Colorectal Cancer Liver Metastasis
Conditions
Keywords
colorectal cancer liver metastasis, deep learning, multimodal, predictive model
Brief summary
This is a prospective, multicenter, observational study designed to validate the predictive accuracy of a pre-developed multimodal deep learning model. The model integrates preoperative contrast-enhanced CT scans, digitized postoperative pathology images, and standard clinical data to estimate the risk of liver metastasis within two years after curative surgery in patients with stage I-III colorectal cancer. The primary objective is to evaluate the model's performance in an independent, prospectively enrolled patient cohort. Participants will receive standard-of-care treatment according to clinical guidelines. The study involves no experimental interventions; it solely involves the collection and analysis of routinely generated clinical data. The goal is to assess the model's potential for clinical translation by providing a reliable tool for stratifying patients' risk of liver metastasis, which could inform personalized surveillance strategies.
Interventions
This is a non-therapeutic, prognostic study. The intervention under investigation is the application of a pre-specified multimodal deep learning model that integrates preoperative CT imaging, digital pathology, and clinical data to stratify patients' risk of developing metachronous liver metastasis. This model functions as a prognostic tool and is not used to guide patient management in this study. Its performance is being evaluated prospectively against the actual clinical outcomes.
Sponsors
Study design
Eligibility
Inclusion criteria
* Age 18-75 years, any gender. * Clinical diagnosis of primary colon or rectal adenocarcinoma (Stage I-III). Scheduled to undergo curative radical resection for colorectal cancer. * Preoperative contrast-enhanced abdominal/pelvic CT scan performed within 1 month before surgery, with acceptable image quality. * No evidence of distant metastasis (including synchronous liver metastasis) on preoperative examination. * ECOG Performance Status of 0 or 1. * Patient or their legal representative voluntarily participates and provides written informed consent.
Exclusion criteria
* Postoperative pathological confirmation of non-primary colorectal adenocarcinoma or presence of distant metastasis. * Intraoperative determination of non-R0 resection, or performance of palliative surgery/ostomy only. * History of other malignant tumors. * Previous history of liver surgery or liver transplantation. * Death within the perioperative period (within 30 days after surgery). * Refusal to participate in follow-up, withdrawal of informed consent, or loss to follow-up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Receiver Operating Characteristic Curve (AUC) | 2 years after surgery | The discriminatory performance of the pre-specified multimodal deep learning model for predicting the occurrence of metachronous liver metastasis within 2 years after curative resection. The model integrates preoperative contrast-enhanced CT, digital pathology, and clinical data. Performance is evaluated on the entire prospectively enrolled validation cohort. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Liver Metastasis-Free Survival (LMFS) by Risk Group | From the date of surgery until the date of first documented liver metastasis or last follow-up, assessed up to 3 years. | The difference in liver metastasis-free survival between the high-risk and low-risk groups, as stratified by the model. LMFS is defined as the time from surgery to the first radiological diagnosis of liver metastasis. |
Countries
China