Can we Predict 5-Year Metastasis-Free Survival After Surgery?

Added: 2026-06-02

[00:00:00]I think oncologic outcomes are important because that's the reason why we're doing this, right? So, that's one of the biggest reasons.

[00:00:06]Obviously, it's to reduce the risk of immediate embolism from the thrombus, but second is to hopefully [music] cure these patients. And if you're non-metastatic and you have a tumor thrombus, you certainly do have a risk of long-term progression-free survival.

[00:00:20]On average, there is, I would say, a 50% [music] metastasis-free survival in the 5-year range, on average. I just like rough numbers, and so that's that's a rough number to to think [music] about.

[00:00:32]You could use many models to risk stratify patients for post-operative metastasis. [music] And there's the Shurnomogram, there's the Leibowitz score, which we developed at Mayo, there's >> [music] >> the UCLA staging system, there's there's many many nomograms. But, looking at thrombuses or thrombi in particular, thrombi all tend [music] to, in general, be bigger tumors. They tend to have be clear cell, like we talked about, and they they have a higher rate of adverse pathologic features, like [music] higher grade, necrosis. And so, we recently looked at our data to create our thrombus-specific nomogram using Mayo internal data, and we validated this with Johns Hopkins data with Nirmal Singla and >> [music] >> University of Wisconsin data with Dan Shapiro and Jason Abel. And >> [music] >> we call this model the tennis nomogram, and that's because we basically [music] found four risk factors: thrombus extent, necrosis, nodal involvement, and sarcomatoid features. Those four risk factors had an [music] AUC of roughly 0.7-0.74 in discriminating between patients who, you know, would or would not metastasize. [music]