Prognostic Implication of KRAS Status after Hepatectomy for Colorectal Liver Metastases Varies According to Primary Colorectal Tumor Location

Sasaki, Kazunari; Margonis, Georgios Antonios; Wilson, Ana; Kim, Yuhree; Buettner, Stefan; Andreatos, Nikolaos; Gani, Faiz; Amini, Neda; Spolverato, Gaya; Pawlik, Timothy M.

doi:10.1245/s10434-016-5361-6

Cited by 54 publications

(52 citation statements)

References 35 publications

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“…22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years. 22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years.…”

Section: Discussionmentioning

confidence: 70%

“…Because recurrence alone is not predictive of short survival, DFS is not an appropriate outcome parameter with which to assess the efficacy of LT in CRLM. 22 Similar to the experience seen in liver resection [24][25][26] and palliative chemotherapy, 27 right-sided tumors were associated with an inferior outcome, with no patient surviving 5 years. Thus, caution is probably warranted in offering these patients LT ( Figure 4B).…”

Section: Discussionmentioning

confidence: 70%

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Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Dueland

Grut

Syversveen

et al. 2020

American Journal of Transplantation

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Patients with nonresectable colorectal cancer receiving palliative chemotherapy have a 5-year overall survival rate of about 10%. Liver transplant provided a Kaplan-Meier-estimated 5-year overall survival of up to 83%. The objective of the study was to evaluate the ability of different scoring systems to predict long-term overall survival after liver transplant. Patients with colorectal cancer with nonresectable liveronly metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography (PET)-CT scans from 2 prospective studies (SECA-I and -II) were included. All included patients had previously received chemotherapy. PET-CT was performed within 90 days of the liver transplant. Overall survival, disease-free survival, and survival after relapse based on the Fong Clinical Risk Score, total PET liver uptake (metabolic tumor volume), and Oslo Score were compared. At median follow-up of 85 months for live patients, Kaplan-Meier overall survival rates at 5 years were 100%, 78%, and 67% in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low group, and Oslo Score 0 to 2, respectively. Median overall survival was 101, 68, and 65 months in patients with Fong ClinicalRisk Score 0 to 2, metabolic tumor volume-low, and Oslo Score 0 to 2. These selection criteria may be used to obtain 5-year overall survival rates comparable to other indications for liver transplant. K E Y W O R D Scancer/malignancy/neoplasia, cancer/malignancy/neoplasia: metastatic disease, clinical research/practice, clinical trial, liver disease: malignant, liver transplantation/hepatology

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 70%

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Dueland

Grut

Syversveen

et al. 2020

American Journal of Transplantation

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“…Furthermore, five of the ten patients included in the present study had a right‐sided (ascending colon) primary tumour. Patients with right‐sided primaries have a reduced OS after liver resection, as well as reduced OS from the start of first‐line chemotherapy. In the SECA‐I study, none of the patients with right‐sided tumours survived for 5 years after LT (unpublished results).…”

Section: Discussionmentioning

confidence: 98%

Liver transplantation for unresectable colorectal liver metastases in patients and donors with extended criteria (SECA-II arm D study)

Smedman

Line

Hagness³

et al. 2020

BJS Open

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Background: Patients with metastatic colorectal cancer receiving palliative chemotherapy have a 5-year survival rate of approximately 10 per cent. Liver transplantation using strict selection criteria in patients with colorectal cancer and unresectable liver-only disease will result in a 5-year survival rate of 56-83 per cent. The aim of this study was to evaluate survival of patients with colorectal liver metastases (CRLM) after liver transplantation using extended criteria for both patients and donors.Methods: This was a prospective single-arm study. Patients with synchronous unresectable CRLM who were not suitable for arms A, B or C of the SEcondary CAncer (SECA) II study who had undergone radical resection of the primary tumour and received chemotherapy were included; they underwent liver transplantation with extended criteria donor grafts. Patients who had resectable pulmonary metastases were eligible for inclusion. The main exclusion criteria were BMI above 30 kg/m 2 and liver metastases larger than 10 cm. Survival was estimated using Kaplan-Meier analysis.Results: Ten patients (median age 54 years; 3 women) were included. They had an extensive liver tumour load with a median of 20 (range 1-45) lesions; the median size of the largest lesion was 59 (range 15-94) mm. Eight patients had (y)pN2 disease, six had poorly differentiated or signet ring cell-differentiated primary tumours, and five had primary tumour in the ascending colon. The median Fong clinical risk score was 3 (range 2-5) and the median Oslo score was 1 (range 1-4). The median plasma carcinoembryonic antigen level was 4⋅3 (range 2-4346) g/l. Median disease-free and overall survival was 4 and 18 months respectively. Conclusion:Patients with unresectable liver-only CRLM undergoing liver transplantation with extended patient and donor criteria have relatively short overall survival.

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“…In CRLM patients undergoing hepatic resection, many factors such as tumor size of liver metastases, tumor number and serum carcinoembryonic antigen (CEA) level are associated with outcomes [5]. Primary tumor factors including lymph node status, pathology grade and genetic status may also influence the survival [6,7]. Besides survival, genetic status of primary tumor were also found to predict resection margin and pathologic response in CRLM patients treated with neoadjuvant chemotherapy [8,9].…”

Section: Introductionmentioning

confidence: 99%

Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

Yuan

Wang

Yuan

et al. 2020

Preprint

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Background: Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods: From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis. Results: Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM (P = 0.575; P = 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P = 0.028, P = 0.003). Conclusions: Compared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.

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Prognostic Implication of KRAS Status after Hepatectomy for Colorectal Liver Metastases Varies According to Primary Colorectal Tumor Location

Abstract: KRAS status has a variable prognostic impact after hepatic resection for CRLM depending on the site of the primary CRC. Future studies examining the impact of KRAS status on prognosis after hepatectomy should take into account the primary CRC tumor site.

Cited by 54 publications

References 35 publications

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Liver transplantation for unresectable colorectal liver metastases in patients and donors with extended criteria (SECA-II arm D study)

Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

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