The challenge of molecular selection in liver-limited metastatic colorectal cancer for surgical resection: a systematic review and meta-analysis in the context of current and future approaches  

作　　者：ROSSANA RONCATO JERRY POLESEL FEDERICA TOSI ELENA PERUZZI ERIKA BRUGUGNOLI CLAUDIA LAURIA PANTANO MARIA FURFARO FILIPPO DI GIROLAMO ALESSANDRO NANI ARIANNA PANI NOEMI MILAN ELENA DE MATTIA ANDREA SARTORE-BIANCHI ERIKA CECCHIN 

机构地区：[1]Experimental and Clinical Pharmacology Unit,Centro di Riferimento Oncologico di Aviano(CRO)IRCCS,Aviano,33081,Italy [2]Department of Medicine(DMED),University of Udine,Udine,33100,Italy [3]Unit of Cancer Epidemiology,Centro di Riferimento Oncologico di Aviano(CRO)IRCCS,Aviano,33081,Italy [4]Department of Oncology and Hemato-Oncology,Universitàdegli Studi di Milano,Milan,20122,Italy [5]Department of Hematology,Oncology,and Molecular Medicine,Grande Ospedale Metropolitano Niguarda,Milan,20122,Italy [6]Oncology Pharmacy Unit,IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori,Meldola,47014,Italy [7]Pharmacy Unit,Fondazione IRCCS Istituto Tumori di Milano,Milan,20122,Italy [8]Department of Pharmacy,Ca’Foncello Treviso Regional Hospital,Piazzale Ospedale 1,Treviso,31100,Italy [9]Department of Medical Surgical and Health Sciences,University of Trieste,Trieste,34127,Italy [10]Hospital Pharmacy,Cattinara Hospital,Azienda Sanitaria Universitaria Giuliano Isontina,Trieste,34148,Italy [11]Department of Oncology and Onco-Hematology,Postgraduate School of Clinical Pharmacology and Toxicology,University of Milan,Milan,20122,Italy

出　　处：《Oncology Research》2024年第9期1407-1422,共16页肿瘤学研究（英文）

基　　金：partially funded by Italian Ministry of Health—Ricerca Corrente(no grant number).

摘　　要：Objectives:Treatment of metastatic colorectal cancer(mCRC)includes resection of liver metastases(LM),however,no validated biomarker identifies patients most likely to benefit from this procedure.This meta-analysis aimed to assess the impact of the most relevant molecular alterations in cancer-related genes of CRC(i.e.,RAS,BRAF,SMAD4,PIK3CA)as prognostic markers of survival and disease recurrence in patients with mCRC surgically treated by LM resection.Methods:A systematic literature review was performed to identify studies reporting data regarding survival and/or recurrence in patients that underwent complete liver resection for CRC LM,stratified according to RAS,BRAF,PIK3CA,and SMAD4 mutational status.Hazard ratios(HRs)from multivariate analyses were pooled in the meta-analysis and various adjustment strategies for confounding factors were combined.The search was conducted in numerous databases,including MEDLINE(PubMed),Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL)(EBSCO host),and WHO Global Index Medicus,through March 18th,2022.Meta-analyses,editorials,letters to the editor,case reports,studies on other primary cancers,studies with primary metastatic sites other than the liver,studies lacking specific oncological outcome variables or genetic data,non-English language studies,and studies omitting residual disease data from liver metastasectomy were excluded.The remaining 47 studies were summarized in a descriptive table which outlines the key characteristics of each study and final results were graphically presented.Results:RAS mutation status was negatively associated with overall survival(OS)(HR,1.68;95%CI,1.54–1.84)and recurrence free survival(RFS)(HR,1.46;95%CI,1.33–1.61).A negative association was also found for BRAF regarding OS(HR,2.64;95%CI,2.15–3.24)and RFS(HR,1.89;95%CI,1.32–2.73)and SMAD4 regarding OS(HR,1.93;95%CI,1.56–2.38)and RFS(HR,1.95;95%CI,1.31–2.91).For PIK3CA only three studies were eligible and no significant association with either OS or RFS could be hi

关 键 词：METASTASECTOMY Liver metastases RAS BRAF SMAD4 PIK3CA COLORECTAL 

分 类 号：R735.7[医药卫生—肿瘤]