Effect Of Braf Mutation On Prognosis In Patients With Resectable And Unresectable Colorectal Liver Metastasis

[Background]To date,few articles have been published about the impact of Braf mutation on the prognosis of patients with resectable and unresectable colorectal cancer liver metastasis(CRLM).The Braf gene mutation rate is low in CRLM patients,so no definite prognostic conclusions can be drawn.[Purpose]The aim is to investigate the clinical characteristics of patients with Braf mutations,and to evaluate the prognostic relationship between Braf mutations and CRLM patients’ survival and recurrence.[Materials and methods]First,the approval of the ethics committee of the First Affiliated Hospital of Chongqing Medical University and the informed consent of all patients participating in the study were approved.Then,according to the established inclusion and exclusion criteria,collecting CRLM patients who had been discussed by the CRLM Multidisciplinary Diagnosis and Treatment(MDT)team from 2014 to 2018 in the First Hospital of Major Hospital,and would be included according to whether the liver metastasis was resectable or not.Divided into resectable group and unresectable group.Next,collecting the Braf mutation status of all included patients and other prognostic-related data(such as gender,age,primary tumor location,number of liver metastases,maximum diameter of liver metastases,etc.).At the same time,the outcome indicators were determined as overall survival(OS)and disease-free survival(DFS).Finally,SPSS 22.0 software was used to analyze the correlation between the Braf genotype and clinical characteristics of the two groups of patients using Fisher’s exact method or chi-square test,and the Kaplan-Meier method and Cox proportional hazard regression model were used to evaluate the prognostic value of the Braf mutation of the two groups of patients.[Results]A total of 143 CRLM patients were included in the study,and there were 13 Braf mutation patients,accounting for 9.1%.The resectable group included 66 patients,including 7 patients with Braf mutations.Fisher’s precise analysis showed that patients with Braf mutations were more likely to be over 60 years old(P=0.001)and the location of the primary tumor was also more likely to be on the right side(P=0.042).Through Kaplan-Meier survival analysis,it was found that Braf mutation was significantly associated with poor OS and DFS in patients with resectable CRLM(P=0.032,P=0.038,respectively);multivariate analysis showed that Braf mutation was an independent negative of OS and DFS Prognostic factors(P=0.022,P=0.004,respectively).The unresectable group included 77 patients,including 6 patients with Braf mutations.Fisher’s precise analysis showed that the Braf genotype was not significantly correlated with clinical characteristics.Through Kaplan-Meier survival analysis,it was found that Braf mutation was significantlyassociated with poor OS in patients with unresectable CRLM(P=0.041);multivariate analysis showed that Braf mutation was an independent negative prognostic factor of OS(P=0.040).[Conclusion]Braf mutation is associated with poor OS and DFS in patients with resectable CRLM,and poor OS in patients with unresectable CRLM,and is a biomarker of poor prognosis in CRLM patients.