Evidence map›Paper›PMID 40650541›Full record

ArticleJournal of surgical oncology2025

The Role of KRAS Status Among Patients Undergoing Staged Versus Simultaneous Resection for Synchronous Colorectal Liver Metastases.

Andrea Baldo, Odysseas P Chatzipanagiotou, Jun Kawashima, Gaya Spolverato, Andrea Ruzzenente, George A Poultsides, Kazunari Sasaki, Itaru Endo, Minoru Kitago, Federico Aucejo and 8 more

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

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Prognostic impact of tumour burden score on colorectal cancer liver metastasis survival following resection: a meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Article
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

18 authors.

Andrea BaldoDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Odysseas P ChatzipanagiotouDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Jun KawashimaDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Gaya SpolveratoDepartment of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Andrea RuzzenenteDivision of General and Hepatobiliary Surgery, University of Verona, Verona, Italy.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, California, USA.
Kazunari SasakiDepartment of Surgery, Stanford University, Stanford, California, USA.
Itaru EndoDepartment of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Federico AucejoDepartment of Hepato-Pancreato-Biliary & Liver Transplant Surgery, Cleveland Clinic Foundation, Digestive Diseases and Surgery Institute, Cleveland, Ohio, USA.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Tom HughDepartment of Surgery, School of Medicine, The University of Sydney, Sydney, Australia.
Nazim BhimaniDepartment of Surgery, School of Medicine, The University of Sydney, Sydney, Australia.
Matthew WeissDepartment of Surgery, Cancer Institute, Northwell Health, New York City, New York, USA.
Sepideh GholamiDepartment of Surgery, Cancer Institute, Northwell Health, New York City, New York, USA.ORCID https://orcid.org/0000-0001-9294-1710
Jin HeDivision of Hepato-Pancreato-Biliary Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Luca AldrighettiDepartment of Surgery, San Raffaele Hospital, Milan, Italy.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.ORCID https://orcid.org/0000-0002-7994-9870

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundThis study aimed to evaluate the impact of surgical timing-simultaneous versus staged resection-on outcomes of patients with colorectal liver metastases (CRLM) in relation to KRAS mutation status, which is a key factor affecting prognosis.

methodsPatients who underwent curative-intent resection for synchronous CRLM (sCRLM) were identified from an international, multi-institutional database. The association between clinicopathologic factors, staged versus simultaneous approach and wild-type (wtKRAS) versus mutated (mtKRAS) KRAS with long-term outcomes was assessed.

resultsAmong 385 patients who underwent curative-intent resection for sCRLM, 205 (53.2%) individuals underwent a simultaneous primary tumor and CRLM resection; 180 (46.8%) individuals underwent a staged surgical approach. On multivariable analysis, the staged approach remained associated with improved OS compared with the simultaneous approach among patients who had mtKRAS CRLM (HR: 0.62, 95% CI: 0.39-0.99). Patients with mtKRAS and high TBS demonstrated an improved 5-year OS (67.0%, 95% CI: 54.2%-83.0% vs. 47.5%, 95% CI: 31.4%, 71.9%; p = 0.04) compared with a simultaneous procedure. There was no difference in OS among patients with either wtKRAS or mtKRAS and low TBS who underwent staged versus simultaneous resection (p > 0.05).

conclusionPatients with sCRLM and an aggressive tumor biology as defined by KRAS status and TBS may benefit from a two-stage resection which may improve patient selection relative to achieving better long-term outcomes.

Indexed as

Colorectal NeoplasmsHepatectomyLiver NeoplasmsProto-Oncogene Proteins p21(ras)AdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedMutationPrognosisRetrospective StudiesSurvival RateKRAS protein, humanProto-Oncogene Proteins p21(ras)colorectal liver metastasesdisease‐free survivalKRASliver surgeryoverall survivaltumor burden score

Identifiers

PMID40650541
PMCPMC12455551

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.