Impact of BRAF mutations on clinical outcomes following liver surgery for colorectal liver metastases: An updated meta-analysis |
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| Affiliation: | 1. Department of Digestive and Hepatobiliary Surgery, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France;2. Biostatistics, Direction de La Recherche Clinique et de L’Innovation, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France;3. Department of Surgery, Léon Bérard Cancer Center, Lyon, France;4. U1071 INSERM, Université Clermont-Auvergne, Clermont-Ferrand, France;1. Dept. of Surgical Oncology, Zydus Hospital, Ahmedabad, India;2. Dept. of Surgical Oncology, Saifee Hospital, Mumbai, India;3. Dept. of Radiology, Centre Hospitalier Lyon-sud, Lyon, France;4. Dept. of Surgical Oncology, Jehangir Hospital, Pune, India;5. Dept. of Pathology, Zydus Hospital, Ahmedabad, India;6. Dept. of Radiology, Zydus Hospital, Ahmedabad, India;7. Dept. of Surgical Oncology, Centre Hospitalier Lyon-sud, Lyon, France;8. India Dept. of Pathology, Centre Hospitalier Lyon-sud, Lyon, France;1. Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China;2. Department of Anesthesiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China;1. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy;2. IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy;3. Department of Community and Clinical Sciences, University of Milan, Milan, Italy;1. Department of Gynaecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 78300, Poissy, France;2. Department of Gynaecology and Obstetrics, Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France;3. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France;4. Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France;5. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France;6. Department of Obstetrics and Gynecology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France;7. Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France;8. Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France;9. Department of Obstetrics and Gynecology, Jean-Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France;10. CRLCC Eugène-Marquis, Service de Gynécologie, CHU de Rennes, Université de Rennes 1, Rennes, France;11. Department of Obstetrics and Gynecology, Hopital Nord, APHM, Marseille, France;12. EA 7285 Risques Cliniques et Sécurité en Santé des Femmes, University of Versailles-Saint-Quentin en Yvelines, France;13. Department of Obstetrics and Gynecology, Assistance Publique – Hôpitaux de Paris, Hôpital LARIBOISIERE, University of Paris, France;1. Department of Surgery, Division of Plastic Surgery, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland;2. Departments of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland;3. Departments of Pathology, Diagnostic Imaging Centre, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland;4. University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Clinical Radiology, Yliopistonranta 1, 70210, Kuopio, Finland;5. University of Eastern Finland, Cancer Center of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland;1. Department of Surgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA;2. Division of Surgical Oncology, Department of Surgery, Henry Ford Hospital, 2800 West Grand Blvd, Detroit, MI, 48202, USA;3. Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Detroit, MI, 48202, USA |
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| Abstract: | BackgroundData regarding clinical outcomes of patients undergoing hepatic resection for BRAF-mutated colorectal liver metastases (CRLM) are scarce. Most of the studies report an impaired median overall survival (OS) in BRAF-mutated patients, but controversial Results regarding both recurrence-free survival (RFS) and recurrence patterns. The purpose of this updated meta-analysis was to better precise the impact of BRAF mutations on clinical outcomes following liver surgery for CRLM study, especially on recurrence.MethodsA systematic literature review was performed to identify articles reporting clinical outcomes including both OS and RFS, recurrence patterns, and clinicopathological details of patients who underwent complete liver resection for CRLM, stratified according to BRAF mutational status.ResultsThirteen retrospective studies, including 5192 patients, met the inclusion criteria. The analysis revealed that both OS (OR = 1.981; 95% CI = [1.613–2.432]) and RFS (OR = 1.49; 95% CI [1.01–2.21]) were impaired following liver surgery for CRLM in BRAF-mutated patients. Risks of both hepatic (OR = 0.42; 95% CI [0.18–0.98]) and extrahepatic recurrences (OR = 0.53; 95% CI [0.33–0.83] were significantly higher in BRAF-mutated patients. These patients tended to have higher rates of right-sided colon primary tumors, primary positive lymph nodes, and multiple CRLM.ConclusionsThis meta-analysis confirms that BRAF mutations impair both OS and RFS following liver surgery. Therefore, BRAF mutational status should probably be included in further prognostic scores for the assessment of the expected clinical outcomes following surgery for CRLM. |
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| Keywords: | Colorectal liver metastases Surgery Hepatectomy Prognosis |
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