Evidence map›Paper›PMID 39377842›Full record

ArticleAnnals of surgical oncology2025

Evaluating Combinations of Biological and Clinicopathologic Factors Linked to Poor Outcomes in Resected Colorectal Liver Metastasis: An External Validation Study.

Kazunari Sasaki, Jane Wang, Carsten Kamphues, Stefan Buettner, Johan Gagniere, Victoria Ardilles, Katsunori Imai, Doris Wagner, Ioannis Pozios, Dimitris Papakonstantinou and 16 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Kazunari SasakiDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Jane WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Carsten KamphuesDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Stefan BuettnerDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johan GagniereService de Chirurgie Digestive, CHU Clermont-Ferrand, Inserm, Université Clermont Auvergne, Clermont-Ferrand, France.
Victoria ArdillesHPB Surgery and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Katsunori ImaiDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Doris WagnerDepartment of General Surgery, Medical University of Graz, Graz, Austria.
Ioannis PoziosDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Dimitris PapakonstantinouThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Emmanouil PikoulisThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Efstathios AntoniouThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Daisuke MoriokaDepartment of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Inger Marie LøesDepartment of Clinical Science, University of Bergen, Bergen, Norway.
Per Eystein LønningDepartment of Clinical Science, University of Bergen, Bergen, Norway.
Peter KornpratDepartment of General Surgery, Medical University of Graz, Graz, Austria.
Federico N AucejoDepartment of General Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Hideo BabaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Eduardo de SantibañesHPB Surgery and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Klaus KaczirekDepartment of General Surgery, Medical University of Vienna, Vienna, Austria.
Richard BurkhartDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Itaru EndoDepartment of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Katharina BeyerDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Martin E KreisDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Timothy M PawlikDepartment of Surgery, Ohio State University, Columbus, OH, USA.
Georgios Antonios MargonisDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. margonig@mskcc.org.ORCID http://orcid.org/0000-0003-4894-5743

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI National Cancer Institute P30-CA008748NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundRecent studies have suggested that certain combinations of KRAS or BRAF biomarkers with clinical factors are associated with poor outcomes and may indicate that surgery could be "biologically" futile in otherwise technically resectable colorectal liver metastasis (CRLM). However, these combinations have yet to be validated through external studies. PATIENTS AND

methodsWe conducted a systematic search to identify these studies. The overall survival (OS) of patients with these combinations was evaluated in a cohort of patients treated at 11 tertiary centers. Additionally, the study investigated whether using high-risk KRAS point mutations in these combinations could be associated with particularly poor outcomes.

resultsThe recommendations of four studies were validated in 1661 patients. The first three studies utilized KRAS, and their validation showed the following median and 5-year OS: (1) 30 months and 16.9%, (2) 24.3 months and 21.6%, and (3) 46.8 months and 44.4%, respectively. When analyzing only patients with high-risk KRAS mutations, median and 5-year OS decreased to: (1) 26.2 months and 0%, (2) 22.3 months and 15.1%, and (3) not reached and 44.9%, respectively. The fourth study utilized BRAF, and its validation showed a median OS of 10.4 months, with no survivors beyond 21 months.

conclusionThe combinations of biomarkers and clinical factors proposed to render surgery for CRLM futile, as presented in studies 1 (KRAS high-risk mutations) and 4, appear justified. In these studies, there were no long-term survivors, and survival was similar to that of historic cohorts with similar mutational profiles that received systemic therapies alone for unresectable disease.

Indexed as

Biomarkers, TumorColorectal NeoplasmsHepatectomyLiver NeoplasmsProto-Oncogene Proteins p21(ras)AgedFemaleFollow-Up StudiesHumansMaleMiddle AgedMutationPrognosisProto-Oncogene Proteins B-rafSurvival RateBiomarkers, TumorBRAF protein, humanKRAS protein, humanProto-Oncogene Proteins B-rafProto-Oncogene Proteins p21(ras)BiomarkerColorectal liver metastasesPoor outcomesSurgery

Identifiers

PMID39377842
PMCPMC12129113

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.