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dc.contributor.authorUutela, Aki
dc.contributor.authorOsterlund, Emerik
dc.contributor.authorHalonen, Päivi
dc.contributor.authorKallio, Raija
dc.contributor.authorÅlgars, Annika
dc.contributor.authorSalminen, Tapio
dc.contributor.authorLamminmäki, Annamarja
dc.contributor.authorSoveri, Leena-Maija
dc.contributor.authorRistamäki, Raija
dc.contributor.authorLehtomäki, Kaisa
dc.contributor.authorStedt, Hanna
dc.contributor.authorHeervä, Eetu
dc.contributor.authorMuhonen, Timo
dc.contributor.authorKononen, Juha
dc.contributor.authorNordin, Arno
dc.contributor.authorOvissi, Ali
dc.contributor.authorKytölä, Soili
dc.contributor.authorKeinänen, Mauri
dc.contributor.authorSundström, Jari
dc.contributor.authorNieminen, Lasse
dc.contributor.authorMäkinen, Markus J.
dc.contributor.authorKuopio, Teijo
dc.contributor.authorRistimäki, Ari
dc.contributor.authorIsoniemi, Helena
dc.contributor.authorOsterlund, Pia
dc.date.accessioned2022-06-16T11:15:24Z
dc.date.available2022-06-16T11:15:24Z
dc.date.issued2022
dc.identifier.citationUutela, A., Osterlund, E., Halonen, P., Kallio, R., Ålgars, A., Salminen, T., Lamminmäki, A., Soveri, L.-M., Ristamäki, R., Lehtomäki, K., Stedt, H., Heervä, E., Muhonen, T., Kononen, J., Nordin, A., Ovissi, A., Kytölä, S., Keinänen, M., Sundström, J., . . . Osterlund, P. (2022). Resectability, conversion, metastasectomy and outcome according to RAS and BRAF status for metastatic colorectal cancer in the prospective RAXO study. <i>British Journal of Cancer</i>, <i>127</i>(4), 686-694. <a href="https://doi.org/10.1038/s41416-022-01858-8" target="_blank">https://doi.org/10.1038/s41416-022-01858-8</a>
dc.identifier.otherCONVID_144407968
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/81822
dc.description.abstractBackground Outcomes after metastasectomy for metastatic colorectal cancer (mCRC) vary with RAS and BRAF mutational status, but their effects on resectability and conversion rates have not been extensively studied. Methods This substudy of the prospective RAXO trial included 906 patients recruited between 2011 and 2018. We evaluated repeated centralised resectability assessment, conversion/resection rates and overall survival (OS), according to RAS and BRAF status. Results Patients included 289 with RAS and BRAF wild-type (RAS and BRAFwt), 529 with RAS mutated (RASmt) and 88 with BRAF mutated (BRAFmt) mCRC. Metastatic prevalence varied between the RAS and BRAFwt/RASmt/BRAFmt groups, for liver (78%/74%/61%), lung (24%/35%/28%) and peritoneal (15%/15%/32%) metastases, respectively. Upfront resectability (32%/29%/15%), conversion (16%/13%/7%) and resection/local ablative therapy (LAT) rates (45%/37%/17%) varied for RASa and BRAFwt/RASmt/BRAFmt, respectively. Median OS for patients treated with resection/LAT (n = 342) was 83/69/30 months, with 5-year OS-rates of 67%/60%/24%, while systemic therapy-only patients (n = 564) had OS of 29/21/15 months with 5-year OS-rates of 11%/6%/2% in RAS and BRAFwt/RASmt/BRAFmt, respectively. Resection/LAT was associated with improved OS in all subgroups. Conclusions There were significant differences in resectability, conversion and resection/LAT rates according to RAS and BRAF status. OS was also significantly longer for RAS and BRAFwt versus either mutant. Patients only receiving systemic therapy had poorer long-term survival, with variation according to molecular status.en
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.publisherNature Publishing Group
dc.relation.ispartofseriesBritish Journal of Cancer
dc.rightsCC BY 4.0
dc.subject.othercolorectal cancer
dc.subject.othermetastasis
dc.subject.otherprognostic markers
dc.subject.othersurgical oncology
dc.titleResectability, conversion, metastasectomy and outcome according to RAS and BRAF status for metastatic colorectal cancer in the prospective RAXO study
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-202206163431
dc.contributor.laitosBio- ja ympäristötieteiden laitosfi
dc.contributor.laitosDepartment of Biological and Environmental Scienceen
dc.contributor.oppiaineSolu- ja molekyylibiologiafi
dc.contributor.oppiaineCell and Molecular Biologyen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.description.reviewstatuspeerReviewed
dc.format.pagerange686-694
dc.relation.issn0007-0920
dc.relation.numberinseries4
dc.relation.volume127
dc.type.versionpublishedVersion
dc.rights.copyright© 2022 the Authors
dc.rights.accesslevelopenAccessfi
dc.subject.ysoonkologia
dc.subject.ysoetäpesäkkeet
dc.subject.ysosyöpätaudit
dc.subject.ysoleikkaushoito
dc.subject.ysohoitotulokset
dc.subject.ysopaksusuolisyöpä
dc.subject.ysoennusteet
dc.subject.ysobiomarkkerit
dc.subject.ysosyöpägeenit
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p12865
jyx.subject.urihttp://www.yso.fi/onto/yso/p2298
jyx.subject.urihttp://www.yso.fi/onto/yso/p678
jyx.subject.urihttp://www.yso.fi/onto/yso/p842
jyx.subject.urihttp://www.yso.fi/onto/yso/p25941
jyx.subject.urihttp://www.yso.fi/onto/yso/p5937
jyx.subject.urihttp://www.yso.fi/onto/yso/p3297
jyx.subject.urihttp://www.yso.fi/onto/yso/p12288
jyx.subject.urihttp://www.yso.fi/onto/yso/p23580
dc.rights.urlhttps://creativecommons.org/licenses/by/4.0/
dc.relation.doi10.1038/s41416-022-01858-8
jyx.fundinginformationThis investigator-initiated RAXO-study was supported by Finska Läkaresällskapet (2016, 2018, 2019, 2020, 2021, 2022); Cancer Foundation Finland (2019–2020, 2021, 2022–2023; Relander’s Foundation (2020–2022); the Competitive State Research Financing of the Expert Responsibility Area of Tampere, Helsinki and Turku (2016, 2017, 2018, 2019, 2020, 2021, 2022); Tampere University Hospital Funds (Tukisäätiö 2019, 2020; OOO 2020); and the Research Fund of Helsinki University Hospital (2019, 2020, 2021). The infrastructure with database and study nurses were partly supported by pharmaceutical companies (Amgen unrestricted grant 2012–2020, Eli Lilly 2012–2017, Merck KGaA 2012–2020, Roche Oy 2012–2020, Sanofi 2012–2017 and Servier unrestricted grant 2016–2020).
dc.type.okmA1


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