Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Margonis, GA; Sasaki, K; Andreatos, N; Kim, Y; Merath, K; Wagner, D; Wilson, A; Buettner, S; Amini, N; Antoniou, E; Pawlik, TM.
KRAS Mutation Status Dictates Optimal Surgical Margin Width in Patients Undergoing Resection of Colorectal Liver Metastases.
Ann Surg Oncol. 2017; 24(1): 264-271.
Doi: 10.1245/s10434-016-5609-1
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Wagner Doris
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- Abstract:
- The optimal tumor-free margin width remains controversial and may be inappropriate to investigate without considering differences in the underlying tumor biology. R1 resection was defined as margin clearance less than 1 mm. R0 resection was further divided into 3 groups: 1-4, 5-9, and ≥10 mm. The impact of margin width on overall survival (OS) relative to KRAS status [wild type (wtKRAS) vs. mutated (mutKRAS)] was assessed. A total of 411 patients met inclusion criteria. Median patient age was 58 years (interquartile range, 49.7-66.7); most patients were male (n = 250; 60.8 %). With a median follow-up of 28.3 months, median and 5-year OS were 69.8 months and 55.1 %. Among patients with wtKRAS tumors, although margin clearance of 1-4 mm or more was associated with improved OS compared to R1 (all P < 0.05), no difference in OS was observed when comparing margin clearance of 1-4 mm to the 5-9 mm and the ≥10 mm groups (all P > 0.05). In contrast, among patients with mutKRAS tumors, all three groups of margin clearance (1-4, 5-9, and ≥10 mm) fared no better in terms of 5-year survival compared to R1 resection (all P > 0.05). While a 1-4 mm margin clearance in patients with wtKRAS tumors was associated with improved survival, wider resection width did not confer an additional survival benefit. In contrast, margin status-including a 1 cm margin-did not improve survival among patients with mutKRAS tumors.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Colorectal Neoplasms - pathology
- Female -
- Hepatectomy -
- Humans -
- Liver Neoplasms - genetics
- Liver Neoplasms - secondary
- Liver Neoplasms - surgery
- Male -
- Margins of Excision -
- Middle Aged -
- Mutation -
- Prognosis -
- Proto-Oncogene Proteins p21(ras) - genetics
- Survival Rate -