Hepatectomy versus systemic therapy for liver-limited BRAF V600E-mutated colorectal liver metastases: Multicentre retrospective study Journal Article

   

Authors:	Margonis, G. A.; Wang, J. J.; Boerner, T.; Moretto, R.; Buettner, S.; Andreatos, N.; Gagnière, J.; Wagner, D.; Løes, I. M.; Bergamo, F.; Pietrantonio, F.; Scartozzi, M.; Spallanzani, A.; Vincenzi, B.; Antoniou, E.; Pikoulis, E.; Sartore-Bianchi, A.; Stasinos, G.; Sasaki, K.; Pawlik, T. M.; Orlandi, A.; Pella, N.; Fitschek, F.; Kaczirek, K.; Dupré, A.; Pozios, I.; Beyer, K.; Kornprat, P.; Aucejo, F. N.; Burkhart, R.; Weiss, M. J.; Lønning, P. E.; Poultsides, G.; Cremolini, C.; Kreis, M. E.; D’Angelica, M.
Article Title:	Hepatectomy versus systemic therapy for liver-limited BRAF V600E-mutated colorectal liver metastases: Multicentre retrospective study
Abstract:	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. © The Author(s) 2024.
Keywords:	vasculotropin; adult; controlled study; human tissue; treatment outcome; aged; middle aged; retrospective studies; major clinical study; overall survival; genetics; mutation; clinical trial; mortality; bevacizumab; fluorouracil; systemic therapy; liver neoplasms; capecitabine; comparative study; disease free survival; metastasis; progression free survival; neoplasm recurrence, local; pneumonectomy; epidermal growth factor receptor; cohort analysis; pathology; retrospective study; histology; irinotecan; colorectal neoplasms; multicenter study; colorectal tumor; tumor recurrence; folinic acid; microsatellite instability; liver tumor; surgery; hepatectomy; observational study; oxaliplatin; b raf kinase; proto-oncogene proteins b-raf; braf protein, human; comparative effectiveness; procedures; propensity score; colorectal liver metastasis; humans; human; male; female; article
Journal Title:	British Journal of Surgery
Volume:	111
Issue:	7
ISSN:	0007-1323
Publisher:	Oxford University Press
Date Published:	2024-07-01
Start Page:	znae176
Language:	English
DOI:	10.1093/bjs/znae176
PUBMED:	39051667
PROVIDER:	scopus
PMCID:	PMC11270119
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85199641352&doi=10.1093%2fbjs%2fznae176&partnerID=40&md5=add6698031746c31807875300d42fb73
Notes:	Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Georgios Antonios Margonis -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/218033