In a nutshell
This study investigated the outcomes of patients with BRAF-positive colorectal cancer liver-metastasis (CRLM; spread to the liver) undergoing surgery. Researchers suggested that surgery is associated with improved outcomes for these patients.
Some background
Colorectal cancer is one of the most common cancers in the US. Around 25% of these patients have metastatic disease. BRAF mutation (a permanent change in a gene) is present in 7 to 15% of the patients. This mutation is associated with more aggressive tumors and with worse overall survival. Therefore, it is used as a prognostic predictive factor.
Prior studies showed that BRAF is associated with worse survival in patients without spread cancer. However, too little is known about the effects of this mutation in patients with operable CRLM. Therefore, the role of the surgery in these patients also needs to be better investigated.
Methods & findings
This study included information about 66 patients with BRAF-positive CRLM who underwent liver surgery. The outcomes of these patients were compared to 183 patients with BRAF-negative tumors.
The 1-year disease-free survival (DFS; time from treatment to disease progression) rates were 46% in the BRAF-positive group and 55.4% in the BRAF-negative group. However, this difference was not statistically significant.
The 1-year overall survival (time from treatment to death by any cause) rates after surgery were slightly lower in the BRAF-positive group (94%) compared to those BRAF-negative (95.8%).
The average survival rate after cancer progression was 23 months for BRAF-positives and 44.3 months for BRAF-negatives. Metastasis in more than one site was more often seen in patients with BRAF-positive tumor (48%) than in BRAF-negatives (29.8%)
The bottom line
This study concluded that patients with BRAF-positive CRLM have worse survival if the cancer progresses after surgery. Liver surgery should still be considered as a treatment option for these patients.
The fine print
This study was based on information from medical records. Data may have been missing. Further studies are needed.
Published By :
British Journal of Surgery
Date :
Jun 10, 2019
