A previous cancer diagnosis can preclude patients from consideration for solid organ transplantation. Statistical models may improve candidate selection. We fitted statistical cure models and estimated 5-year cancer-specific survival (5yCSS) for colorectal cancer patients in the United States using registry data. The median cure probability at cancer diagnosis for patients in the general population was 0.67. Among 956 colorectal cancer patients who underwent solid organ transplantation, the median time since diagnosis was 6.3 years and the median 5yCSS at transplantation was 0.96. Patients with a 5yCSS below 0.90 had increased posttransplant cancer-specific mortality (hazard ratio 3.31, 95% CI 1.52-7.21). Compared with recently published guidelines, our models suggested shorter wait times for some groups of colorectal cancer patients (eg, stage IIA cancers) and longer wait times for others (stages IIB, IIIB, IIIC, IV). In conclusion, colorectal cancer patients undergoing solid organ transplantation had excellent prognoses, reflecting selection incorporating existing guidelines and clinical judgment. Nonetheless, 5yCSS probabilities estimated from cure models offer additional prognostic information for patients considered for transplantation and identify situations where current guidelines might be revised. We developed a web-based tool for clinicians to calculate 5yCSS probabilities for use in transplant evaluation for individual colorectal cancer patients (https://dceg.cancer.gov/tools/risk-assessment/calculator-of-colorectal-cancer-survival-probability).

中文翻译：

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结直肠癌患者的治愈模型、生存概率和实体器官移植


既往癌症诊断可能使患者无法考虑实体器官移植。统计模型可以改善候选人的选择。我们拟合了统计治愈模型，并使用登记数据估计了美国结直肠癌患者的 5 年癌症特异性生存期 （5yCSS）。普通人群患者癌症诊断的中位治愈概率为 0.67。在 956 例接受实体器官移植的结直肠癌患者中，诊断后的中位时间为 6.3 年，移植时的中位 5yCSS 为 0.96。5yCSS 低于 0.90 的患者移植后癌症特异性死亡率增加 （风险比 3.31,95% CI 1.52-7.21）。与最近发布的指南相比，我们的模型建议某些结直肠癌患者群体（例如，IIA 期癌症）的等待时间更短，而其他群体（IIB、IIIB、IIIC、IV 期）的等待时间更长。总之，接受实体器官移植的结直肠癌患者预后良好，反映了结合现有指南和临床判断的选择。尽管如此，根据治愈模型估计的 5yCSS 概率为考虑移植的患者提供了额外的预后信息，并确定了当前指南可能修订的情况。我们为临床医生开发了一种基于 Web 的工具，用于计算用于个体结直肠癌患者移植评估的 5yCSS 概率 （https://dceg.cancer.gov/tools/risk-assessment/calculator-of-colorectal-cancer-survival-probability。