Tool Estimates Colorectal Cancer Survival for Patients in Need of Organ Transplantation
, by Jennifer K. Loukissas, M.P.P.
Organ transplantation can enable long-term survival for patients with end-stage organ disease. Whether a patient can be safely placed on the transplant waitlist depends on many factors including co-morbid medical conditions, such as cancer, that would make transplantation high-risk or of limited benefit to the patient. Compared with recent guidelines for evaluation of transplant candidates, a new statistical model suggests shorter wait times for some groups of patients with a history of colorectal cancer and longer wait times for others. These results and the model that generated them were published online on September 5, 2024, in the American Journal of Transplantation.
Colorectal cancer is a common malignancy among people considered for organ transplantation. To select patients for transplantation, clinicians seek to identify individuals who have an acceptably low risk of recurrence or death from their cancer. Current guidelines for someone with a history of cancer are based on limited evidence and depend instead on expert opinion.
The research team, led by Eric A. Engels, M.D., M.P.H., Director, Infections and Immunoepidemiology Branch, developed and validated statistical cure models tailored to colorectal cancer and applied them to U.S. patients undergoing solid organ transplantation during 1991-2019 using data from the Transplant Cancer Match Study.
The Calculator of Colorectal Cancer Survival Probability estimates the probability that a colorectal cancer patient will survive their cancer over the next five years, from the time of diagnosis or at any point following diagnosis. The probability incorporates readily available demographic and clinical information and can be used for evaluation of individual patients. In contrast to current clinical guidelines, results from the calculator suggest shorter wait times for patients with stage IIA colorectal cancers and longer wait times for stages IIB, IIIB, IIIC, IV. For other stages, the model results match current guidelines.
The authors note the intended users of this tool are clinical researchers and clinicians in cancer treatment and organ transplantation. The tool may also be useful for cancer clinicians outside the field of transplantation who are seeking accurate prognostic information for their patients with colorectal cancer.
Reference
Engels EA et al. Cure models, survival probabilities, and solid organ transplantation for patients with colorectal cancer. Am J Transplant. 2024.