Oncologist: Professor Xu Jianmin found that CERR scores can better assess relapse after liver metastasis of colorectal cancer

At present, surgical removal is the most important milestone in the treatment of colon cancer liver metastasis, 5 years of survival can reach more than 50%difficulties of rectal liver metastasis surgery to remove:(1) is the simultaneous removal or phased excision?existing studies support phased excision in patients with high-risk factors(2) surgery chose whether anatomically invasive liver or non-anatomically partial excisionour team's research shows that anatomical liver excision is of little significance and supports local excision that preserves the essence of the liver as much as possibleProfessor Xu Jianmin's team analyzed data on 787 adult patients treated with CRLM liver resection at Sun Yat-sen Hospital affiliated with Fudan University between June 2010 and January 2018, with tumor recurrence-free survival rate (RFS) as its main prognostic indicatorUsing the geometric algorithm, the improved TBS (mTBS) is established by using the parameters of CRLM size, CRLM number and single/double leaf transfer, and the results show that the mTBS model predicts that RFS is superior to the TBS model (AUC: 0.62 vs0.54, P.002) in 33 monthsfurther, combined mTBS with 4 other factors as a preoperative predictor, established a CERR score that included 5 preoperative factors predicting RFS: (1) KRAS/NRAS/BRAF mutation (1 point), (2) primary nodule positive (1 point) (3) liver disease (1 point), (4) CEA level of 200 ng/ml or CA19 to 200 U/ml (1 point), (5) mTBS between 5 to 11 (1 point), 12 to 12 (2 points)divided patients who received CRLM liver excision according to CERR score: 9.77% of 3 yearRFS in the high-risk group (CERR score of 4 points), 21.96% RFS for 3 years in the mid-critical group (CERR score 2 to 3 points), and 3 years rfS for the low-risk group (CERR score 0-1) for 3 yearsBootstrap validation showed that the ability to distinguish CERR scores was significantly better than Fong's clinical risk score and genetic morphological evaluation (GAME) scoreImproved TBS can be replicated, and CERR scoring is a powerful predictive tool that can help make the best clinical decisionsRisk assessment is a combination of clinical risk factors for colon liver metastasis and genetic risk factors, more accurate and effective than a simple CS scoreIts efficacy and guiding significance are more clinicalapplication of mTBS model: colorectal cancer liver metastasis tumor load score (mTBS) online use CERR model: colorectal cancer liver metastasis recurrent risk comprehensive assessment score (CER ScoreR) Professor Xu Jianmin is currently the director of colorectal surgery at Sun Yat-sen Hospital affiliated with Fudan University members of the Expert Group on Early Diagnosis and Treatment of Colorectal Cancer, members of the Expert Group of the Ministry of Health on the Diagnosis and Treatment of Colorectal Cancer and the Code for the Diagnosis and Treatment of Colorectal Cancer, members of the Colorectal Cancer Professional Committee of the Chinese Cancer Association, as well as members of the Colorectal Cancer Hepatosotic And Hereditary Colorectal Cancer Group, experts from the National Nature Foundation and the Shanghai Science and Technology Commission Fund, and members of the Colorectal Cancer Center of the Shanghai Center for Disease Control Editor-in-Chief of the Chinese Journal of Gastroenterology, the Chinese Journal of Cancer, the Journal of Oncology Research and Clinical Research and The Journal of Digestive Oncology Special review experts from the Chinese Journal of Surgery and the Chinese Journal of Clinical Medicine