BRAF mutation may have different prognostic implications in early- and late-stage colorectal cancer
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The prognostic implication of BRAF mutant colorectal cancer remains paradoxical. Records of BRAF mutant and wild-type colorectal cancer patients at all stages were reviewed. Clinicopathologic features, including microsatellite instability, CpG islands methylator phenotype, and overall survival, of these patients were analyzed. Between 2005 and 2013, 428 colorectal cancer patients were enrolled in this study. The overall survival between BRAF mutant and wild-type patients with early-stage (stages I and II) colorectal cancer differed nonsignificantly (P = 0.99). By contrast, in late-stage (stages III and IV) patients, the median overall survival of BRAF mutant patients (N = 25) was significantly poorer than that of BRAF wild-type (N = 207) patients (BRAF mutant: 21.3 months (95 % confidence interval [CI] 7.1–35.5); BRAF wild-type: 53.5 months (95 % CI 37.5–69.5), P < 0.0001). In early-stage patients, we found that BRAF mutation was significantly associated with CpG island methylator phenotype-positive (P < 0.001), and microsatellite instability-high status (P = 0.0013). Conversely, in late-stage patients, BRAF mutation was significantly associated with CpG island methylator phenotype-positive (P = 0.0015) and the right-side colon (P = 0.014). BRAF mutation may have different prognostic implications in early- and late-stage colorectal cancer.
KeywordsColorectal cancers BRAF gene mutation Prognosis Microsatellite instability (MSI) CpG island methylator phenotype (CIMP)
The authors acknowledge statistical assistance provided by the Taiwan Clinical Trial Bioinformatics and Statistical Center, Training Center, and Pharmacogenomics Laboratory, which was founded by the National Research Program for Biopharmaceuticals, at the Ministry of Science and Technology of Taiwan; MOST 103-2325-B-002-033. The authors are grateful for the statistical assistance provided by the Department of Medical Research at National Taiwan University Hospital. This study was supported by grants from the Department of Health, Executive Yuan (DOH100-TD-C-111-001), Taipei, Taiwan.
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Conflict of interest
The authors declare that they have no conflict of interest.
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