Effect of BRAF mutation on the prognosis for patients with colorectal cancer undergoing cytoreductive surgery for synchronous peritoneal metastasis
Zhijie Wu
Xiusen Qin
Yuanxin Zhang
Jian Luo
Rui Luo
Zonglu Cai
Hui Wang
Department of General Surgery(Colorectal Surgery),The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China;Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China
摘要：Background:KRAS/BRAF mutations(mutKRAS/mutBRAF)are unfavorable prognostic factors for colorectal cancer(CRC)metastases to the liver and lungs.However,their effects on the prognosis for patients with synchronous peritoneal metastasis(S-PM)of CRC after cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are controversial.In the study,we aimed to de-termine the effects of mutKRAS/mutBRAF on the prognosis for patients with S-PM who received CRS.
Methods:A total of 142 patients diagnosed with S-PM between July 2007 and July 2019 were included in this study.The demo-graphics,mutKRAS/mutBRAF status,overall survival(OS),and progression-free survival(PFS)of the patients were evaluated.The Kaplan-Meier method and log-rank test were used to estimate the difference in survival between groups.
Results:Among 142 patients,68(47.9%)showed mutKRAS and 42(29.5%)showed mutBRAF.The median OS values were 8.4 and 34.3 months for patients with mutBRAF and BRAF wild-type,respectively(P<0.01).However,KRAS status was not significantly associ-ated with median OS(P=0.76).Multivariate analysis revealed carcinoembryonic antigen,CRS,HIPEC,and mutBRAF as independent predictors for OS.Based on these findings,a nomogram was constructed.The C-index was 0.789(95%confidence interval,0.742-0.836),indicating good predictive ability of the model.Furthermore,the 1-and 2-year survival calibration plots showed good agreement be-tween the predicted and actual OS rates.The area under curves of the 1-and 2-year survival predictions based on the nomogram were 0.807 and 0.682,respectively.Additionally,mutBRAF was significantly associated with lower PFS(P<0.001).
Conclusions:mutBRAF is an independent prognostic risk factor for S-PM.The established nomogram predicted the OS of patients with CRC having S-PM with high accuracy,indicating its usefulness as a valuable prognostic tool for the designated patient cohort.
机标关键词：mutationprognosisbrafsurgerycancerwithcolorectalcytoreductive
论文发表日期：2024-06-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：8( 215-222 )
英文信息