Evidence map›Paper›PMID 41842895›Full record

Trial reportJAMA network open2026

Time of Detection of Liver Metastases and Survival in Patients With Colorectal Cancer.

Ruby Kemna, Hannah H Schulz, Mahsoem Ali, Madelon Dijkstra, Susan van der Lei, Marinde J G Bond, Cornelis J A Punt, Inez M Verpalen, Tineke E Buffart, Rutger-Jan Swijnenburg and 2 more

Abstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ruby KemnaAmsterdam University Medical Center, Department of Surgery, VU University, Amsterdam, the Netherlands.
Hannah H SchulzCancer Center Amsterdam, the Netherlands.
Mahsoem AliAmsterdam University Medical Center, Department of Surgery, VU University, Amsterdam, the Netherlands.
Madelon DijkstraCancer Center Amsterdam, the Netherlands.
Susan van der LeiCancer Center Amsterdam, the Netherlands.
Marinde J G BondUniversity Medical Centre Utrecht, Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, the Netherlands.
Cornelis J A PuntUniversity Medical Centre Utrecht, Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, the Netherlands.
Inez M VerpalenCancer Center Amsterdam, the Netherlands.
Tineke E BuffartCancer Center Amsterdam, the Netherlands.
Rutger-Jan SwijnenburgAmsterdam University Medical Center, Department of Surgery, VU University, Amsterdam, the Netherlands.
Geert KazemierAmsterdam University Medical Center, Department of Surgery, VU University, Amsterdam, the Netherlands.
Martijn R MeijerinkCancer Center Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Colorectal cancer liver metastases (CRLM) are a common manifestation of colorectal cancer, and clinical decision-making for these patients is complex. The timing of CRLM detection, defined as synchronous, early metachronous, or late metachronous, is hypothesized to influence survival outcomes, but the prognostic implications of these classifications remain unclear. Objective: To determine whether the timing of CRLM detection is associated with overall survival (OS) in patients with up-front locally treatable or initially nonlocally treatable CRLM. Design, Setting, and Participants: Multicenter cohort study including adult patients from the Amsterdam Colorectal Liver Met Registry and the phase 3 CAIRO5 trial between 2000 and 2024, with analyses conducted from March 2025 to January 2026. Patients were followed up for a median (IQR) of 44 (41-48) months. Survival outcomes were analyzed using multivariable Cox regression models. Inclusion criteria were up-front locally treatable or initially nonlocally treatable CRLM, with key clinical and demographic characteristics recorded. Exposure: Timing of CRLM detection categorized as synchronous (detected before or at primary CRC diagnosis or during surgery), early metachronous (within 12 months of diagnosis or surgery), or late metachronous (more than 12 months after surgery), according to European-African Hepato-Pancreato-Biliary Association consensus guidelines. Main Outcomes and Measures: OS from diagnosis of CRLM, stratified by CRLM timing and treatment received. Multivariable analysis accounted for tumor number, size, variant status, carcinoembryonic antigen levels, and treatment strategy. Results: A total of 1250 patients were included (median [IQR] age, 63 [56-72] years; 823 [65.9%] men), of whom 817 (65%) had synchronous CRLM, 208 (17%) early metachronous CRLM, and 225 (18%) late metachronous CRLM. Among all patients, 676 (54%) died during follow-up. Synchronous CRLM were associated with worse OS compared with early metachronous CRLM (hazard ratio [HR], 0.79; 95% CI, 0.64-0.97) and late metachronous CRLM (HR, 0.54; 95% CI, 0.43-0.68). After adjustment for tumor and treatment factors, timing of detection of CRLM was not independently associated with OS. Conclusions and Relevance: In this retrospective multicenter cohort study, timing of CRLM detection was not associated with OS when accounting for tumor characteristics and treatment strategy. These findings suggest that synchronicity may primarily reflect underlying tumor biology rather than directly influencing survival, emphasizing that clinical decisions should focus on synchronicity in combination with tumor burden, variant status, and local treatment.

Indexed as

Colorectal NeoplasmsLiver NeoplasmsAgedCohort StudiesFemaleHumansMaleMiddle AgedPrognosisSurvival AnalysisTime Factors

Identifiers

PMID41842895
PMCPMC13446806

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.