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Metastasectomy and BRAF mutation, an analysis of survival outcome in metastatic colorectal cancer


Prasanna, T and Wong, R and Price, T and Shapiro, J and Tie, J and Wong, HL and Nott, LM and Roder, D and Lee, M and Kosmider, S and Jalali, A and Burge, M and Padbury, R and Maddern, G and Carruthers, S and Moore, J and Sorich, M and Karapetis, CS and Gibbs, P and Yip, D, Metastasectomy and BRAF mutation, an analysis of survival outcome in metastatic colorectal cancer, Current Problems in Cancer, 45, (1) pp. 1-9. ISSN 0147-0272 (2021) [Refereed Article]

Copyright Statement

Copyright 2020 Elsevier Inc.

DOI: doi:10.1016/j.currproblcancer.2020.100637


Background: Resection of oligometastases improves survival in metastatic colorectal cancer (mCRC). It is unclear whether the benefit is consistent for BRAF V600E mutant (MT) and wild type (WT) mCRC. This retrospective analysis explores the influence of BRAF MT on survival after metastasectomy.

Methods: Overall survival (OS) and recurrence-free survival (RFS) for BRAF MT and WT mCRC were evaluated. Survival was also analyzed in the cohort of BRAF MT with or without metastasectomy.

Results: Five hundred and thirteen patients who had undergone metastasectomy were identified, 6% were BRAF-MT. Median age 63. Median OS in BRAF MT vs WT: 25.7 vs 48.5 months (hazard ratio [HR] 1.95; 1.18-3.22). However, difference was not significant in a multivariate model. Right primary tumor, intact primary, >1 metastatic site, non-R0 resection, peritoneal metastasis, and synchronous metastasis were independent predictors of worse OS. Among 364 patients with RFS data there was no difference between BRAF MT and WT (16 vs 19 months, p=0.09). In another cohort of 158 BRAF-MT patients, OS was significantly better after metastasectomy compared to "no metastasectomy" (HR 0.34; 0.18-0.65, P= 0.001). Proficient mismatch repair status showed a trend toward worse survival after metastasectomy in BRAF MT (HR 1.71, P = 0.08).

Conclusion: OS did not differ after metastasectomy between BRAF MT and WT in a multivariate model. Median OS was >2 years in this study after metastasectomy among BRAFV600E MT patients suggesting a survival benefit of metastasectomy in this group where systemic therapeutic options are limited. Metastasectomy may be considered in carefully selected BRAF-MT patients.

Item Details

Item Type:Refereed Article
Keywords:BRAF V600E mutation, Metastasectomy, Metastatic colorectal cancer, Survival
Research Division:Biomedical and Clinical Sciences
Research Group:Oncology and carcinogenesis
Research Field:Cancer genetics
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Nott, LM (Dr Louise Nott)
ID Code:152805
Year Published:2021
Web of Science® Times Cited:7
Deposited By:Medicine
Deposited On:2022-08-24
Last Modified:2022-09-19

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