BRAF Mutasyonu Taşıyan Kolorektal Kanserin Klinikopatolojik Değerlendirilmesi

Abstract

Colorectal cancer is an important health problem globally. In the management of colorectal cancer, molecular characteristics are important. These characteristics are being used in diagnosis, treatment and follow-up of the patients. BRAF mutation is one of the important genetic/molecular properties. The characteristics of the BRAF mutation have been listed as particularly positive in metastatic disease; more prevalent in older and female population, more frequent in proximal colon tumors and histopathologically in cancers developing from serrated adenomas. Mucinous histopathology and lymphocyte-rich differentiation is more frequent in BRAF mutant tumors. Clinically, BRAF mutation in metastatic tumors reduces the success of EGFR-based therapies and leads to shorter overall survival. In current guidelines it is advised to investigate the BRAF mutation status especially in metastatic disease. The aim of this study is to compare the data regarding BRAF mutant tumors of our patients and literature. Additionally, comparison of different BRAF mutations were done and the clinicopathologic significance of mutations was discussed. Pathology specimens of colorectal cancer patients from Hacettepe University Department of Medical Oncology between 2012-2015 were retrospectively examined and BRAF mutation positive patients were selected. Demographic, clinical and pathological data of these patients were then retrospectively collected and compiled. A total of 30 patients were studied. The median age of the patients was 59.5 months and 53,5% of patients were women. Of the 30 patients, 22 were metastatic. Among BRAF mutant cancers, 60% of the tumors were found to be firstly presented in the right colon and the most common site of BRAF mutant colorectal cancer is the liver (66,7%). Histologically, 42,9% of the tumors had perineural invasion and 85,9% had lymphovascular invasion. The median survival of metastatic patients was 23,5 months. V600E mutation was found to be associated with lower survival. The demographic, histopathologic and clinical features of BRAF mutant metastatic colorectal cancer from our cancer institute were consistent with the data reported in the world. V600E mutation was found to be worst prognostic.