liver metastasis undergoing hepatectomy: A head-to-head comparison of four prognostic systems

Year: 2026

Type: article

Abstract: OBJECTIVE: This study aimed to make a direct comparison of four tumor burden-related prognostic systems in predicting prognoses in patients with colorectal liver metastasis (CRLM) undergoing hepatectomy. METHODS: Clinicopathological and survival data of 197 consecutive CRLM patients were extracted from a public database. Clinical Risk Score-derived N1S5 (lesion number of 1 and the largest size of 5 cm are cutoffs for risk stratification), tumor burden score (TBS), modified TBS (mTBS) and total tumor volume (TTV) were calculated, and patients were stratified to different risk groups. Kaplan-Meier plots were adopted to depict the survival probabilities. Cox regression analyses were performed to evaluate the association between these systems and overall survival (OS) and disease-free survival (DFS). RESULTS: N1S5 and TTV systems effectively stratified patients into distinct risk groups with significantly different OS and DFS (p < 0.05), but TBS and mTBS did not. Multivariable Cox regression analysis demonstrated N1S5 and TTV as independent variables associated with OS (HRs: 1.43 to 1.97, 1.59 to 1.76, respectively) and DFS (HRs: 1.34 to 2.09, and 1.80 to 2.51, respectively) (p < 0.05). Compared with the other three systems, TTV showed a relatively higher time-dependent area under the curve (median: 0.60) and C-index (median: 0.64) for predicting OS. N1S5 had the highest C-index (median: 0.63) for predicting DFS. CONCLUSION: Total tumor volume seems to be a robust and effective tool for risk stratification and prognosis prediction in CRLM patients undergoing liver resection. N1S5 may provide a pragmatic simplified alternative to total tumor volume for prognostic prediction.

Source: European Journal of Radiology

DOI: 10.1016/j.ejrad.2026.112811

Authors: Yicheng Jiang, Nianzhou Liu, Yunhua Tan, Dongqin Zhao, Guojie Bai, Qiang Wang

Institutions: The Affiliated Yongchuan Hospital of Chongqing Medical University, Tianjin Beichen Hospital, Karolinska Institutet

Language: English

Topic: Colorectal Cancer Treatments and Studies

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,440