Abstract
Prognosis after resection of colorectal liver metastases (CLM) widely varies depending on risk factors for survival. Studies reported that information on somatic gene alteration of CLM is useful for prognostication after CLM resection, finer stratification of recurrence risk, decision-making of postoperative surveillance intensity, and potential for guiding future therapy in patients undergoing CLM resection. Recently, alterations of multiple somatic genes provide better prognostication in patients undergoing CLM resection, rather than single somatic gene alteration. In this chapter, we demonstrate an approach to understand molecular biology of metastatic colorectal cancer in the context of cancer-related signaling pathway, as shown by The Cancer Genome Atlas project. According to our recent study, four signaling pathways (p53, RTK-RAS, TGFβ, and Notch) and corresponding predominant member genes (TP53, RAS/BRAF, SMAD4, and FBXW7) were associated with worse survival in patients undergoing CLM resection, and alterations of the Wnt pathway and APC were associated with better survival. Pathway-centric risk classification integrating alterations of TP53, RAS/BRAF, SMAD4, and APC is useful for finer prognostication in patients undergoing CLM resection.
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The authors thank Ms. Ruth Haynes for administrative support in the preparation of this manuscript.
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Kawaguchi, Y. (2022). Cancer-Related Signaling Pathway and Prognosis. In: Vauthey, JN., Kawaguchi, Y., Adam, R. (eds) Colorectal Liver Metastasis. Springer, Cham. https://doi.org/10.1007/978-3-031-09323-4_51
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DOI: https://doi.org/10.1007/978-3-031-09323-4_51
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