Corsini Erin M, Mitchell Kyle G, Mehran Reza J, Rice David C, Sepesi Boris, Walsh Garrett L, Swisher Stephen G, Roth Jack A, Hofstetter Wayne L, Vaporciyan Ara A, Morris Van K, Antonoff Mara B
Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
J Surg Oncol. 2019 Sep;120(4):729-735. doi: 10.1002/jso.25630. Epub 2019 Jul 9.
While knowledge has grown extensively regarding the impact of mutations on colorectal cancer prognosis, their role in outcomes after pulmonary metastasectomy (PM) remains minimally understood. We sought to determine the prognostic role of mutant disease on survival and recurrence after metastasectomy.
Patients with available tumor sequencing profiles who underwent PM for colorectal cancer at a single institution from 2011 to 2017 were reviewed. Various demographic and clinicopathologic factors, as well as mutational status, were tested in the Cox regression analyses to identify predictors of survival and disease-free survival (DFS).
A total of 130 patients met inclusion criteria, among whom 78 (60%) were male and the mean age was 57 years. The median survival time and 5-year survival rate were 58.2 months and 47%, respectively. A single pulmonary nodule was present in 54%. Disease recurrence occurred for 87 (67%) patients, including 75 (58%) who had at least one lung recurrence after metastasectomy at a median time to recurrence of 19.4 months. Upon multivariable analysis, RAS and TP53 mutations were associated with shorter survival DFS, while APC is associated with prolonged survival.
After metastasectomy for colorectal cancer, mutations in RAS, TP53, and APC play an important role in survival and recurrence.
虽然关于突变对结直肠癌预后的影响已有广泛认识，但其在肺转移瘤切除术后（PM）的转归中所起的作用仍知之甚少。我们试图确定突变型疾病在转移瘤切除术后生存和复发中的预后作用。
回顾了2011年至2017年在单一机构接受PM治疗的结直肠癌患者的肿瘤测序资料。在Cox回归分析中测试了各种人口统计学和临床病理因素以及突变状态，以确定生存和无病生存（DFS）的预测因素。
共有130例患者符合纳入标准，其中78例（60%）为男性，平均年龄为57岁。中位生存时间和5年生存率分别为58.2个月和47%。54%的患者存在单个肺结节。87例（67%）患者出现疾病复发，其中75例（58%）在转移瘤切除术后至少有一次肺部复发，复发的中位时间为19.4个月。多变量分析显示，RAS和TP53突变与较短的生存DFS相关，而APC与延长生存相关。
结直肠癌转移瘤切除术后，RAS、TP53和APC突变在生存和复发中起重要作用。
