TY  - JOUR
A1  - Belias, Michail
A1  - Sasaki, Kazunari
A1  - Wang, Jane
A1  - Andreatos, Nikolaos
A1  - Kamphues, Carsten
A1  - Kyriakos, Georgios
A1  - Seeliger, Hendrik
A1  - Beyer, Katharina
A1  - Kreis, Martin E.
A1  - Margonis, Georgios Antonios
T1  - Is laterality prognostic in resected KRAS-mutated colorectal liver metastases? A systematic review and meta-analysis
T2  - Cancers
N2  - Background: It is debated whether primary tumor laterality (PTL) is prognostic in all patients with colorectal liver metastases (CRLM) or only those with KRAS wild-type or KRAS-mutated tumors.

Methods: We systematically reviewed PubMed for studies reporting on resected CRLM originating from left-sided (LS) versus right-sided (RS) colon cancer stratified by KRAS status. Individual participant data (IPD) were used if available. Given that there are two definitions of PTL, we performed two meta-analyses for KRAS-mutated and two for wild-type patients. To assess if an interaction underlies the possible difference between the effects of PTL in KRAS-mutated vs. wild-type CRLM, we similarly performed two meta-analyses of interaction terms. 

Results: The meta-analyses included eight studies and 7475 patients. PTL had a prognostic association with OS in patients with wild-type tumors (HR for LS: 0.71 [0.60-0.84]), but not in those with KRAS-mutated tumors (HR: 0.99 [0.82-1.19]). This difference stemmed from a truly variable effect of PTL for each KRAS status (mutated vs. wild-type) as the meta-analysis of interaction terms showed a significant interaction between them (HR:1.38 [1.24-1.53]). Similar results were obtained when the second definition of PTL (LS to not include the rectum) was used.

Conclusions: KRAS status modifies the association of tumor site with survival. Right-sided tumors are associated with worse OS only in patients with wild-type CRLM.
Y1  - 2022
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123822
SN  - 2072-6694
VL  - 14
IS  - 3
SP  - 799
PB  - MDPI AG
ER  -