Abstract 1976
Background
BRAF V600E-mutated colorectal liver metastases (CRLM) are associated with higher relapse rate and shorter survival time after resection as compared to BRAF wild-type CRLM. It remains unsure whether metastatic surgery has a benefit over chemotherapy alone in this setting. To address this question, we analyzed a large cohort of BRAF-mutated CRLM patients in order to evaluate the impact of liver surgery on overall survival (OS).
Methods
We retrospectively identified BRAF-mutated colorectal cancers diagnosed with liver-only metastases (n = 91) resected or not from October 1, 2003 to December 31,2017 in 24 French centers. The impact of CRLM resection on OS (primary endpoint) was analyzed by Kaplan-Meier method and Cox model. OS was defined from the time of CRLM diagnosis to death from any cause. Progression free survival (PFS) was defined from the time of first chemotherapy (even for resected patients) to first progression or death.
Results
Ninety-one patients were included: 43 (47%) with resected CRLM and 48 (53%) treated with chemotherapy only. Among resected CRLM, 34 (79%) received chemotherapy before surgery. BRAF V600E mutation was detected in 83 (91%) patients and non-V600E mutation in 8 (9%) patients. In comparison to resected CRLM, unresected CRLM were more often bilobar (76% versus 51%, p = 0.03) and greater than 5 (62% versus 34%, p = 0.02). There was no statistical difference in the other criteria especially in rates of synchronous metastases (94% versus 81%, p = 0.11). Median OS was 32.1 months for resected patients and 11.4 months for unresected patients (p < 0.0001). In univariate analysis, 4 parameters were statistically associated with poor OS: rectum primary site (p = 0.002), greater than 5 (p = 0.018), BRAF V600E mutation (p = 0.010) and no liver surgery (p < 0.0001). In multivariate analysis, liver surgery was the only variable associated with significant longer OS (hazard ratio [HR]= 0.125, CI 95%: 0.068 – 0.229, p < 0.0001) and PFS (HR = 0.173, CI 95% 0.101 – 0.296, p < 0.0001).
Conclusions
To our knowledge, this is the largest cohort of colorectal cancer with liver-only metastases harboring BRAF V600E mutation. Liver surgery extend significantly OS and therefore CRLM resectability should be assessed in BRAF-mutated colorectal cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Ploquin, Anne.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4317 - Prognostic factors analysis of 343 patients with adenocarcinoma of esophagogastric junction
Presenter: Yixun Lu
Session: Poster Display session 2
Resources:
Abstract
4099 - Effects of preoperative preparation time on efficacy of neoadjuvant chemotherapy (SOX) in patients with advanced gastric cancer
Presenter: Xinxin Wang
Session: Poster Display session 2
Resources:
Abstract
3769 - The prognostic value of higher absolute lymphocyte counts for patients with surgically resected non-advanced gastric cancer
Presenter: Se Jun Park
Session: Poster Display session 2
Resources:
Abstract
1718 - Trastuzumab and pertuzumab added to neoadjuvant chemoradiotherapy in resectable HER2+ esophageal adenocarcinoma patients: an update on survival and predictive biomarkers in the TRAP study
Presenter: Charlotte Stroes
Session: Poster Display session 2
Resources:
Abstract
5403 - Interim analysis of a phase II trial of perioperative chemotherapy plus avelumab in esophagogastric and gastric adenocarcinoma
Presenter: Thierry Alcindor
Session: Poster Display session 2
Resources:
Abstract
591 - Evaluation of the introduction of primary G-CSF prophylaxis to the FLOT chemotherapy regimen.
Presenter: Kelly-Marie Crampton
Session: Poster Display session 2
Resources:
Abstract
1402 - Subgroup analyses of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with 2 and 4 courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer
Presenter: Tsutomu Hayashi
Session: Poster Display session 2
Resources:
Abstract
3743 - HER2 Copy Number as Predictor of Disease-Free Survival in HER2-Positive Resectable Gastric Cancer
Presenter: Zimin Liu
Session: Poster Display session 2
Resources:
Abstract
2032 - Effect of neoadjuvant chemotherapy on the Programmed Death-1 pathway in esophageal and gastric cancer
Presenter: Maria Svensson
Session: Poster Display session 2
Resources:
Abstract
4304 - A user-friendly nomogram to predict relapse-free survival (RFS) in western patients with resected gastric cancer (GC)
Presenter: Massimiliano Salati
Session: Poster Display session 2
Resources:
Abstract