A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Resectability, conversion, metastasectomy and outcome according to RAS and BRAF status for metastatic colorectal cancer in the prospective RAXO study (2022)
Uutela, A., Osterlund, E., Halonen, P., Kallio, R., Ålgars, A., Salminen, T., Lamminmäki, A., Soveri, L.-M., Ristamäki, R., Lehtomäki, K., Stedt, H., Heervä, E., Muhonen, T., Kononen, J., Nordin, A., Ovissi, A., Kytölä, S., Keinänen, M., Sundström, J., . . . Osterlund, P. (2022). Resectability, conversion, metastasectomy and outcome according to RAS and BRAF status for metastatic colorectal cancer in the prospective RAXO study. British Journal of Cancer, 127(4), 686-694. https://doi.org/10.1038/s41416-022-01858-8
JYU-tekijät tai -toimittajat
Julkaisun tiedot
Julkaisun kaikki tekijät tai toimittajat: Uutela, Aki; Osterlund, Emerik; Halonen, Päivi; Kallio, Raija; Ålgars, Annika; Salminen, Tapio; Lamminmäki, Annamarja; Soveri, Leena-Maija; Ristamäki, Raija; Lehtomäki, Kaisa; et al.
Lehti tai sarja: British Journal of Cancer
ISSN: 0007-0920
eISSN: 1532-1827
Julkaisuvuosi: 2022
Ilmestymispäivä: 24.05.2022
Volyymi: 127
Lehden numero: 4
Artikkelin sivunumerot: 686-694
Kustantaja: Nature Publishing Group
Julkaisumaa: Britannia
Julkaisun kieli: englanti
DOI: https://doi.org/10.1038/s41416-022-01858-8
Julkaisun avoin saatavuus: Avoimesti saatavilla
Julkaisukanavan avoin saatavuus: Osittain avoin julkaisukanava
Julkaisu on rinnakkaistallennettu (JYX): https://jyx.jyu.fi/handle/123456789/81822
Tiivistelmä
Outcomes after metastasectomy for metastatic colorectal cancer (mCRC) vary with RAS and BRAF mutational status, but their effects on resectability and conversion rates have not been extensively studied.
Methods
This substudy of the prospective RAXO trial included 906 patients recruited between 2011 and 2018. We evaluated repeated centralised resectability assessment, conversion/resection rates and overall survival (OS), according to RAS and BRAF status.
Results
Patients included 289 with RAS and BRAF wild-type (RAS and BRAFwt), 529 with RAS mutated (RASmt) and 88 with BRAF mutated (BRAFmt) mCRC. Metastatic prevalence varied between the RAS and BRAFwt/RASmt/BRAFmt groups, for liver (78%/74%/61%), lung (24%/35%/28%) and peritoneal (15%/15%/32%) metastases, respectively. Upfront resectability (32%/29%/15%), conversion (16%/13%/7%) and resection/local ablative therapy (LAT) rates (45%/37%/17%) varied for RASa and BRAFwt/RASmt/BRAFmt, respectively. Median OS for patients treated with resection/LAT (n = 342) was 83/69/30 months, with 5-year OS-rates of 67%/60%/24%, while systemic therapy-only patients (n = 564) had OS of 29/21/15 months with 5-year OS-rates of 11%/6%/2% in RAS and BRAFwt/RASmt/BRAFmt, respectively. Resection/LAT was associated with improved OS in all subgroups.
Conclusions
There were significant differences in resectability, conversion and resection/LAT rates according to RAS and BRAF status. OS was also significantly longer for RAS and BRAFwt versus either mutant. Patients only receiving systemic therapy had poorer long-term survival, with variation according to molecular status.
YSO-asiasanat: syöpätaudit; paksusuolisyöpä; etäpesäkkeet; leikkaushoito; hoitotulokset; ennusteet; biomarkkerit; syöpägeenit; onkologia
Vapaat asiasanat: colorectal cancer; metastasis; prognostic markers; surgical oncology
Liittyvät organisaatiot
OKM-raportointi: Kyllä
Raportointivuosi: 2022
JUFO-taso: 2
