TY - JOUR
T1 - The evolving Use of prognostic factors after resection of colorectal liver metastases
AU - Karagkounis, Georgios
AU - Choti, Michael A.
N1 - Funding Information:
Conflict of Interest Georgios Karagkounis declares that he has no conflict of interest. Michael A. Choti has received non-financial support from Bristol–Myers Squibb for a funded clinical study on colorectal cancer, and has received compensation and non-financial support from Bayer Healthcare for serving on a steering committee for an ongoing sponsored clinical trial on adjuvant therapy for colorectal liver metastases.
PY - 2014/6
Y1 - 2014/6
N2 - The expanding use of surgical therapy for patients with colorectal liver metastases (CRLM) and developments in chemotherapeutic regimens have led to a significant improvement in survival. However, outcomes can vary substantially and criteria for determining the prognosis of individual patients are lacking. Traditionally, clinicopathologic factors, for example primary tumor stage, number and size of liver metastases, preoperative carcinoembryonic antigen levels, presence of extrahepatic disease, and others, have been used to determine which patients are more likely to experience recurrence and poor survival. However, these factors, both separately and as part of scoring systems, have been inconsistent and conflicting in determining prognosis. Recently, molecular and biological indicators have emerged as potential prognosticators for CRLM patients undergoing hepatic resection. Tumor response to chemotherapy, both on imaging and on pathology, mutation status of such oncogenes as KRAS and BRAF, and expression patterns of proliferative markers including MACC1 and Ki-67, have all furnished promising results in prediction of patient outcomes. Moreover, circulating tumor cells and tumor DNA may not only be a useful prognostic instrument but also an excellent means of screening for early detection of recurrence.
AB - The expanding use of surgical therapy for patients with colorectal liver metastases (CRLM) and developments in chemotherapeutic regimens have led to a significant improvement in survival. However, outcomes can vary substantially and criteria for determining the prognosis of individual patients are lacking. Traditionally, clinicopathologic factors, for example primary tumor stage, number and size of liver metastases, preoperative carcinoembryonic antigen levels, presence of extrahepatic disease, and others, have been used to determine which patients are more likely to experience recurrence and poor survival. However, these factors, both separately and as part of scoring systems, have been inconsistent and conflicting in determining prognosis. Recently, molecular and biological indicators have emerged as potential prognosticators for CRLM patients undergoing hepatic resection. Tumor response to chemotherapy, both on imaging and on pathology, mutation status of such oncogenes as KRAS and BRAF, and expression patterns of proliferative markers including MACC1 and Ki-67, have all furnished promising results in prediction of patient outcomes. Moreover, circulating tumor cells and tumor DNA may not only be a useful prognostic instrument but also an excellent means of screening for early detection of recurrence.
KW - BRAF
KW - Colorectal liver metastases
KW - Hepatectomy
KW - KRAS
KW - Molecular
KW - Prognostic factors
KW - Resection
KW - Scoring systems
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84903718056&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903718056&partnerID=8YFLogxK
U2 - 10.1007/s11888-014-0220-y
DO - 10.1007/s11888-014-0220-y
M3 - Article
AN - SCOPUS:84903718056
SN - 1556-3790
VL - 10
SP - 218
EP - 226
JO - Current Colorectal Cancer Reports
JF - Current Colorectal Cancer Reports
IS - 2
ER -