Objective:

To validate the prognostic value of Immunoscore (IS) between primary tumors and corresponding liver metastases in colorectal cancer liver metastasis (CRLM) after liver resection, specifically focusing on the differences in prognostic outcomes.

Key Findings:

• IS of liver metastases is a more reliable prognostic indicator than IS of primary tumors for CRLM patients post-hepatectomy, suggesting a need for revised prognostic models.
• High IS in liver metastases correlates with improved overall survival (OS) and disease-free survival (DFS), indicating its potential as a key biomarker.
• Current clinical risk scores do not fully account for survival discrepancies among CRLM patients, highlighting the limitations of existing prognostic tools.

Interpretation:

The findings suggest that profiling the immune microenvironment in liver metastases provides better prognostic information than analyzing primary tumors, underscoring the necessity for tailored approaches in CRLM management to improve patient outcomes.

Limitations:

• Limited external validation of some clinicopathological factors and biomarkers, which may restrict the applicability of findings.
• Variability in study designs and patient populations may affect generalizability, necessitating cautious interpretation of results.
• Potential publication bias in the included studies could skew the overall conclusions drawn from the meta-analysis.

Conclusion:

The Immunoscore of liver metastases should be prioritized in prognostic assessments for CRLM, as it offers significant insights into patient outcomes post-surgery.