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Mutational profiles and prognostic impact in colorectal and high-grade appendiceal adenocarcinoma with peritoneal metastases.
Morgan, Ryan B; Dhiman, Ankit; Sood, Divya; Ong, Cecilia T; Wu, Xiaoyang; Shergill, Ardaman; Polite, Blase; Turaga, Kiran K; Eng, Oliver S.
Afiliación
  • Morgan RB; Department of Surgery, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Dhiman A; Department of Surgery, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Sood D; Department of Surgery, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Ong CT; Department of Surgery, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Wu X; Ben May Department of Cancer Research, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Shergill A; Department of Medicine, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Polite B; Department of Medicine, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Turaga KK; Department of Surgery, Biological Sciences Division, University of Chicago, Chicago, Illinois, USA.
  • Eng OS; Department of Surgery, Division of Surgical Oncology, Yale University, Hew Haven, CT, USA.
J Surg Oncol ; 127(5): 831-840, 2023 Apr.
Article en En | MEDLINE | ID: mdl-36636792
ABSTRACT

BACKGROUND:

Next-generation sequencing (NGS) personalizes cancer treatments. In this study, we analyze outcomes based on NGS testing for colorectal cancer (CRC) and high-grade appendiceal adenocarcinoma (HGA) with peritoneal metastases.

METHODS:

Retrospective review of genomic analyses and outcomes in patients with CRC or HGA with peritoneal metastases at a high-volume center from 2012 to 2019.

RESULTS:

Ninety-two patients (57 CRC, 35 HGA) were identified. Overall survival was longer for CRC (52.8 vs. 30.5 months, p = 0.03), though rates of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) were similar. Multiple genes were more frequently mutated in CRC, including KRAS (51% vs. 29%, p = 0.04), TP53 (47% vs. 20%, p < 0.01), and APC (46% vs. 6%, p < 0.01). For CRC, multivariate regression showed an increased hazard ratio (HR) with increasing peritoneal cancer index (1.06 [1.01-1.11], p = 0.02) and a decreased HR following CRS/HIPEC (0.30 [0.11-0.80], p = 0.02). PIK3CA mutation associated with significantly increased HR (3.62 [1.06-12.41], p = 0.04), though only in non-CRS/HIPEC patients. Multivariate analysis in the HGA group showed a benefit following CRS/HIPEC (0.18 [0.06-0.61], p = 0.01) and for mucinous disease (0.38 [0.15-0.96], p = 0.04), while there was an increased HR with TP53 mutation (6.89 [2.12-22.44], p < 0.01).

CONCLUSION:

CRC and HGA with peritoneal spread have distinct mutational profiles. PIK3CA and TP53 mutations are associated with survival for CRC or HGA with peritoneal metastases, respectively.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias del Apéndice / Neoplasias Peritoneales / Neoplasias Colorrectales / Adenocarcinoma / Hipertermia Inducida Tipo de estudio: Prognostic_studies Idioma: En Revista: J Surg Oncol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias del Apéndice / Neoplasias Peritoneales / Neoplasias Colorrectales / Adenocarcinoma / Hipertermia Inducida Tipo de estudio: Prognostic_studies Idioma: En Revista: J Surg Oncol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos