Accuracy of Modern Clinical Risk Score Including RAS Status Changes Based on Whether Patients Received Perioperative Chemotherapy for Colorectal Liver ... View Full Text


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Article Info

DATE

2021-04-20

AUTHORS

Yoshinori Takeda, Yoshihiro Mise, Masaru Matsumura, Kiyoshi Hasegawa, Jiro Yoshimoto, Hiroshi Imamura, Takuji Noro, Junji Yamamoto, Naoki Ishizuka, Yosuke Inoue, Hiromichi Ito, Yu Takahashi, Akio Saiura

ABSTRACT

BackgroundA modified Fong clinical score (m-Fong CS) that includes the RAS mutation status has recently been proposed and offered an improved survival stratification of patients who undergo surgery and systemic chemotherapy for colorectal liver metastases (CLM). The aim of this study is to assess whether a CS that includes RAS status is influenced by whether patients receive perioperative chemotherapy.MethodsWe created a new CS using multivariate analysis of data of patients who underwent hepatectomy for CLM for the first time between 2010 and 2016 at a single hospital (n = 341, 79% received perioperative chemotherapy). The resulting CS and m-Fong CS were then validated in the patient cohort at three other hospitals (n = 309). Furthermore, the applicability of the two CS in the total cohort (n = 650) was tested according to whether the patients received perioperative chemotherapy.ResultsThe new CS comprised mutant RAS status, ≥4 CLMs, and a CA19-9 level ≥100 U/mL (1 point per factor). Both the new CS and m-Fong CS failed to stratify the survival of the 309 patients in the validation cohort, including those who did not receive perioperative chemotherapy (29%). Both of the CS accurately stratified the survival of patients who underwent perioperative chemotherapy but not of those who underwent surgery alone.ConclusionA CS that includes the RAS mutation status can stratify the survival of patients who undergo hepatectomy combined with perioperative chemotherapy, but it has limited value for patients who undergo surgery alone. More... »

PAGES

2176-2184

References to SciGraph publications

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  • 2012-02-23. Resectability and outcome with anti-EGFR agents in patients with KRAS wild-type colorectal liver-limited metastases: a meta-analysis in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • 2010-06-21. Peri-operative chemotherapy for the treatment of resectable liver metastases from colorectal cancer: A systematic review and meta-analysis of randomized trials in BMC CANCER
  • 2016-05-20. Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2019-06-13. Optimal indication criteria for neoadjuvant chemotherapy in patients with resectable colorectal liver metastases in WORLD JOURNAL OF SURGICAL ONCOLOGY
  • 2014-09-17. RAS Mutations Predict Radiologic and Pathologic Response in Patients Treated with Chemotherapy Before Resection of Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2013-12-18. Early Recurrence After Liver Resection for Colorectal Metastases: Risk Factors, Prognosis, and Treatment. A LiverMetSurvey-Based Study of 6,025 Patients in ANNALS OF SURGICAL ONCOLOGY
  • 2016-10-08. High preoperative serum CA19-9 level is predictive of poor prognosis for patients with colorectal liver oligometastases undergoing hepatic resection in MEDICAL ONCOLOGY
  • 2011-10-22. A nomogram predicting disease-free survival in patients with colorectal liver metastases treated with hepatic resection: multicenter data collection as a Project Study for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33880608


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    21 schema:description BackgroundA modified Fong clinical score (m-Fong CS) that includes the RAS mutation status has recently been proposed and offered an improved survival stratification of patients who undergo surgery and systemic chemotherapy for colorectal liver metastases (CLM). The aim of this study is to assess whether a CS that includes RAS status is influenced by whether patients receive perioperative chemotherapy.MethodsWe created a new CS using multivariate analysis of data of patients who underwent hepatectomy for CLM for the first time between 2010 and 2016 at a single hospital (n = 341, 79% received perioperative chemotherapy). The resulting CS and m-Fong CS were then validated in the patient cohort at three other hospitals (n = 309). Furthermore, the applicability of the two CS in the total cohort (n = 650) was tested according to whether the patients received perioperative chemotherapy.ResultsThe new CS comprised mutant RAS status, ≥4 CLMs, and a CA19-9 level ≥100 U/mL (1 point per factor). Both the new CS and m-Fong CS failed to stratify the survival of the 309 patients in the validation cohort, including those who did not receive perioperative chemotherapy (29%). Both of the CS accurately stratified the survival of patients who underwent perioperative chemotherapy but not of those who underwent surgery alone.ConclusionA CS that includes the RAS mutation status can stratify the survival of patients who undergo hepatectomy combined with perioperative chemotherapy, but it has limited value for patients who undergo surgery alone.
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    29 CA19-9 levels
    30 CS
    31 MethodsWe
    32 RA status
    33 RAS mutation status
    34 RAS status
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    36 aim
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    38 applicability
    39 chemotherapy
    40 clinical risk score
    41 clinical scores
    42 cohort
    43 colorectal liver metastases
    44 data
    45 first time
    46 hepatectomy
    47 hospital
    48 levels
    49 liver metastases
    50 mL
    51 metastasis
    52 multivariate analysis
    53 mutation status
    54 new CS
    55 patient cohort
    56 patients
    57 perioperative chemotherapy
    58 risk score
    59 scores
    60 single hospital
    61 status
    62 stratification
    63 study
    64 surgery
    65 survival
    66 survival of patients
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    68 systemic chemotherapy
    69 time
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    73 schema:name Accuracy of Modern Clinical Risk Score Including RAS Status Changes Based on Whether Patients Received Perioperative Chemotherapy for Colorectal Liver Metastases
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