文章：

RAS-Beppu分类：一种结合Beppu评分与RAS状态用于结直肠肝转移复发风险的新型分类系统

RAS-Beppu Classification: A New Recurrence Risk Classification System Incorporating the Beppu Score andRASStatus for Colorectal Liver Metastases

原文发布日期：14 February 2025

DOI: 10.3390/cancers17040640

类型: Article

开放获取: 是

英文摘要：

Background: Preoperative recurrence risk stratification for colorectal liver metastases (CRLM) undergoing hepatectomy is essential when designing a treatment strategy. We developed a Beppu classification system consisting of three risk groups and found that theRASmutation increased risk in low- and moderate-risk patients.Methods: A total of 173 patients undergoing initial hepatectomy for CRLM between 2004 and 2020 were analyzed. Disease-free survival (DFS) and overall survival (OS) were assessed. Patients in the low- and moderate-risk groups of the Beppu classification withRASmutations were moved into the moderate- and high-risk groups, respectively, in theRAS-Beppu classification.Results: The DFS curves of the three risk groups in the Beppu andRAS-Beppu classification were significantly different. Five-year DFS rates were 57%, 31%, and 16% in theRAS-Beppu classification of low-, moderate-, and high-risk groups, respectively. With multivariate analysis, Beppu classifications (p= 0.0017) andRAS-Beppu classifications (p= 0.0002) were independent prognostic factors for DFS. TheRAS-Beppu classification showed higher hazard ratios than the Beppu classification, as well as the genetic and morphological evaluation score and the modified clinical risk score, which include theRASstatus. The hazard ratios in theRAS-Beppu classification were significant in all two-group comparisons (2.22 for moderate vs. low, 3.48 for high vs. low, and 1.70 for high vs. moderate). The multivariate analysis of OS showed benefits of theRAS-Beppu classification in the high- vs. low-risk and high- vs. moderate-risk comparisons.Conclusions: TheRAS-Beppu classification using standard parameters is a novel suitable tool for predicting recurrence risk before liver resection.

摘要翻译： 

背景：对于接受肝切除术的结直肠癌肝转移（CRLM）患者，术前进行复发风险分层对于制定治疗策略至关重要。我们开发了包含三个风险组的Beppu分类系统，并发现RAS突变会增加低风险和中风险患者的复发风险。 方法：本研究分析了2004年至2020年间173例首次接受肝切除术的CRLM患者，评估了无病生存期（DFS）和总生存期（OS）。在RAS-Beppu分类中，将Beppu分类中低风险和中风险组且携带RAS突变的患者分别调整至中风险和高风险组。 结果：Beppu分类与RAS-Beppu分类中三个风险组的DFS曲线均存在显著差异。在RAS-Beppu分类中，低风险、中风险和高风险组的5年DFS率分别为57%、31%和16%。多变量分析显示，Beppu分类（p=0.0017）和RAS-Beppu分类（p=0.0002）均为DFS的独立预后因素。与包含RAS状态的遗传形态学评估评分和改良临床风险评分相比，RAS-Beppu分类显示出更高的风险比。在RAS-Beppu分类中，所有两组比较的风险比均具有显著性（中风险 vs. 低风险为2.22，高风险 vs. 低风险为3.48，高风险 vs. 中风险为1.70）。OS的多变量分析显示，RAS-Beppu分类在高风险 vs. 低风险以及高风险 vs. 中风险的比较中具有预测优势。 结论：采用标准参数的RAS-Beppu分类是一种新型且适用的工具，可用于预测肝切除术前患者的复发风险。

原文链接：

RAS-Beppu Classification: A New Recurrence Risk Classification System Incorporating the Beppu Score andRASStatus for Colorectal Liver Metastases