ArticleJournal of the American College of Surgeons2021
Genomic Sequencing and Insight into Clinical Heterogeneity and Prognostic Pathway Genes in Patients with Metastatic Colorectal Cancer.
Article in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 36 citations in OpenAlex.
- Review
- Worse Survival in Co-Altered RAS-TP53 Patients With Resected Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Patterns of Genetic Alterations Inform Prognostication in Patients with Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
- Cell cycle pathway alterations predict outcomes post-liver transplantation for hepatocellular carcinoma.Frontiers in transplantation · 2026Article
- Synthetic tumor extracellular volume as a predictive biomarker for colorectal liver metastasis patients prior to curative hepatectomy.European radiology · 2025Article
- Mutational status of RAS, SMAD4 and APC predicts survival after resection of colorectal liver metastases in Chinese patients: prognostic stratification based on genetic sequencing data of multiple somatic genes.World journal of surgical oncology · 2025Article
- Transplantation for colorectal liver metastases: lessons from TransMet and future challenges.Hepatobiliary surgery and nutrition · 2025Article
- Sample size required for prognostic genes analysis in colorectal cancer.Discover oncology · 2025Article
- CEA Rebound After Discontinuation of Pre-Hepatectomy Chemotherapy Predicts Worse Outcomes After Resection of Colorectal Cancer Liver Metastases.Annals of surgical oncology · 2025Article
- TGF-β Modulated Pathways in Colorectal Cancer: New Potential Therapeutic Opportunities.International journal of molecular sciences · 2024Review
- Article
- Local Therapy Improves Survival for Early Recurrence After Resection of Colorectal Liver Metastases.Annals of surgical oncology · 2024Article
- Review
- TP53 Alteration and Its Effect on Pathologic Response Are Associated with Survival after Resection of Colorectal Liver Metastases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer.Annals of surgical oncology · 2023Article
- Locoregional treatment for colorectal liver metastases aiming for precision medicine.Annals of gastroenterological surgery · 2023Review
- Survival improvement for patients with metastatic colorectal cancer over twenty years.NPJ precision oncology · 2023Article
- Article
- TGF-β Signaling in Metastatic Colorectal Cancer (mCRC): From Underlying Mechanism to Potential Applications in Clinical Development.International journal of molecular sciences · 2022Review
- Precision surgery for colorectal liver metastases: Current knowledge and future perspectives.Annals of gastroenterological surgery · 2022Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAn understanding of signaling pathways has not been fully incorporated into prognostication and therapeutic options. We evaluated the hypothesis that information about cancer-related signaling pathways can improve prognostic stratification and explain some of the clinical heterogeneity in patients with metastatic colorectal cancer. STUDY
designWe analyzed prognostic relevance of signaling pathways in patients undergoing resection of colorectal liver metastases (CLM) from 2004-2017, and clinical actionability of gene alterations in 7 signaling pathways: p53, Wnt, RTK-RAS, PI3K, TGFβ, Notch, and cell cycle. To assess the wide applicability, the results were validated in an external retrospective cohort including patients with unresectable metastatic colorectal cancer.
resultsOf 579 patients, the numbers of patients with pathway alterations were as follows: p53, n = 420 (72.5%); Wnt, 340 (58.7%); RTK-RAS, 333 (57.5%); PI3K, 110 (19.0%); TGFβ, 65 (11.2%); Notch, 41 (7.1%); and cell cycle, 15 (2.6%). More than 80% of alterations in each pathway occurred in a single predominant gene TP53, APC, KRAS, PIK3CA, FBXW7, and RB1 in p53, Wnt, RTK-RAS, PI3K, Notch, and cell cycle pathways, respectively. Alterations of 4 pathways (p53, RTK-RAS, TGFβ, and Notch) and corresponding predominant genes (TP53, RAS/BRAF, SMAD4, and FBXW7) were significantly associated with worse overall survival (OS), and alterations of Wnt pathway (APC) were associated with better OS in the median follow-up duration of 3.8 years. Similarly, in the external cohort, alterations of p53 (TP53) and RTK-RAS (RAS/BRAF) were significantly associated with worse OS, whereas alteration of Wnt (APC) was associated with better OS in the median follow-up duration of 2.6 years.
conclusionsGenomic sequencing provides insights into clinical heterogeneity and permits finer prognostic stratification in patients with metastatic colorectal cancer.
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