1. The Prognostic Value of Total Tumor Volume Response Compared With RECIST1.1 in Patients With Initially Unresectable Colorectal Liver Metastases Undergoing Systemic Treatment
- Author
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Nina J. Wesdorp, MD, Karen Bolhuis, MD, Joran Roor, MSc, Jan-Hein T. M. van Waesberghe, MD, PhD, Susan van Dieren, MSc, PhD, Martin J. van Amerongen, MD, PhD, Thiery Chapelle, MD, PhD, Cornelis H. C. Dejong, MD, PhD, Marc R. W. Engelbrecht, MD, PhD, Michael F. Gerhards, MD, PhD, Dirk Grunhagen, MD, PhD, Thomas M. van Gulik, MD, PhD, John J. Hermans, MSc, MD, PhD, Koert P. de Jong, MD, PhD, Joost M. Klaase, MD, PhD, Mike S. L. Liem, MD, PhD, Krijn P. van Lienden, MD, PhD, I. Quintus Molenaar, MD, PhD, Gijs A. Patijn, MD, PhD, Arjen M. Rijken, MD, PhD, Theo M. Ruers, MD, PhD, Cornelis Verhoef, MD, PhD, Johannes H. W. de Wilt, MD, PhD, Rutger-Jan Swijnenburg, MD, PhD, Cornelis J. A. Punt, MD, PhD, Joost Huiskens, MD, PhD, Geert Kazemier, MD, PhD, and for the Dutch Colorectal Cancer Group Liver Expert Panel
- Subjects
Surgery ,RD1-811 - Abstract
Objectives:. Compare total tumor volume (TTV) response after systemic treatment to Response Evaluation Criteria in Solid Tumors (RECIST1.1) and assess the prognostic value of TTV change and RECIST1.1 for recurrence-free survival (RFS) in patients with colorectal liver-only metastases (CRLM). Background:. RECIST1.1 provides unidimensional criteria to evaluate tumor response to systemic therapy. Those criteria are accepted worldwide but are limited by interobserver variability and ignore potentially valuable information about TTV. Methods:. Patients with initially unresectable CRLM receiving systemic treatment from the randomized, controlled CAIRO5 trial (NCT02162563) were included. TTV response was assessed using software specifically developed together with SAS analytics. Baseline and follow-up computed tomography (CT) scans were used to calculate RECIST1.1 and TTV response to systemic therapy. Different thresholds (10%, 20%, 40%) were used to define response of TTV as no standard currently exists. RFS was assessed in a subgroup of patients with secondarily resectable CRLM after induction treatment. Results:. A total of 420 CT scans comprising 7820 CRLM in 210 patients were evaluated. In 30% to 50% (depending on chosen TTV threshold) of patients, discordance was observed between RECIST1.1 and TTV change. A TTV decrease of >40% was observed in 47 (22%) patients who had stable disease according to RECIST1.1. In 118 patients with secondarily resectable CRLM, RFS was shorter for patients with less than 10% TTV decrease compared with patients with more than 10% TTV decrease (P = 0.015), while RECIST1.1 was not prognostic (P = 0.821). Conclusions:. TTV response assessment shows prognostic potential in the evaluation of systemic therapy response in patients with CRLM.
- Published
- 2021
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