Impact of genetic alterations on long-term outcomes in resectable intrahepatic cholangiocarcinoma: meta-analysis.

IF 8.6 1区医学 Q1 SURGERY

British Journal of Surgery Pub Date : 2024-10-30 DOI:10.1093/bjs/znae257

Fabio Giannone, Fabio Del Zompo, Antonio Saviano, Erwan Pencreach, Catherine Schuster, Thomas F Baumert, Patrick Pessaux

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引用次数: 0

Abstract

Background: Intrahepatic cholangiocarcinoma is a public health threat because of its aggressiveness. Its genetic background differs from other biliary cancers. The aim of this study was to investigate the impact of genetic alterations on long-term outcomes.

Methods: PubMed, MEDLINE, Scopus, and Cochrane Library databases were systematically searched for studies assessing long-term outcomes after resection of intrahepatic cholangiocarcinoma according to genetic mutational profiling until 31 May 2022. The main outcome was the impact of genetic alterations on long-term outcomes in these patients. HR (95% c.i.) was used for effect size. Publication bias was investigated.

Results: A total of 24 retrospective studies were included. KRAS, IDH1/2, and TP53 were identified as the only three genes whose mutation correlated with survival (HR: 2.476, 95% c.i. 1.67-3.671, P < 0.01 for KRAS; HR: 0.624, 95% c.i. 0.450-0.867, P < 0.01 for IDH1/2; and HR: 2.771, 95% c.i. 2.034-3.775, P < 0.01 for TP53). The prevalence of KRAS and IDH1/2 mutations differed between western and eastern studies (P < 0.001 for both genes).

Conclusion: Determining the overall prevalence of the most common actionable and undruggable mutations may help to expand target therapy indications in the adjuvant setting. Inconsistent results have been found for some infrequent gene alterations; their rare involvement could potentially bias their prognostic meaning.

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基因改变对可切除肝内胆管癌长期预后的影响：荟萃分析。

背景：肝内胆管癌因其侵袭性而对公众健康构成威胁。其遗传背景与其他胆道癌症不同。本研究旨在探讨基因改变对长期预后的影响：方法：系统检索了 PubMed、MEDLINE、Scopus 和 Cochrane Library 数据库中截至 2022 年 5 月 31 日根据基因突变图谱评估肝内胆管癌切除术后长期预后的研究。主要结果是基因改变对这些患者长期预后的影响。HR（95% c.i.）用于衡量效应大小。对发表偏倚进行了调查：共纳入 24 项回顾性研究。KRAS、IDH1/2和TP53是仅有的三个基因突变与生存相关的基因（KRAS的HR：2.476，95% c.i.为1.67-3.671，P＜0.01；IDH1/2的HR：0.624，95% c.i.为0.450-0.867，P＜0.01；TP53的HR：2.771，95% c.i.为2.034-3.775，P＜0.01）。KRAS和IDH1/2基因突变的发生率在东西方研究中存在差异（P < 0.001）：结论：确定最常见的可治疗突变和不可治疗突变的总体发生率有助于扩大辅助治疗的靶向治疗适应症。对于一些不常见的基因改变，研究结果并不一致；这些基因的罕见参与可能会影响其预后意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Surgery 医学-外科

CiteScore

12.70

自引率

7.30%

发文量

1102

审稿时长

1.5 months

期刊介绍： The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.