EORTC1527/JCOG1609INT/ESSO02: Diffusion-weighted magnetic resonance imaging (DW-MRI) assessment of initially unresectable liver metastasis to improve surgical planning (DREAM)—Primary analysis.

• DOI: 10.1200/jco.2025.43.4_suppl.257
• Publication Date: 2025-01-27T14:33:47Z
• Authors: Kozo Kataoka; Murielle E. Mauer; Manabu Shiozawa; Sandrine Marreaud; Yoji Kishi; Jedelyn Cabrieto; Hiroaki Onaya; Michel Pierre Duc...; Takeshi Suto; Hyunseon Kang; Nobuhisa Matsuhashi; Alice Fung; Masayoshi Yasui; Michel Rivoire; Toru Tonooka; Roberto Troisi; Kenichi Nakamura; Stefan Staettner; Yukihide Kanemitsu; Serge Evrard
• Keywords: Surgical Planning

257 Background: Disappearing liver metastases (DLMs) diagnosed on post-chemotherapy (Cx) computed tomography (CT) is a favorable prognostic factor in patients (pts) with colorectal (CRLM). However, the optimal treatment of DLMs - whether they should be resected or left behind controversial. This prospective, multi-centred, international study examining added value MRI (DWI, T1/T2 and contrast-enhanced) to that CT alone accurate assessment viability DLMs. Methods: Pts initially unresectable CRLM downstaged planned resection after Cx were enrolled, based obligatory decision multidisciplinary team. imaged by both at baseline presurgical timepoints. defined as disappeared lesions alone, while confirmed (cDLMs) MRI. cDLMs either followed-up for 2 years if not resected. All imaging scans collected centrally quality assurance. The primary endpoint was negative predictive (NPV) confirming status using pathological complete response absence local recurrence site during year follow up. aimed excluding NPV ≤0.85 1-sided alfa 5% power 90% under alternative ≥0.95. sample size 92 evaluable (resected behind) cDLMs, assuming within-patient correlation between 0.2 an average number per pt. Results: 233 pts registered 22 participating centres, 112 enrolled analysis. A median 8 cycles delivered, had 7 CRLMs baseline. total 203 identified 296. Of these, 152 227 DLMs, respectively, according protocol. Intraoperative ultrasound performed 195 and, 59 (30.2%) still detected. rate R0/R1 95.5%. 62.5 % (95/152, 95% CI:50.8-74.2), which lower than prespecified threshold. 52.9% (119/227, CI:42.7, 63.0). those 56.8% (50/88, CI: 44.2, 69.5) 70.3% (45/64, 48.6 -92.0), respectively. For 45.6% (72/158, 35.4-55.7) 69.6% (48/69, 47.7-91.5), Conclusions: CRLM, do correspond tumor viability, even highly effective chemotherapy. Ongoing survival analysis (to presented annual meeting) may impact strategy Clinical trial information: NCT02781935 .