The role of molecular biomarkers in outcomes and patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases of colorectal origin
Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is effective in select patients with peritoneal metastases of colorectal (CRC) origin. The impact of different biomarkers in predicting recurrence after CRS/HIPEC is unclear.
METHODS: Retrospective review of patients who underwent CRS/HIPEC for PC of CRC origin from 03/2007-08/2017. Molecular profile of the primary tumor was obtained from pathology reports, whenever available.
RESULTS: Overall, 100 patients underwent CRS/HIPEC for peritoneal metastases of CRC origin. Most patients presented high grade tumor histology (G2/G3, n = 97, 97%), and a majority showed mucinous features (n = 61, 61%). At a median follow-up of 18 months, median DFS for the overall population was 13 months (95% CI 9.6, 16.4). Data reporting at least one mutational analysis was available in 64 patients. Microsatellite stability was detected in 42/50 (84%) patients, mKRAS in 25/51 (49%), and mBRAF in 5/35 (14.3%). On Kaplan-Meier analysis, BRAF was the only mutation associated with poor DFS (16 months, CI 95% 11.7-43.3 vs. 7 months, CI 95% 2.1-11.9, p = .008). On multivariate analysis, mBRAF independently predicted earlier recurrence (p = .032).
CONCLUSIONS: In this analysis, mBRAF was independently associated with earlier recurrence in patients undergoing CRS/HIPEC for CRC, leading to dismal median DFS (7 months). Strict patient selection is advisable in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland - 19(2021), 6 vom: 15. Dez., Seite e379-e385 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Solomon, Daniel [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 16.11.2021 Date Revised 16.11.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.surge.2020.11.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319874338 |
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| 245 | 1 | 4 | |a The role of molecular biomarkers in outcomes and patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases of colorectal origin |
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| 520 | |a Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is effective in select patients with peritoneal metastases of colorectal (CRC) origin. The impact of different biomarkers in predicting recurrence after CRS/HIPEC is unclear | ||
| 520 | |a METHODS: Retrospective review of patients who underwent CRS/HIPEC for PC of CRC origin from 03/2007-08/2017. Molecular profile of the primary tumor was obtained from pathology reports, whenever available | ||
| 520 | |a RESULTS: Overall, 100 patients underwent CRS/HIPEC for peritoneal metastases of CRC origin. Most patients presented high grade tumor histology (G2/G3, n = 97, 97%), and a majority showed mucinous features (n = 61, 61%). At a median follow-up of 18 months, median DFS for the overall population was 13 months (95% CI 9.6, 16.4). Data reporting at least one mutational analysis was available in 64 patients. Microsatellite stability was detected in 42/50 (84%) patients, mKRAS in 25/51 (49%), and mBRAF in 5/35 (14.3%). On Kaplan-Meier analysis, BRAF was the only mutation associated with poor DFS (16 months, CI 95% 11.7-43.3 vs. 7 months, CI 95% 2.1-11.9, p = .008). On multivariate analysis, mBRAF independently predicted earlier recurrence (p = .032) | ||
| 520 | |a CONCLUSIONS: In this analysis, mBRAF was independently associated with earlier recurrence in patients undergoing CRS/HIPEC for CRC, leading to dismal median DFS (7 months). Strict patient selection is advisable in these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CRS/HIPEC | |
| 650 | 4 | |a Colorectal cancer | |
| 650 | 4 | |a Mutational status | |
| 650 | 4 | |a Peritoneal carcinomatosis | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 700 | 1 | |a Leigh, Natasha |e verfasserin |4 aut | |
| 700 | 1 | |a Bekhor, Eliahu |e verfasserin |4 aut | |
| 700 | 1 | |a Feferman, Yael |e verfasserin |4 aut | |
| 700 | 1 | |a Dhorajiya, Poojaben |e verfasserin |4 aut | |
| 700 | 1 | |a Feingold, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Hofstedt, Margaret |e verfasserin |4 aut | |
| 700 | 1 | |a Aycart, Samantha N |e verfasserin |4 aut | |
| 700 | 1 | |a Golas, Benjamin J |e verfasserin |4 aut | |
| 700 | 1 | |a Sarpel, Umut |e verfasserin |4 aut | |
| 700 | 1 | |a Labow, Daniel M |e verfasserin |4 aut | |
| 700 | 1 | |a Magge, Deepa R |e verfasserin |4 aut | |
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