Kras mutation is a marker of worse oncologic outcomes after percutaneous radiofrequency ablation of colorectal liver metastases.
Kras mutation is a marker of worse oncologic outcomes after percutaneous radiofrequency ablation of colorectal liver metastases.
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DOI：
10.18632/oncotarget.19806
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发表时间：
2017-09-12
期刊：
影响因子：
--
通讯作者：
Sofocleous CT
中科院分区：
文献类型：
--
作者：
Shady W;Petre EN;Vakiani E;Ziv E;Gonen M;Brown KT;Kemeny NE;Solomon SB;Solit DB;Sofocleous CT
Kras突变与结肠直肠癌肝转移瘤（CLM）切除后较短的总生存期和疾病复发时间相关。本研究评估Kras突变在经皮射频消融（RFA）治疗的CLM患者中的预后价值。这是一项IRB豁免的回顾性分析，研究KRAS突变状态对CLM RFA后肿瘤预后的影响。终点是总生存期（OS）、局部肿瘤进展率（LTP）以及新发肝、肺和腹膜转移的发生率。从RFA时间开始，使用Kaplan-Meier方法计算生存时间。该研究招募了97名患者。39%（38/97）的患者检测到Kras外显子2突变。在单因素分析中，Kras突变（P=0.016） （HR: 1.8; 95% CI: 1.1 - 2.9）是OS的显著预测因子，在多因素分析中仍具有显著性。多因素分析显示，Kras突变是新发肝转移（P=0.037） （SHR: 2.0; CI: 1.0-3.7）和腹膜转移（P=0.015） （SHR: 3.0; 95% CI: 1.2-7.2）的重要预测因子。Kras突变是RFA切除边缘为1-5 mm的CLM后LTP的重要预测因子（P=0.018） （SHR: 3.0; 95% CI: 1.2-7.7）， LTP率为80%(12/15)，而野生型为41%（11/27）。Kras突变是CLM RFA后总生存率、新肝脏和腹膜转移的重要预测因子。对于局部肿瘤控制，尤其是突变型CLM，最小的放射消融边缘≥6mm是必要的。
Kras mutation has been associated with shorter overall survival and time to disease recurrence after resection of colorectal liver metastases (CLM). This study evaluated the prognostic value of Kras mutation in patients with CLM treated by percutaneous radiofrequency ablation (RFA). This is an IRB waived retrospective analysis of the impact of KRAS mutation status on oncologic outcomes after CLM RFA. The endpoints were overall survival (OS), local tumor progression (LTP) rates, and incidence of new liver, lung, and peritoneal metastases. Survival times were calculated using Kaplan-Meier methodology from the time of RFA. The study enrolled 97 patients. Kras exon 2 mutation was detected in 39% (38/97) of patients. On univariate analysis, Kras mutation (P=0.016) (HR: 1.8; 95% CI: 1.1 – 2.9) was a significant predictor of OS and retained significance on multivariate analysis. Kras mutation was a significant predictor of new liver metastases (P=0.037) (SHR: 2.0; CI: 1.0-3.7) and peritoneal metastases (P=0.015) (sHR: 3.0; 95% CI: 1.2-7.2) on multivariate analysis. Kras mutation was a significant predictor of LTP after RFA of CLM ablated with margins of 1-5 mm (P=0.018) (SHR: 3.0; 95% CI: 1.2-7.7) with an LTP rate of 80% (12/15) versus 41% (11/27) for wild type. Kras mutation is a significant predictor of overall survival, new liver, and peritoneal metastases after RFA of CLM. A minimal radiographic ablation margin ≥ 6 mm is essential for local tumor control especially for mutant CLM.
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DOI：
10.1002/bjs.10490
发表时间：
2017-05
期刊：
The British journal of surgery
影响因子：
--
作者：
Odisio BC;Yamashita S;Huang SY;Harmoush S;Kopetz SE;Ahrar K;Shin Chun Y;Conrad C;Aloia TA;Gupta S;Hicks ME;Vauthey JN
通讯作者：
Vauthey JN
影响因子：
6.2
作者：
Kemeny NE;Chou JF;Capanu M;Gewirtz AN;Cercek A;Kingham TP;Jarnagin WR;Fong YC;DeMatteo RP;Allen PJ;Shia J;Ang C;Vakiani E;D'Angelica MI
通讯作者：
D'Angelica MI
影响因子：
45.3
作者：
Berber, E;Pelley, R;Siperstein, AE
通讯作者：
Siperstein, AE
影响因子：
3.7
作者：
Sofocleous CT;Garg S;Petrovic LM;Gonen M;Petre EN;Klimstra DS;Solomon SB;Brown KT;Brody LA;Covey AM;Dematteo RP;Schwartz L;Kemeny NE
通讯作者：
Kemeny NE
影响因子：
3.7
作者：
Brudvik KW;Mise Y;Chung MH;Chun YS;Kopetz SE;Passot G;Conrad C;Maru DM;Aloia TA;Vauthey JN
通讯作者：
Vauthey JN