Abstract:
Objective: To evaluate the value of baseline computed tomography (CT) features and liver-function related biochemical indices in assessing the efficacy of immunotherapy for unresectable colorectal cancer liver metastases (CRLM). Methods: A retrospective analysis was conducted on 47 patients with CRLM and unresectable liver metastases who received immunotherapy at our hospital between November 2021 and August 2024. According to immunotherapy efficacy, patients were divided into a non-progressive group (n=20) and a progressive group (n=27). Baseline CT features, including the number of liver metastases, maximum lesion diameter, enhanced morphology, necrosis, venous-phase CT value, ratio of arterial- and venous-phase CT values to those of the corresponding aorta, and ratio of arterial- and venous-phase CT values to those of adjacent normal hepatic parenchyma, were measured and evaluated in all patients. Liver function indices and general clinical data were also collected. The \chi^2 test was used to compare qualitative data between the two groups, while the Independent-samples t-test was used for quantitative variables. Receiver operating characteristic (ROC) curve analysis was performed for statistically significant parameters to evaluate their predictive performance. Results: The number of liver metastases was significantly lower in the non-progressive group than in the progressive group (\chi^2 =6.810, P < 0.05). Serum aspartate aminotransferase (AST) levels were also significantly lower in non-progressive group than in progressive group (t=−2.530, P < 0.05). The area under the curve (AUC) for predicting disease progression was 0.699 for the number of intrahepatic metastases and 0.825 for AST level, with sensitivities of 71.0% and 87.5%, and specificities of 31.3% and 50.0%, respectively. Conclusion: The number of liver metastases and serum AST levels may serve as useful predictors of immunotherapy efficacy in patients with unresectable colorectal cancer liver metastases and may provide supportive evidence for clinical diagnosis and treatment decisions.