KRAS 突变对晚期结直肠癌姑息性原发性肿瘤切除术后结局的影响——一项土耳其肿瘤学组研究

Kras-mutation influences outcomes for palliative primary tumor resection in advanced colorectal cancer-a Turkish Oncology Group study.

作者信息

Korkmaz Levent, Coşkun Hasan Şenol, Dane Faysal, Karabulut Bülent, Karaağaç Mustafa, Çabuk Devrim, Karabulut Senem, Aykan Nuri Faruk, Doruk Hatice, Avcı Nilüfer, Turhal Nazım Serdar, Artaç Mehmet

机构信息

Department of Medical Oncology, NecmettinErbakan University, Meram Faculty of Medicine, Konya, Turkey.

Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey.

出版信息

Surg Oncol. 2018 Sep;27(3):485-489. doi: 10.1016/j.suronc.2018.05.032. Epub 2018 May 30.

DOI:10.1016/j.suronc.2018.05.032

PMID:30217306

Abstract

PURPOSE

We aimed to investigate the prognostic effect of primary tumor resection (PTR) prior to bevacizumab-based treatments in unresectable metastatic colorectal cancer (mCRC).

METHODS

We retrospectively collected 341 mCRC cases with unresectable metastases at diagnosis. PTR was performed in 210 cases (the surgery group) and the other patients (n = 131) were followed without PTR (the no-surgery group). All the patients were treated with bevacizumab combined chemotherapy regimens.

RESULTS

The median progression free survival (PFS) of the surgery group was 10.4 months (95% CI: 8.9-11.9), which was significantly better than that of the no-surgery group (7.6 months, 95% CI: 6.4-8.8, P=0.000). The median overall survival (OS) of the surgery group was longer than that of the no-surgery group (27.4 months vs. 18.3 months, respectively, P=0.000). The median PFS and OS of the surgery group were 10.4 months and 28.2 months, which were significantly longer than that of the no-surgery group in Kras-mutant patients (7.8 months and 18.3 months; P=0.004, P=0.028, respectively). There was no difference in terms of PFS and OS between the surgery and the no-surgery groups in Kras-wild type patients.

CONCLUSION

Palliative PTR may improve the survival outcomes for unresectable mCRC patients. PTR may be preferred, particularly in Kras-mutant patients.

摘要

目的

我们旨在研究在不可切除的转移性结直肠癌（mCRC）中，基于贝伐单抗治疗前进行原发性肿瘤切除（PTR）的预后效果。

方法

我们回顾性收集了341例诊断时伴有不可切除转移灶的mCRC病例。210例患者进行了PTR（手术组），其他患者（n = 131）未进行PTR而接受随访（非手术组）。所有患者均接受贝伐单抗联合化疗方案治疗。

结果

手术组的中位无进展生存期（PFS）为10.4个月（95%CI：8.9 - 11.9），显著优于非手术组（7.6个月，95%CI：6.4 - 8.8，P = 0.000）。手术组的中位总生存期（OS）长于非手术组（分别为27.4个月和18.3个月，P = 0.000）。手术组的中位PFS和OS分别为10.4个月和28.2个月，在Kras突变患者中显著长于非手术组（分别为7.8个月和18.3个月；P = 0.004，P = 0.028）。在Kras野生型患者中，手术组和非手术组的PFS和OS无差异。