Effect of BRAF mutation on the prognosis for patients with colorectal cancer undergoing cytoreductive surgery for synchronous peritoneal metastasis

作     者：Zhijie Wu Xiusen Qin Yuanxin Zhang Jian Luo Rui Luo Zonglu Cai Hui Wang 

作者机构：Department of General Surgery(Colorectal Surgery)The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Biomedical Innovation CenterThe Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2023年第11卷第1期

页      面：492-499页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：The Sixth Affiliated Hospital,Sun Yat-Sen University Clinical Research 1010 Program[1010CG(2022)-08] Sun Yat-sen University Clinical Reacher 5010 Program supported by National Key Clinical Discipline and the program of Guangdong Provincial Clinical Research Center for Digestive Diseases[2020B1111170004]. 

主　　题：colorectal cancer peritoneal metastasis BRAF prognosis 

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 determine 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 demographics,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(P0.01).However,KRAS status was not significantly associated 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 between 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(P0.001).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.