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
2670 - Molecular subtypes of metastatic(met) gastric cancer(GC) (MoTriGastric): new biomarkers closer to the clinics
Presenter: Maria Alsina Maqueda
Session: Poster Display session 2
Resources:
Abstract
3797 - Exploring candidate signal transduction pathways for targeted therapy in esophageal cancer
Presenter: Aafke Creemers
Session: Poster Display session 2
Resources:
Abstract
5485 - Clinical implication of CLDN18, RhoGAP, and E-cadherin in gastric signet ring cell carcinoma
Presenter: Hyunho Kim
Session: Poster Display session 2
Resources:
Abstract
1970 - Identification of a spectrum of germline mutations for hereditary diffuse gastric cancer in the Russian population by next-generation sequencing.
Presenter: IRINA EFIMOVA
Session: Poster Display session 2
Resources:
Abstract
4989 - The molecular profiling and prognostic value of Chinese gastric signet ring cell carcinoma patients
Presenter: Jia Wei
Session: Poster Display session 2
Resources:
Abstract
7145 - A phase 2 basket study of MCLA-128, a bispecific antibody targeting the HER3 pathway, in NRG1 fusion-positive advanced solid tumors
Presenter: Alison Schram
Session: Poster Display session 2
Resources:
Abstract
1406 - Simultaneous Resection of Pancreatic Cancer and Liver Oligometastases After Induction Chemotherapy in Stage IV Patients:an Open-Label Prospective Randomized Multicenter phase 3 trial(CSPAC-1)
Presenter: Miaoyan Wei
Session: Poster Display session 2
Resources:
Abstract
1530 - Multicenter randomized phase II trial of 5-Fluorouracil/leucovorin (5-FU/LV) with or without liposomal irinotecan (nal-IRI) in metastatic biliary tract cancer (BTC) as second-line therapy after progression on gemcitabine plus cisplatin (GemCis): NIFTY trial
Presenter: Changhoon Yoo
Session: Poster Display session 2
Resources:
Abstract
1563 - A randomized phase II study of Maintenance therapy with multiepitope vaccine Tedopi (OSE2101) ± nivolumab or FOLFIRI after induction chemotherapy (CT) with FOLFIRINOX in patients (Pts) with advanced Pancreatic ductal adenocarcinoma (aPDAC) (TEDOPaM – PRODIGE 63 GERCOR study)
Presenter: Cindy Neuzillet
Session: Poster Display session 2
Resources:
Abstract
2780 - A phase 3, randomized, double-blind, placebo-controlled, international study of durvalumab in combination with gemcitabine plus cisplatin for patients with advanced biliary tract cancers: TOPAZ-1
Presenter: Do-Youn Oh
Session: Poster Display session 2
Resources:
Abstract