Reevaluating the prognostic role of BRAF mutation in colorectal cancer liver metastases

Am J Surg. 2022 May;223(5):879-883. doi: 10.1016/j.amjsurg.2021.09.006. Epub 2021 Sep 8.

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: BRAF; Hepatectomy; Liver metastases; Meta-analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Colonic Neoplasms* / surgery
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Hepatectomy
  • Humans
  • Liver Neoplasms* / genetics
  • Liver Neoplasms* / secondary
  • Liver Neoplasms* / surgery
  • Mutation
  • Prognosis
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins p21(ras) / genetics

Substances

  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Proto-Oncogene Proteins p21(ras)