Hepatectomy v°ersus systemic therapy for liver-limited BRAF V600E-mutated colorectal liver metastases: multicentre retrospective study

被引：1

作者：

Margonis, Georgios Antonios ^{[1
]}

Wang, Jaeyun Jane ^{[2
]}

Boerner, Thomas ^{[1
]}

Moretto, Roberto ^{[3
]}

Buettner, Stefan ^{[2
]}

Andreatos, Nikolaos ^{[4
]}

Gagniere, Johan ^{[5
]}

Wagner, Doris ^{[6
]}

Loes, Inger Marie ^{[7
]}

Bergamo, Francesca ^{[8
]}

Pietrantonio, Filippo ^{[9
]}

Scartozzi, Mario ^{[10
]}

Spallanzani, Andrea ^{[11
]}

Vincenzi, Bruno ^{[12
]}

Antoniou, Efstathios ^{[13
]}

Pikoulis, Emmanouil ^{[13
]}

Sartore-Bianchi, Andrea ^{[14
,15
,16
]}

Stasinos, Georgios ^{[17
]}

Sasaki, Kazunari ^{[18
]}

Pawlik, Timothy M. ^{[19
]}

Orlandi, Armando ^{[20
]}

Pella, Nicoletta ^{[21
]}

Fitschek, Fabian ^{[22
]}

Kaczirek, Klaus ^{[22
]}

Dupre, Aurelien ^{[23
]}

Pozios, Ioannis ^{[24
]}

Beyer, Katharina ^{[24
]}

Kornprat, Peter ^{[6
]}

Aucejo, Federico N. ^{[4
]}

Burkhart, Richard ^{[2
]}

Weiss, Matthew J. ^{[25
]}

Lonning, Per Eystein ^{[7
]}

Poultsides, George ^{[17
]}

Cremolini, Chiara ^{[3
]}

Kreis, Martin E. ^{[24
]}

D'Angelica, Michael ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave, New York, NY 10065 USA

[2] Johns Hopkins Univ Sch Med, Dept Surg, Baltimore, MD USA

[3] Univ Pisa, Azienda Osped Univ Pisana, Dept Translat Res & New Technol Med & Surg, Unit Med Oncol, Pisa, Italy

[4] Cleveland Clin, Digest Dis Inst, Dept Gen Surg, Cleveland, OH USA

[5] Clermont Auvergne Univ Hosp Clermont Ferrand, Inserm, U1071, Dept Digest & Hepatobiliary Surg Liver Transplanta, Clermont Ferrand, France

[6] Med Univ Graz, Dept Gen Surg, Graz, Austria

[7] Univ Bergen, Haukeland Univ Hosp, Dept Clin Sci, Dept Oncol, Bergen, Norway

[8] IRCCS, Veneto Inst Oncol, Dept Oncol, Unit Med Oncol 1, Padua, Italy

[9] Fdn IRCCS Ist Nazl Tumori, Med Oncol Dept, Milan, Italy

[10] Univ Hosp Cagliari, Med Oncol, Cagliari, Italy

[11] Univ Hosp Modena, Dept Oncol & Haematol, Div Oncol, Modena, Italy

[12] Univ Roma, Dept Med Oncol, Campus Biomed, Rome, Italy

[13] Natl & Kapodistrian Univ Athens, Attikon Univ Gen Hosp, Sch Med, Dept Surg 3, Athens, Greece

[14] Univ Milan, Dept Oncol & Hematooncol, Milan, Italy

[15] Grande Osped Metropolitano Niguarda, Dept Hematol Oncol & Mol Med, Milan, Italy

[16] Grande Osped Metropolitano Niguarda, Div Clin Res & Innovat, Milan, Italy

[17] Tech Chamber Greece, Athens, Greece

[18] Stanford Univ, Sch Med, Dept Surg, Stanford, CA USA

[19] Ohio State Univ, Wexner Med Ctr, Dept Surg, Columbus, OH USA

[20] Fdn Policlin Univ Agostino Gemelli IRCCS, Comprehens Canc Ctr, Med Oncol Unit, Rome, Italy

[21] ASUFC Univ Hosp Udine, Dept Oncol, Udine, Italy

[22] Med Univ Vienna, Dept Gen Surg, Vienna, Austria

[23] Leon Berard Canc Ctr Lyon, Dept Surg, Lyon, France

[24] Charite Campus Benjamin Franklin, Dept Gen & Visceral Surg, Berlin, Germany

[25] Northwell Hlth Canc Inst, Zucker Sch Med Hofstra, New York, NY USA

来源：

BRITISH JOURNAL OF SURGERY | 2024年 / 111卷 / 07期

关键词：

CANCER; RESECTION; MUTATION; IMPACT; KRAS; SURVIVAL; SURGERY; SCORE;

D O I：

10.1093/bjs/znae176

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: To date, only two studies have compared the outcomes of patients with liver-limited BRAF V600E-mutated colorectal liver metastases (CRLMs) managed with resection versus systemic therapy alone, and these have reported contradictory findings. Methods: In this observational, international, multicentre study, patients with liver-limited BRAF V600E-mutated CRLMs treated with resection or systemic therapy alone were identified from institutional databases. Patterns of recurrence/progression and overall survival were compared using multivariable analyses of the entire cohort and a propensity score-matched cohort. Results: Of 170 patients included, 119 underwent hepatectomy and 51 received systemic treatment. Surgically treated patients had a more favourable pattern of recurrence with most recurrences limited to a single site, whereas diffuse progression was more common among patients who received systemic treatment (19 versus 44%; P = 0.002). Surgically treated patients had longer median overall survival (35 versus 20 months; P < 0.001). Hepatectomy was independently associated with better OS than systemic treatment alone (HR 0.37, 95% c.i. 0.21 to 0.65). In the propensity score-matched cohort, surgically treated patients had longer median overall survival (28 versus 20 months; P < 0.001); hepatectomy was independently associated with better overall survival (HR 0.47, 0.25 to 0.88). Conclusion: BRAF V600E mutation should not be considered a contraindication to surgery for patients with resectable, liver-only CRLMs.

引用

页数：9

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