Abstract 4961
Background
Hepatic resection of liver metastases is considered the optimal potentially curative treatment for colorectal liver metastases. Numerous clinical and pathological factors have been proved to be prognostic. The Genetic And Morphological Evaluation (GAME) has been proposed as a preoperative prognostic tool to select patients candidates for liver resection. This study aimed to validate the utility of GAME score risk groups in patients with colorectal liver metastases that underwent hepatic resection.
Methods
Clinical and pathological data were collected from 142 metastatic colorectal cancer patients undergoing liver resection (48% after neoadjuvant chemotherapy) between August 1999 and February 2018 at Sant Pau Hospital. The GAME score was calculated allocating points for KRAS mutation, CEA levels, lymph node metastasis, Tumour Burden score (TBS) and extrahepatic disease. We analysed the progression free survival (PFS) and overall survival (OS) according to the GAME score risk groups. Additionally, we considered other KRAS, NRAS and BRAF mutations not included in the original GAME score. Histopathological changes in malignant tissue and liver parenchyma were documented to identify potential prognostic factors for tumor recurrence.
Results
The high-risk group (GAME score ≥ 4 points) had a median PFS of 15.8 months compared with 24.2 months for the low-risk group (GAME score 0–1 point; p = 0.019). The high-risk group had a medium OS of 38.6 months compared with 68.8 months for the low-risk group (p = 0.05). When all RAS and BRAF status was considered regardless of the GAME score a median OS of 66.2 months was observed in wild type tumours compared to 44.5 months for mutated tumours (p = 0.005). Histological examination showed that a mixed and infiltrative growth pattern and the absence of a fibrotic pseudocapsule or liver cell rosettes were associated with a worse outcome.
Conclusions
The GAME score was validated as a useful preoperative prognostic tool in our cohort of patients. However, in our series, molecular profile was a prognostic factor regardless of the GAME score. Some pathologic characteristics may help on further clinical decisions after liver resection.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2376 - Patient Reported Outcomes (PRO) in patients (pts) with HER2- advanced breast cancer (ABC) and a germline BRCA1/2 mutation (gBRCAm) receiving talazoparib (TALA) vs physician’s choice chemotherapy (PCT) in the EMBRACA trial: A focus on subgroups with/ without visceral disease
Presenter: Johannes Ettl
Session: Poster Display session 2
Resources:
Abstract
4874 - Complete Responses in Patients With 2nd-Line or Greater Metastatic Triple-Negative Breast Cancer (TNBC) Following First-in-Human Immunotherapy Combining NK and T Cell Activation with Off-the-Shelf High-Affinity CD16 NK Cell Line (haNK)
Presenter: Chaitali Nangia
Session: Poster Display session 2
Resources:
Abstract
4362 - Reproducibility and concordance of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays in triple-negative breast cancer (TNBC)
Presenter: Aurelia Noske
Session: Poster Display session 2
Resources:
Abstract
4528 - Systemic Therapy in 2nd-Line Metastatic Triple Negative Breast Cancer (mTNBC): A Systematic Literature Review (SLR) and Meta-Analysis (MA) of Efficacy
Presenter: Peter Kaufman
Session: Poster Display session 2
Resources:
Abstract
4112 - Cisplatin given at three divided doses for three consecutive days in metastatic breast cancer: an alternative schedule for one full dose with comparable efficacy but less CINV and hypomagnesaemia
Presenter: Yang Chen
Session: Poster Display session 2
Resources:
Abstract
5699 - Patterns and predictors of first-line (1L) taxane use in US patients with metastatic triple-negative breast cancer (mTNBC)
Presenter: Joyce O’Shaughnessy
Session: Poster Display session 2
Resources:
Abstract
1931 - Maintenance Chemotherapy is effective in Patients with Metastatic Triple Negative Breast Cancer After First-line Platinum-based Chemotherapy
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract
4696 - Using the Patient-Reported Outcomes Measurement Information System (PROMIS) to investigate symptom burden enrichment in Stage IV patients at an academic center
Presenter: Madeline Matthys
Session: Poster Display session 2
Resources:
Abstract
4582 - Measures of functional status in adults aged ≥70 years with advanced breast cancer (ABC) receiving palbociclib (PAL) combination therapy in POLARIS
Presenter: Meghan Karuturi
Session: Poster Display session 2
Resources:
Abstract
3565 - Real-World 1-Year Survival Analysis of Patients with Metastatic Breast Cancer with Liver or Lung Metastasis Treated with Eribulin, Gemcitabine or Capecitabine
Presenter: Shayma Kazmi
Session: Poster Display session 2
Resources:
Abstract