Systematic review and meta-analysis of prognostic models for recurrence after colorectal liver metastases treatment

Postoperative circulating tumor DNA positivity was the strongest predictor of recurrence after curative treatment of colorectal liver metastases (HR 4.78), a meta-analysis of 293 studies finds.

• External validation was uncommon (33/293 studies), and heterogeneous reporting limited clinical translation.
• Imaging-based models represented only 19 studies with small cohorts and conventional regression pipelines.
• Other strong predictors: postoperative CEA >5 ng/mL (HR 2.79), poor RECIST response (HR 2.76), and positive resection margins (HR 1.73).

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