Highlights
- •BRAF mutations decrease overall survival of patients with resectable colorectal liver metastases by 180%.
- •BRAF mutations increase the risk for disease recurrence in patients undergoing curative intent liver metastasectomy by 129%.
- •The effect was especially pronounced in the subgroup of patients with wild-type (versus unknown) KRAS status.
- •The V600E variant of BRAF mutation is likely linked to even worse outcomes.
Abstract
Introduction
Mutations in the BRAF proto-oncogene have been shown to predict poor patient survival
following curative-intent liver surgery for metastatic colorectal cancer. The aim
of the present systematic review and meta-analysis is to evaluate the effect of mutated
BRAF status (mutBRAF) on the overall (OS) and disease-free survival (DFS) in these
patients.
Methods
A comprehensive literature search was performed for studies reporting outcomes of
patients undergoing curative-intent surgery stratified by BRAF mutation status. Subgroup
analysis was performed to evaluate whether inclusion of KRAS mutation status significantly
influenced the results.
Results
Six studies incorporating 1857 patients with known BRAF status were identified. Pooled
results revealed significantly worse OS (Hazard Ratio 2.8, 95% C.I. 2.09 to 3.77)
and DFS (Hazard Ratio 2.29, 95% C.I. 2.09 to 3.77) in mutBRAF patients. Subgroup analysis
revealed no statistically significant impact of including KRAS status testing on the
obtained results.
Conclusions
Patients with metastatic colorectal cancer carrying BRAF mutations have significantly
worse oncologic outcomes following surgery and more aggressive disease phenotype overall.
Keywords
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Article info
Publication history
Published online: September 08, 2021
Accepted:
September 6,
2021
Received in revised form:
August 8,
2021
Received:
June 21,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
