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Tytuł:
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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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Autorzy:
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Solomon D; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Leigh N; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Bekhor E; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Feferman Y; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Dhorajiya P; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Feingold D; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Hofstedt M; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Aycart SN; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Golas BJ; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Sarpel U; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Labow DM; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Magge DR; Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: .
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Źródło:
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The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2021 Dec; Vol. 19 (6), pp. e379-e385. Date of Electronic Publication: 2021 Jan 07.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Edinburgh : Publications Office, The Royal College of Surgeons of Edinburgh, 2003-
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MeSH Terms:
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Colorectal Neoplasms*/therapy
Hyperthermia, Induced*
Peritoneal Neoplasms*/drug therapy
Biomarkers ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Neoplasm Recurrence, Local ; Patient Selection ; Retrospective Studies ; Survival Rate
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Contributed Indexing:
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Keywords: CRS/HIPEC; Colorectal cancer; Mutational status; Peritoneal carcinomatosis
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Substance Nomenclature:
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0 (Biomarkers)
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Entry Date(s):
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Date Created: 20210111 Date Completed: 20211116 Latest Revision: 20211116
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Update Code:
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20240105
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DOI:
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10.1016/j.surge.2020.11.002
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PMID:
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33423919
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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.
(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.)
