Metastasectomy and BRAF mutation; an analysis of survival outcome in metastatic colorectal cancer

被引：18

作者：

Prasanna, Thiru ^{[1
,2
,3
]}

Wong, Rachel ^{[4
,5
,6
]}

Price, Timothy ^{[7
,8
]}

Shapiro, Jeremy ^{[9
]}

Tie, Jeanne ^{[4
,10
,11
]}

Wong, Hui-Li ^{[4
]}

Nott, Louise ^{[12
,13
]}

Roder, David ^{[14
,15
]}

Lee, Margaret ^{[4
,5
]}

Kosmider, Suzanne ^{[10
]}

Jalali, Azim ^{[4
,10
]}

Burge, Matthew ^{[16
]}

Padbury, Robert ^{[17
,18
]}

Maddern, Guy ^{[19
]}

Carruthers, Scott ^{[20
]}

Moore, James ^{[21
]}

Sorich, Michael ^{[22
]}

Karapetis, Christos S. ^{[17
,23
]}

Gibbs, Peter ^{[4
,10
]}

Yip, Desmond ^{[1
,2
]}

机构：

[1] Canberra Hosp, Dept Med Oncol, Yamba Dr, Garran, ACT 2605, Australia

[2] Australian Natl Univ, ANU Med Sch, Canberra, ACT, Australia

[3] Univ Canberra, Canberra, ACT, Australia

[4] Walter & Eliza Hall Inst Med Res, Melbourne, Vic, Australia

[5] Eastern Hlth, Dept Med Oncol, Melbourne, Vic, Australia

[6] Monash Univ, Fac Med Nursing & Hlth Sci, Melbourne, Vic, Australia

[7] Queen Elizabeth Hosp, Adelaide, SA, Australia

[8] Univ Adelaide, Adelaide, SA, Australia

[9] Cabrini Haematol & Oncol Ctr, Melbourne, Vic, Australia

[10] Western Hosp, Dept Med Oncol, Melbourne, Vic, Australia

[11] Peter MacCallum Canc Ctr, Dept Med Oncol, Melbourne, Vic, Australia

[12] Royal Hobart Hosp, Dept Med Oncol, Hobart, Tas, Australia

[13] Menzies Res Inst, Hobart, Tas, Australia

[14] South Australian Hlth & Med Res Inst SAHMRI, Adelaide, SA, Australia

[15] Univ South Australia, Adelaide, SA, Australia

[16] Royal Brisbane Hosp, Dept Med Oncol, Brisbane, Qld, Australia

[17] Flinders Univ S Australia, Bedford Pk, SA, Australia

[18] Flinders Med Ctr, Dept Surg, Bedford Pk, SA, Australia

[19] Univ Adelaide Discipline Surg, QueenElizabeth Hosp, Adelaide, SA, Australia

[20] Royal Adelaide Hosp, Dept Radiat Oncol, Adelaide, SA, Australia

[21] Royal Adelaide Hosp, Dept Surg, Adelaide, SA, Australia

[22] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA, Australia

[23] Flinders Med Ctr, Dept Med Oncol, Bedford Pk, SA, Australia

来源：

CURRENT PROBLEMS IN CANCER | 2021年 / 45卷 / 01期

关键词：

Metastasectomy; Metastatic colorectal cancer; BRAF V600E mutation; Survival; HEPATIC RESECTION; PERITONEAL CARCINOMATOSIS; LIVER METASTASES; RAS MUTATIONS; SURGERY; IMPACT; HIPEC; KRAS;

D O I：

10.1016/j.currproblcancer.2020.100637

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Resection of oligometastases improves survival in metastatic colorectal cancer (mCRC). It is unclear whether the benefit is consistent for BRAF V600E mutant (MT) and wild type (WT) mCRC. This retrospective analysis explores the influence of BRAF MT on survival after metastasectomy. Methods: Overall survival (OS) and recurrence-free survival (RFS) for BRAF MT and WT mCRC were evaluated. Survival was also analyzed in the cohort of BRAF MT with or without metastasectomy. Results: Five hundred and thirteen patients who had undergone metastasectomy were identified, 6% were BRAF-MT. Median age 63. Median OS in BRAF MT vs WT: 25.7 vs 48.5 months (hazard ratio [HR] 1.95; 1.18-3.22). However, difference was not significant in a multivariate model. Right primary tumor, intact primary, > 1 metastatic site, non R0 resection, peritoneal metastasis, and synchronous metastasis were independent predictors of worse OS. Among 364 patients with RFS data there was no difference between BRAF MT and WT (16 vs 19 months, p = 0.09). In another cohort of 158 BRAF-MT patients, OS was significantly better after metastasectomy compared to "no metastasectomy" (HR 0.34; 0.18-0.65, P = 0.001). Proficient mismatch repair status showed a trend toward worse survival after metastasectomy in BRAF MT (HR 1.71, P = 0.08). Conclusion: OS did not differ after metastasectomy between BRAF MT and WT in a multivariate model. Median OS was > 2 years in this study after metastasectomy among BRAFV600E MT patients suggesting a survival benefit of metastasectomy in this group where systemic therapeutic options are limited. Metastasectomy may be considered in carefully selected BRAF-MT patients. (c) 2020 Elsevier Inc. All rights reserved.

引用

页数：9

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