Jiang Bin-Bin, Wang Ji-Chen, Yan Kun, Zhang Zhong-Yi, Wang Song, Wu Wei, Yang Wei
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China.
Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):108418. doi: 10.4240/wjgs.v17.i8.108418.
mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases (CLMs). Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.
To investigate the association of mutations with recurrence in patients with CLM who underwent radiofrequency ablation (RFA) according to the primary tumor location.
This retrospective study analyzed 164 patients with -determined CLM treated with percutaneous RFA between January 2012 and December 2018. The clinicopathological characteristics, recurrence patterns, and survival outcomes were systematically evaluated.
A total of 164 patients (mean age: 58.0 ± 9.8 years, range: 34-83 years) who underwent percutaneous RFA of 325 CLMs (mean size: 2.2 ± 1.0 cm, range: 0.7-5.0 cm) were included in the study. Eighty-nine (54.3%) patients had wild-type , and 75 (45.7%) patients had mutated . Compared with wild-type patients, patients with mutations presented significantly higher local tumor progression rates (30.7% 14.6%, = 0.013). Among 126 patients (76.8%) who experienced post-RFA recurrence, 61.6% developed intrahepatic metastases, and 53.7% developed extrahepatic metastases. Primary tumor location significantly modified -related outcomes: Compared with wild-type patients, left-sided colorectal cancer (CRC) patients with mutations presented higher intrahepatic recurrence rates (77.2% 52.5%, = 0.003) and shorter median intrahepatic recurrence-free survival (15 25 months, = 0.007). No significant differences in expression were detected in right-sided tumors.
mutation status predicts differential recurrence patterns after CLM ablation, with significant prognostic implications, specifically in left-sided CRCs. These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.
突变状态和原发肿瘤位置是结直肠癌肝转移（CLM）的关键预后因素。新出现的证据表明这两个变量之间可能存在相互作用，可能会影响临床结果。
根据原发肿瘤位置，研究CLM患者接受射频消融（RFA）后突变与复发的关联。
这项回顾性研究分析了2012年1月至2018年12月期间接受经皮RFA治疗的164例确诊为CLM的患者。系统评估了临床病理特征、复发模式和生存结果。
共有164例患者（平均年龄：58.0±9.8岁，范围：34 - 83岁）接受了325个CLM的经皮RFA（平均大小：2.2±1.0 cm，范围：0.7 - 5.0 cm），纳入本研究。89例（54.3%）患者为野生型，75例（45.7%）患者为突变型。与野生型患者相比，突变患者的局部肿瘤进展率显著更高（30.7%对14.6%，P = 0.013）。在126例（76.8%）经历RFA后复发的患者中，61.6%发生肝内转移，53.7%发生肝外转移。原发肿瘤位置显著改变了与相关的结果：与野生型患者相比，左侧结直肠癌（CRC）突变患者的肝内复发率更高（77.2%对52.5%，P = 0.003），肝内无复发生存期的中位数更短（15对25个月，P = 0.007）。右侧肿瘤中未检测到表达的显著差异。
突变状态可预测CLM消融后的不同复发模式，具有重要的预后意义，特别是在左侧CRC中。这些发现强调了在转移性CRC患者的治疗决策中整合分子谱和原发肿瘤特征的重要性。
