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Treatment Patterns and Prognostic Nomograms for Overall Survival and Hepatic Progression-Free Survival in Unresectable Colorectal Liver Metastases Treated with Drug-Eluting Bead Chemoembolization: A Single-Center Study
by
and
Ketong Wu
1,2,†, 
Haiyang Chen
2,3,†,
Dan Li
1,2,
Yuan Wan
1,2,
Weiyao Li
2,3,* and
Bo Zhang
1,2,* 1
Department of Interventional Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
2
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
3
Department of Radiotherapy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Curr. Oncol. 2026, 33(9), 497; https://doi.org/10.3390/curroncol33090497 (registering DOI)
Submission received: 7 July 2026
/
Revised: 14 August 2026
/
Accepted: 20 August 2026
/
Published: 22 August 2026
(This article belongs to the Topic Metastatic Colorectal Cancer: From Laboratory to Clinical Studies, 2nd Edition)
Simple Summary
About half of people with colorectal cancer develop liver metastases, and for many the disease cannot be removed surgically. One option delivers chemotherapy directly into the liver tumors using drug-eluting beads (DEB-TACE), but how long individual patients benefit varies widely, and clinicians have lacked simple tools to estimate prognosis. In this single-center study of 63 such patients, two routinely available measures—namely, the number of liver tumors and the blood level of carcinoembryonic antigen (CEA) together with its early change after treatment—captured much of the variation in outcome. We combined these factors into easy-to-use charts (nomograms) that translate them into individualized estimates of overall survival and of the time before the liver disease progresses, which sorted patients into risk groups with markedly different outcomes. These tools could help clinicians discuss prognosis, identify higher-risk patients who might benefit from more intensive systemic therapy or closer monitoring, and support shared decision-making. Because the study was small and single-center, the tools require validation in larger, independent cohorts before routine use.
Abstract
(1) Background: Drug-eluting bead transarterial chemoembolization (DEB-TACE) is increasingly used for unresectable colorectal liver metastases (CRLM), yet individualized prognostic tools are lacking. We developed and internally validated nomograms predicting overall survival (OS) and hepatic progression-free survival (hPFS). (2) Methods: In this single-center retrospective cohort, reported per the TRIPOD guideline, OS and hPFS were estimated by Kaplan–Meier methods, and independent predictors from multivariable Cox regression were assembled into nomograms. Internal validation combined 1000-sample bootstrap optimism-corrected concordance indices (C-index), a uniform shrinkage factor, a bootstrap calibration slope, and a LASSO–Cox sensitivity analysis. (3) Results: Among 63 patients (44 deaths; 42 intrahepatic-progression events), median OS was 10.9 months and median hPFS was 5.8 months. Independent OS predictors were baseline CEA, high liver tumor burden (≥10 lesions), CEA decline (protective), and second-line-or-beyond interventional therapy (corrected C-index: 0.796). Independent hPFS predictors were high liver tumor burden, CEA decline, and age (corrected C-index: 0.718). Nomogram-defined high-risk groups had markedly shorter OS (5.3 vs. 22.8 months) and hPFS (3.3 vs. 8.6 months; both p < 0.001). Grade ≥3 toxicity occurred in 6%. (4) Conclusions: In real-world DEB-TACE-treated CRLM, liver tumor burden and CEA dynamics dominated prognosis; the internally validated nomograms provide individualized estimates and risk stratification, pending external validation.
