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The challenge of molecular selection in liver-limited metastatic colorectal cancer for surgical resection: a systematic review and meta-analysis in the context of current and future approaches

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Oncology Research 2024年第9期32卷 1407-1422页

作者： RosSANA RONCATO JERRY POLESEL FEDERiCA Tosi ELENA PERUZZi ERiKA BRUGUGNOLi CLAUDiA LAURiA PANTANO MARiA FURFARO FiLiPPO Di GiROLAMO ALESSANDRO NANi ARiANNA PANi NOEMi MiLAN ELENA DE mattia ANDREA SARTORE-BiANCHi ERiKA CECCHiN Experimental and Clinical Pharmacology Unit Centro di Riferimento Oncologico di Aviano(CRO)IRCCSAviano33081Italy Department of Medicine(DMED) University of UdineUdine33100Italy Unit of Cancer Epidemiology Centro di Riferimento Oncologico di Aviano(CRO)IRCCSAviano33081Italy Department of Oncology and Hemato-Oncology Universitàdegli Studi di MilanoMilan20122Italy Department of Hematology Oncologyand Molecular MedicineGrande Ospedale Metropolitano NiguardaMilan20122Italy Oncology Pharmacy Unit IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino AmadoriMeldola47014Italy Pharmacy Unit Fondazione IRCCS Istituto Tumori di MilanoMilan20122Italy Department of Pharmacy Ca’Foncello Treviso Regional HospitalPiazzale Ospedale 1Treviso31100Italy Department of Medical Surgical and Health Sciences University of TriesteTrieste34127Italy Hos.ital Pharmacy Cattinara HospitalAzienda Sanitaria Universitaria Giuliano IsontinaTrieste34148Italy Department of Oncology and Onco-Hematology Postgraduate School of Clinical Pharmacology and ToxicologyUniversity of MilanMilan20122Italy

Objectives:Treatment of metastatic colorectal cancer(mCRC)includes resection of liver metastases(LM),however,no validated biomarker identifies patients most likely to benefit from this *** meta-analysis aimed to assess the impact of the most relevant molecular alterations in cancer-related genes of CRC(i.e.,RAS,BRAF,SMAD4,PiK3CA)as prognos.ic markers of survival and disease recurrence in patients with mCRC surgically treated by LM ***:A systematic literature review was performed to identify studies reporting data regarding survival and/or recurrence in patients that underwent complete liver resection for CRC LM,stratified according to RAS,BRAF,PiK3CA,and SMAD4 mutational *** ratios(HRs)from multivariate analyses were pooled in the meta-analysis and various adjustment strategies for confounding factors were *** search was conducted in numerous databases,including MEDLiNE(PubMed),Embase,Cumulative index to Nursing and Allied Health Literature(CiNAHL)(EBSCO host),and WHO Global index Medicus,through March 18th,***-analyses,editorials,letters to the editor,case reports,studies on other primary cancers,studies with primary metastatic sites other than the liver,studies lacking specific oncological outcome variables or genetic data,non-English language studies,and studies omitting residual disease data from liver metastasectomy were *** remaining 47 studies were summarized in a descriptive table which outlines the key characteristics of each study and final results were graphically ***:RAS mutation status was negatively associated with overall survival(os)(HR,1.68;95%Ci,1.54–1.84)and recurrence free survival(RFS)(HR,1.46;95%Ci,1.33–1.61).A negative association was also found for BRAF regarding os(HR,2.64;95%Ci,2.15–3.24)and RFS(HR,1.89;95%Ci,1.32–2.73)and SMAD4 regarding os(HR,1.93;95%Ci,1.56–2.38)and RFS(HR,1.95;95%Ci,1.31–2.91).For PiK3CA only three studies were eligible and no significant associati

关键词： Metastasectomy Liver metastases RAS BRAF SMAD4 PiK3CA Colorectal

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is there a role for treatment-oriented surgery in liver metastases from gastric cancer?

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World Journal of Clinical Oncology 2020年第7期11卷 477-494页

作者： Fabio Uggeri Lorenzo Ripamonti Enrico Pinotti Mauro Alessandro Scotti Simone Famularo mattia Garancini Luca Gianotti Marco Braga Fabrizio Romano School of Medicine and Surgery University of Milano-BicoccaDepartment of SurgerySan Gerardo HospitalMonza 20900Italy Department of Surgery San Gerardo HospitalMonza 20900Italy

BACKGROUND Distant metastases are found in approximately 35%of patients with gastric cancer at their first clinical observation,and of these,4%-14%involves the ***,only 0.4%-2.3%of patients with metastatic gastric cancer are eligible for radical *** surgical resection for gastric cancer metastases is still debated,there have been changes in recent years,although several clinical issues remain to be defined and that must be taken into account before surgery is *** To analyze the clinicopathological factors related to primary gastric tumor and metastases that impact the survival of patients with liver metastatic gastric *** We performed a systematic review of the literature from 2000 to 2018 according to the Preferred Reporting items for Systematic Reviews and Meta-Analyses *** study protocol was based on identifying studies with clearly defined purpose,eligibility criteria,methodological analysis,and patient *** We selected 47 studies pertaining to the purpose of the review,which involved a total of 2304 *** survival was 7-52.3 mo,median disease-free survival was 4.7-18 *** 1-,2-,3-,and 5-year overall survival(os)was 33%-90.1%,10%-60%,6%-70.4%,and 0%-40.1%,*** five papers reported the 10-year os,which was 5.5%–31.5%.The general recurrence rate was between 55.5%and 96%,and that for hepatic recurrence was between 15%and 94%.CONCLUSiON Serous infiltration and lymph node involvement of the primary cancer indicate an unfavorable prognosis,while the presence of single metastasis or≤3 metastases associated with a size ofidered data that do not contraindicate liver resection.

关键词： Hepatic metastases Gastric cancer Prognos.ic factor Survival Hepatectomy Surgery

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免疫疗法联合立体定向放疗治疗非小细胞肺癌脑转移:一项AiRO多中心回顾性研究

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中国肺癌杂志 2022年第4期25卷 I0007-I0022页

作者： Silvia SCOCCiANTi Emanuela OLMETTO Valentina PiNZi mattia falchetto os.i Rossella Di FRANCO Saverio CAiNi Paola ANSELMO Paolo MATTEUCCi Davide FRANCESCHiNi Cristina MANTOVANi Giancarlo BELTRAMO Francesco PASQUALETTi Alessio BRUNi Paolo TiNi Emilia GiUDiCE Patrizia CiAMMELLA Anna MERLOTTi Sara PEDRETTi Marianna TRiGNANi Marco KRENGLi NiccolòGiAJ-LEVRA isacco DESiDERi Guido PECCHiOLi Paolo MUTO Ernesto MARANZANO Laura FARiSELLi Pierina NAVARRiA Umberto RiCARDi Vieri SCOTTi Lorenzo LiVi 王绿化(翻译/校对) Radiation Oncology Unit Ospedale Santa Maria AnnunziataDepartment of OncologyBagno a RipoliFlorenceItaly Radiation Oncology Unit Azienda Ospedaliero Universitaria CareggiDepartment of Experimental and Clinical Biomedical Sciences"Mario Serio"FlorenceItaly U.O Radioterapia Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of NeurosurgeryMilanItaly U.O.C Radioterapia A.O.U Sant'Andrea Facolta Medicina e Psicologia Universita SapienzaDepartment of MedicineSurgery and Translational MedicineRomeItaly istituto Nazionale Tumori iRCCS Fondazione G.PascaleDepartment of RadiotherapyNaplesItaly institute for Cancer Research Prevention and Clinical Network(ISPRO)Cancer Risk Factors and Life-Style Epidemiology UnitFlorenceItaly Radiotherapy Oncology Center S.Maria HospitalDepartment of OncologyTerniItaly Humanitas Research Hos.ital Radiotherapy and Radiosurgery DepartmentRozzanoItaly Radiotherapy Unit Department of OncologyTurinItaly Cyberknife Centro Diagnos.ico italiano Department of RadiologyMilanItaly Radiation Oncology Azienda Ospedaliero Universitaria PisanaDepartment of Translational MedicinePisaItaly Radiotherapy Unit University Hospital of ModenaDepartment of Oncology and HematologyModenaItaly Radiotherapy Unit University of SienaDepartment of Radiotherapy and OncologySienaItaly UOC di Radioterapia Policlinico Universitario Tor VergataDepartment of Onco-HaematologyRomeItaly Radioterapia Oncologica"G.Prodi "AO-IRCCS Arcispedale S.Maria NuovaDepartment of Oncology and Advanced TechnologyReggio EmiliaItaly Radiation Oncology A.S.O.S.Croce e Carle Department of Radiation OncologyCuneoItaly U.O.Radioterapia Oncologica Department of Radiation OncologyASST Spedali Civili di Brescia e Universita degli studi di BresciaBresciaItaly U.O.C.Radioterapia Oncologica Ospedale Clinicizzato SS Annunziata-Universita Chieti G.D'AnnunzioDepartment of Radiation OncologyChietiItaly Radiation Oncology University Hospital Maggiore della CaritdDepartment of Translational Medicine

背景与目的通过意大利放射治疗和临床肿瘤学学会(italian Association of Radiotherapy and Clinical Oncology, AiRO)的一项多中心回顾性研究,明确免疫疗法(immunotherapy, iT)和立体定向放疗(stereotactic radiotherapy,SRT)包括放射外科治疗(radiosurgery, RS)或大分割立体定向放疗(hypofractionated stereotactic radiotherapy, HFSRT)治疗非小细胞肺癌(non-small cell lung cancer, NSCLC)脑转移的疗效和毒性。方法对来自19个意大利中心接受SRT+iT的NSCLC伴脑转移患者进行分析,并与单独接受SRT的对照组患者进行比较。结果共纳入SRT+iT组100例和单独SRT组50例。接受SRT+iT的患者有更长的颅内局部无进展生存期(intracranial local progression-free survival, i LPFS)(经倾向性评分调整后,P=0.007)。在诊断为脑转移时接受iT合并有颅外进展的患者中(n=24),接受SRT后再进行iT与较好的总生存期(overall survival, os)相关(P=0.037)。多因素分析显示组织学类型为非腺癌、卡氏体能状态(Karnofsky performance status,KPS)评分=70分以及接受HFSRT与显著减少的生存期相关(P值分别为0.019、0.017和0.007)。与SRT和iT治疗间隔>7天(n=10)相比,治疗间隔≤7天(n=90)与更长的os相关(经倾向性评分调整后,P=0.008)。联合治疗耐受性良好。在放射性坏死方面,接受SRT+iT的患者与单独SRT的患者无显著差异。SRT和iT的治疗间隔对毒性发生率无影响。结论 SRT+iT是一种安全的联合治疗方法,与单独SRT相比,具有更长的i LPFS。

关键词：立体定向放疗回顾性研究脑转移倾向性评分临床肿瘤学免疫疗法放射治疗

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