A phase II multicenter study of metastasectomy for intra- and extra-hepatic metastases from colorectal cancer.
Bibliographic record
Abstract
482 Background: Metastasectomy for liver limited metastases from colorectal cancer (CRC) provides excellent 5-year overall survival (OS) rates. The presence of extra-hepatic metastases (EHM) has traditionally been a contraindication to surgery. On this basis, as many as 80% of patients are deemed ineligible for liver resection. Due to the improved safety of hepatic surgery, there is a growing interest in multi-site metastasectomy for patients with intra-hepatic and extra-hepatic metastases (IHM, and EHM). The objective of this study was to evaluate the results of complete metastasectomy for patients with IHM and EHM from CRC. Methods: A phase II study of metastasectomy for both IHM and EHM from CRC was conducted at 2 high volume hepato-pancreato-biliary (HPB) centers. Eligible patients with any number resectable IHM and up to 3 foci of EHM, resectable with RO intent were offered metastasectomy. Clinical and survival data was analyzed using standard statistical methods. Results: Twenty-five patients were enrolled with a median age of 57 (32-84) years; 14/25 (56%) patients presented with synchronous disease. The median number of IHM, EHM and combined sites were 2, 1 and 3, respectively. The lung was the most common site of EHM (12/25, 48%). Protocol surgery was completed in 18/25 (72%) including 11/25 (44%) planned sequential resections. Perioperative morbidity and mortality was 11/25 (44%) and 1/25 (4%), respectively. The median disease free survival was 6 months. The median OS from the time of CRC diagnosis, first metastasectomy and completion metastasectomy was 47, 27 and 23 months, respectively. Conclusions: Complete metastasectomy of multi-site CRC is feasible and safe. However, disease will recur in the majority of patients. The impact to aggressive multi-site metastasectomy is modest but may provide OS benefit in selected patients.
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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 | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".