CRC liver metastases: value of estimating conditional recurrence-free survival

  • Kawaguchi Y & al.
  • J Am Coll Surg
  • 2 mai 2019

  • Par Jim Kling
  • Résumés d'articles
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Takeaway

  • Odds of remaining recurrence-free increase with recurrence-free time from resection of colorectal cancer (CRC).
  • RAS/TP53 comutations were associated with greater chance of recurrence.

Why this matters

  • Traditional assessment of risk for death and recurrence is carried out only after resection, but risks change over time, and conditional recurrence-free survival (RFS) could provide a more accurate prognosis.

Study design

  • Retrospective analysis of 485 patients at a single institution.
  • Funding: National Cancer Institute.

Key results

  • Median follow-up, 3.1 years; 225 subjects were recurrence-free at 1 year, 109 were recurrence-free at 2 years.
  • 5-year RFS: 17.3% in entire cohort, 36.8% 1-year recurrence-free, 70.7% 2-year recurrence-free.
  • 5-year OS rates: 58.6% in entire cohort, 79.7% 1-year recurrence-free, 89.4% 2-year recurrence-free.
  • RAS/TP53 comutation was associated with shorter RFS in the 1-year recurrence-free group (median RFS, 1.5 vs 2.8 years; P=.006) and in the 2-year recurrence-free group (median RFS, 3.0 vs 5.9 years; P=.024).
  • Only RAS/TP53 comutation was associated with recurrence risk in all groups:
    • All patients (HR, 1.47; P<.001>
    • 1-year recurrence-free (HR, 1.69; P=.005).
    • 2-year recurrence-free (HR, 2.41; P=.024).

Limitations

  • Retrospective study.
  • Single institution.