Population-based patterns of systemic therapy use in liver-limited metastatic colorectal cancer (mCRC).
Bibliographic record
Abstract
576 Background: Treatment of liver-limited mCRC frequently involves systemic therapy and surgery. Our aims were to 1) explore the use and choice of systemic therapy pre- and post-liver resection and 2) examine if specific patient characteristics or therapy regimens were associated with improved outcomes. Methods: Patients diagnosed with liver-limited mCRC from 2006 to 2007 in British Columbia were reviewed. Summary statistics were conducted to describe surgical and systemic treatment patterns. Kaplan-Meier methodology was used to characterize the relationship between systemic regimen and overall survival (OS). Results: Among 374 patients, 42% were aged ≥70 years, 60% were men, 29/39/32% were ECOG 0/1/2+, 80% had primary tumor surgery, and 68% received prior adjuvant chemotherapy. For liver metastases, 95 (26%) were offered hepatic resection. Compared to those who did not receive surgery, resected patients were younger (median 60 vs. 69, p<0.01), better functioning (ECOG 0/1 86% vs. 55%, p<0.01), and had smaller (median 3 vs. 4 cm, p<0.03) and fewer (median 2 vs. 4, p<0.01) lesions. They also had improved median OS (11.0 vs. 9.4 months, p<0.01). Surgical patients having a solitary lesion (p=0.03) or a largest lesion ≤3 cm (p=0.02) experienced better survival. Performance status (HR=0.54, p=0.35), age (HR=0.47, p=0.30), and sex (HR=0.68, p=0.48) did not impact outcomes. Among patients who underwent hepatic resection, 80% received some form of chemotherapy (Table). Median OS did not differ significantly based on choice of chemotherapy: FOLFOX (13.9 months), FOLFIRI (11.5 months), and capecitabine (10.9 months) (p=0.44) or receipt of bevacizumab: yes (14.5 months) vs. no (11.1 months) (p=0.57). Conclusions: In this population-based cohort of liver-limited mCRC patients, hepatic resection was associated with improved survival. Among those offered some form of peri-operative therapy, FOLFOX, FOLFIRI, and capecitabine, either alone or in combination with bevacizumab, appear to be reasonable treatment options. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".