Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 6: 786 - 792

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.06.014

Evidence-based medicine

Meta-analysis of the effect of BRAF gene mutation on the prognosis of colorectal cancer patients with liver metastases after hepatectomy

  • Sheng CHENG ,
  • Yi ZHAO ,
  • Yong-chen WANG ,
  • Ping HUANG
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  • Department of Hepatobiliary Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Online published: 2021-06-29

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Abstract

Objective

·To assess the impact of BRAF gene mutation on the prognosis of colorectal cancer liver metastasis (CRLM) patients after hepatectomy.

Methods

·The clinical research was obtained from PubMed from January 2010 to June 2020. Retrieval method was as follows: "BRAF" and ("colon" or "colorectal" or "rectal" or "rectum") and ("metastasis" or "metastatic" or "metastases" or "mets" or "metastasectomy") and ("hepatic" or "liver"). The articles were screened according to inclusion and exclusion criterias, and the quality evaluation and data extraction were carried out. The RevMan 5.4 software was used for meta-analysis. The main outcome index was overall survival (OS), and the secondary outcome index was disease-free survival (DFS).

Results

·Finally, seven studies containing 2 722 patients were included in the meta-analysis. The mutation rate of BRAF was 5.77%. Seven studies reported CRLM patients' OS after hepatic resection through stratified analysis by BRAF gene status. The result of meta-analysis showed that hazard ratio (HR)=3.04, 95% CI 2.30－4.01, P=0.000. That was statistically significant. It indicated that the OS of CRLM patients with BRAF mutation was shortened after hepatectomy. HR funnel plot of OS was basically symmetrical, and no obvious publication bias was found. Three studies reported 1 237 CRLM patients'DFS after hepatectomy through stratified analysis by BRAF gene status. The mutation rate of BRAF was 9.62%. The result of meta-analysis showed that HR=2.07, 95%CI (1.06－4.03), P=0.03. That was statistically significant. It indicated that the DFS of CRLM patients with BRAF mutation was shortened after hepatectomy. HR funnel plot of DFS was asymmetric, and it was uncertain whether there was publication bias, which may be related to the small sample size included in the study.

Conclusion

·BRAF mutation is a biomarker of poor prognosis in CRLM patients after hepatectomy. It is related to poor OS, and more studies are needed to confirm the relationship with poor DFS.

Key words： BRAF gene; mutation; colorectal cancer; liver metastasis; prognosis

Cite this article

Sheng CHENG , Yi ZHAO , Yong-chen WANG , Ping HUANG . Meta-analysis of the effect of BRAF gene mutation on the prognosis of colorectal cancer patients with liver metastases after hepatectomy[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(6) : 786 -792 . DOI: 10.3969/j.issn.1674-8115.2021.06.014

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