Performance of two prognostic scores that incorporate genetic information to predict long-term outcomes following resection of colorectal cancer liver metastases: An external validation of the MD Anderson and JHH-MSK scores

Kazunari Sasaki, Johan Gagnière, Aurélien Dupré, Victoria Ardiles, Juan Manuel O'Connor, Jaeyun Wang, Amika Moro, Daisuke Morioka, Stefan Buettner, Laurence Gau, Mathieu Ribeiro, Doris Wagner, Nikolaos Andreatos, Inger Marie Løes, Fabian Fitschek, Klaus Kaczirek, Per Eystein Lønning, Peter Kornprat, George Poultsides, Carsten KamphuesKatsunori Imai, Hideo Baba, Itaru Endo, Choon Hyuck David Kwon, Federico N. Aucejo, Eduardo de Santibañes, Martin E. Kreis, Georgios Antonios Margonis

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Introduction: Two novel clinical risk scores (CRS) that incorporate KRAS mutation status were developed: modified CRS (mCRS) and GAME score. However, they have not been tested in large national and international cohorts. The aim of this study was to validate the prognostic discrimination utility and determine the clinical usefulness of the two novel CRS. Methods: Patients undergoing hepatectomy for CRLM (2000-2018) in 10 centers were included. The discriminatory abilities of mCRS, GAME, and Fong CRS were evaluated using Harrell's C-index and Akaike's Information Criterion. Results: In the entire cohort, the C-index of the GAME score (0.61) was significantly higher than those of Fong score (0.57) and mCRS (0.54), while the C-Index of mCRS was significantly lower than that of Fong score. When we compared the models in the various geographical regions, the C-index of GAME score was significantly higher than that of mCRS in North America, Europe, and South America. The AIC of Fong score, mCRS, and GAME score were 14 405, 14 447, and 14 319, respectively. Conclusion: In conclusion, using the largest and most heterogenous population of CRLM patients with known KRAS status, this independent, external validation demonstrated that the GAME score outperforms both the traditional Fong score and mCRS.

Original languageEnglish
Pages (from-to)581-592
Number of pages12
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume28
Issue number7
DOIs
StatePublished - Jul 2021

Keywords

  • KRAS
  • clinical risk score
  • colorectal liver metastases
  • hepatectomy
  • long-term outcome

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