The Prognostic Utility Of Tumor Burden Score For Colorectal Liver Metastasis

Background: Liver is the main metastatic site of colorectal cancer(CRC),the major cause of death in patients as well.Nowadays the adequate treatments and strategy of multidisciplinary team increase the survival rate of patients.But part of patients underwent early recurrence after surgery and had poor prognosis.Therefore,how to choose appropriate patients with proper treatments is the important factor that improves the prognosis.Multiple research present the clinical scores to assess the tumor burden of patients and divid them to different individual groups.This study analyzed the prognostic utility of tumor burden score(TBS)retrospectively as well as the tumor burden score interval(TBSI)which is derived from the former in patients with colorectal liver metastasis.Material and Methods: This study retrospectively analyzed of 229 patients with colorectal liver metastasis who underwent hepatectomy and radiofrequency ablation in our center firstly during 2012-2018.And collect the clinical and pathological data,as well as the survival and recurrence data.Univariate log-rank analysis and multivariate Cox proportional hazards models were used to assess the independent risk factors that influenced the prognosis of survival and recurrence and metastasis.The survivorship curve were plotted by the Kaplan-Meier estimator.Finally,this study compared the TBSI with clinical risk score(CRS)for the predictive ability of prognosis.Results: The median survival time of 229 patients in this study was 49.6 months,and the 1-,3-,5-year survival rate was 91%,60%,45% respectively.The median disease-free survival time of these patients was 8 months,and the 1-,3-,5-year disease-free survival rate was 29%,13%,10% respectively.What influenced the prognosis of survival of patients with colorectal liver metastasis independently was CEA level ? 5 mg/m L,TBSI ? 9 to 49 and ?49.Meanwhile,T3-T4 stage,TBSI ? 9 to 49 and ?49 was the important risk factors for the prognosis of recurrence and metastasis.Patients whose TBSI declined after preoperative chemotherapy had better prognosis than those patients whose TBSI remained unchanged.Finally,TBSI had better predictive ability of prognosis than CRS.Conclusions: TBSI can predictive the prognosis of survival,recurrence and metastasis and its predictive power is superior to CRS.CEA level and TBSI influenced the prognosis of survival of patients independently,in the same time,T stage and TBSI are important risk factors for the prognosis of recurrence and metastasis.