The impact of surgical resection in early onset colorectal cancer patients with liver limited disease.
Year: 2025
Type: article
Study design: Observational Study
Abstract: e15569 Background: Recent studies have shown an increased incidence of early-onset CRC (EO-CRC), particularly in advanced stages and with metastatic disease. Our study aimed to evaluate the role of metastasectomies related to the clinical and molecular characteristics of EO-CRC patients with liver metastases compared to late-onset CRC (LO-CRC) patients. Methods: We retrospectively collected data from 1123 stage IV colorectal cancers, including 782 with liver metastases, from 5 different Italian institutions. The main objective of the study was to compare the overall survival of liver metastatic EO-CRC and LO-CRC patients who underwent metastasectomy versus those who were not resected. Results: Liver resected EO-CRCs patients showed a statistically significant lower mOS than liver resected LO-CRCs (44.0 vs 64.0 months, p < 0.0001 ). mPFS was also statistically significant lower in EO-CRCs (13.0 vs 17.0, p < 0.0001 ). Same outcomes were found in RAS mut subgroup (37.0 vs 52.0 months, p < 0.0001) and in RAS/BRAF wild-type subgroup (50.0 vs 81.0 months, p < 0.0001). EO-CRC patients showed a higher prevalence of TP53 alterations (56.2%) and a lower of APC mutation (29.9%). EO-CRCs presented a higher frequency of ARID1A (4.4%) and CTNNB1 (3.0%) alterations. Conclusions: The results indicate a worse overall prognosis for EO-CRC patients undergoing metastasectomy compared to late-onset patients. This outcome appears to occur independently of the molecular status. These observations could have a considerable impact on clinical practice and research.
Source: Journal of Clinical Oncology
Authors: Andrea Pretta, Francesca Bergamo, Federica Marmorino, Federica Bertuzzi, Pina Ziranu, Krisida Cerma, Paolo Ciracì, Federica Manoni, Clelia Donisi, Maria Caterina De Grandis, Ada Taravella, Silvia Marchesi, Valeria Pusceddu, Giulia Maddalena, Roberta Fazio, Riccardo Giampieri, Filippo Pietrantonio, Chiara Cremolini, Sara Lonardi, Mario Scartozzi
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4410822767