Rhaiem Rami, Rached Linda, Tashkandi Ahmad, Bouché Olivier, Kianmanesh Reza
Faculty of Medecine, University Reims Champagne-Ardenne, 51100 Reims, France.
Hepatobiliary, Pancreas, Endocrine and Digestive Surgical Oncology Department, Robert Debré Hospital, CHU de Reims, 51100 Reims, France.
Cancers (Basel). 2022 Feb 5;14(3):816. doi: 10.3390/cancers14030816.
Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related death. More than 50% of patients with CRC will develop liver metastases (CRLM) during their disease. In the era of precision surgery for CRLM, several advances have been made in the multimodal management of this disease. Surgical treatment, combined with a modern chemotherapy regimen and targeted therapies, is the only potential curative treatment. Unfortunately, 70% of patients treated for CRLM experience recurrence. RAS mutations are associated with worse overall and recurrence-free survival. Other mutations such as BRAF, associated RAS /TP53 and APC/PIK3CA mutations are important genetic markers to evaluate tumor biology. Somatic mutations are of paramount interest for tailoring preoperative treatment, defining a surgical resection strategy and the indication for ablation techniques. Herein, the most relevant studies dealing with RAS mutations and the management of CRLM were reviewed. Controversies about the implication of this mutation in surgical and ablative treatments were also discussed.
结直肠癌（CRC）是全球第三大常见癌症，也是癌症相关死亡的第二大主要原因。超过50%的CRC患者在病程中会发生肝转移（CRLM）。在CRLM精准手术时代，该疾病的多模式管理已取得多项进展。手术治疗联合现代化疗方案和靶向治疗是唯一可能的治愈性治疗方法。不幸的是，70%接受CRLM治疗的患者会复发。RAS突变与总体生存率和无复发生存率较差相关。其他突变，如BRAF、相关的RAS/TP53和APC/PIK3CA突变，是评估肿瘤生物学的重要遗传标志物。体细胞突变对于制定术前治疗方案、确定手术切除策略和消融技术的适应证至关重要。在此，对涉及RAS突变和CRLM管理的最相关研究进行了综述。还讨论了关于该突变在手术和消融治疗中的意义的争议。
