4.5 Article

BRAF mutation is a prognostic biomarker for colorectal liver metastasectomy

Journal

JOURNAL OF SURGICAL ONCOLOGY
Volume 106, Issue 2, Pages 123-129

Publisher

WILEY-BLACKWELL
DOI: 10.1002/jso.23063

Keywords

biomarker; BRAF; colorectal cancer; liver resection; KRAS

Funding

  1. Center of Excellence for Cancer Research at Taipei Veterans General Hospital [DOH99-TD-C-111-007]
  2. Taipei Veterans General Hospital [100DHA0100416, 99DHA0100446, 101DHA0100661, 101DHA0100369]
  3. Division of Experimental Surgery of the Department of Surgery, Taipei Veterans General Hospital
  4. Taipei Veterans General Hospital, Taiwan Clinical Oncology Research Foundation, Department of Health, Taiwan (Center of Excellence for Cancer Research at Taipei Veterans General Hospital) [DOH99-TD-C-111-007]

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Background and Objectives In metastatic colorectal cancer, v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) is a predictive biomarker for anti-epidermal growth factor receptor (EGFR) treatment and V-raf murine sarcoma viral oncogene homolog B1 (BRAF) is a prognostic biomarker. We aimed to determine the impact of KRAS and BRAF mutation as determined from liver metastases specimens on overall survival (OS) in patients following colorectal liver metastasectomy. Methods Liver metastases specimens (n?=?292) obtained from patients after liver metastasectomy were used to determine the KRAS/BRAF genotype. Associations between clinicopathological parameters and KRAS/BRAF genotype were identified by univariate and multivariate analyses using the Cox proportional hazards model. The impact of KRAS/BRAF genotype on survival was analyzed using the KaplanMeier method. Results The 5-year survival rate of the cohort was 55.8%. The KRAS and BRAF mutation rates were 38.0 and 2.1%, respectively. BRAF genotype, but not KRAS, was found to be an independent prognostic biomarker (HR?=?5.181, P?=?0.002) after adjustment for other significant confounding clinicopathological variates: Number of liver metastases (HR?=?1.983, P?=?0.009), concomitant extrahepatic disease (HR?=?1.858, P?=?0.014), and surgical margin (HR?=?3.241, P?

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