European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
September 26, 2026 · via Europe PMC
Epidemiology of resected colorectal liver metastasis and use of perioperative chemotherapy: a prospective cohort study on the impact of next generation sequencing and mutation profiling in a real-world population.
Veen T, Lea D, Balto A, Edland KH, Kanani A, Søreide K
AI summary — for doctors, generated from the abstract only
In a Norwegian real-world cohort, wider mutation testing coincided with more neoadjuvant chemotherapy and more resections of synchronous and bilobar colorectal liver metastases, yet with worse recent survival.
What was studied
Population-based cohort of 3,022 colorectal cancer patients linked to the Norwegian Cancer Registry, of whom 777 developed liver metastases, analyzed across time periods for resection, mutation testing, chemotherapy and survival.
Key findings
- 25.8% developed liver metastases and 24.6% underwent hepatectomy, with women less likely to be resected than men (20.6% vs 27.4%)
- Mutation testing rose over time; KRAS was mutated in 30.4%, BRAF in 12.9% and MSI-high in 4.3% in the latest period
- Neoadjuvant chemotherapy rose from 38% to 60% and resection of synchronous disease from 46% to 65%
- The most recent period had inferior recurrence-free and overall survival
Clinical relevance
Shows that molecular profiling is changing selection for liver resection in routine care, and the survival signal should prompt reflection on patient selection.
Who should care
Limitations
Observational temporal comparison that cannot show that mutation testing caused the changes or the worse survival, with likely shifts in case mix and follow-up length.
Be aware that expanding resection criteria may include biologically worse disease; use molecular profile in multidisciplinary selection and monitor outcomes.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
INTRODUCTION
Colorectal liver metastasis (CRLM) selected for surgery is increasingly influenced by mutation-profiling yet scarcely described outside clinical trials. The aim of this study was to investigate impact of mutation-testing in routine care on management of CRLM.
MATERIAL AND METHODS
Analysis of a population-derived cohort study matched with the Cancer Registry of Norway. Clinicopathological, mutational, and survival data were analysed across time-intervals.
RESULTS
The study included 3022 patients with primary colorectal cancer; 777 (25.8%) developed CRLM (synchronous n = 560; 72.1% and metachronous n = 217; 27.9%; liver-only n = 376; 48.4%). Hepatectomy-rate was 24.6% (n = 191/777), and highest for metachronous presentation (33.6%). No time-difference in sex, age, number or size of CRLM lesions was found. Patients having hepatectomy were younger than patients without (median 65 vs. 72 yrs). Females were less likely to undergo hepatectomy compared to males (20.6% vs 27.4%). Mutation-analysis increased over time, with KRAS-mutation (30.4%), BRAF-mutation (12.9%) and MSI+ (4.3%) across all tested in most recent time-period. Mutated KRAS (n = 55) was most common mutation, with KRASand KRASmost frequent subtypes. PIK3CA occurred in 15 (11%) patients. No mutation was found in 44 (31%) of tested CRLMs. Neoadjuvant chemotherapy increased (from 38% to 60%; P = 0.018), with more synchronous CRLM resected (from 46% to 65%; P = 0.039). The most recent time-period was associated with inferior survival.
CONCLUSION
Resection-rates of CRLM were stable but selection factors varied over time. Increased use of mutation-testing was associated with increased use of neoadjuvant chemotherapy, increased resection for bilobar and synchronous CRLM, and with temporal reduced recurrence-free and overall survival.
DOI
10.1016/j.ejso.2026.112178
PMID
42849331
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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