title: Embryonic origin of primary colon cancer predicts survival in patients undergoing ablation for colorectal liver metastases.
abstract: BACKGROUND
  In patients with primary colorectal cancer (CRC) or unresectable metastatic CRC, midgut embryonic origin is associated with worse prognosis. The impact of embryonic origin on survival after ablation of colorectal liver metastases (CLM) is unclear.
  
  
  METHODS
  We identified 74 patients with CLM who underwent percutaneous ablation during 2004-2015. Survival and recurrence after ablation of CLM from midgut origin (n = 18) and hindgut origin (n = 56) were analyzed. Prognostic value of embryonic origin was evaluated.
  
  
  RESULTS
  Recurrence-free survival (RFS) and overall survival (OS) after percutaneous ablation were worse in patients from midgut origin (3-year RFS: 5.6% vs. 24%, P = 0.004; 3-year OS: 25% vs. 70%, P 0.001). In multivariable analysis, factors associated with worse OS were midgut origin (hazard ratio [HR] 4.87, 95% CI 2.14-10.9, P 0.001), multiple CLM (HR 2.35, 95% CI 1.02-5.39, P = 0.044), and RAS mutation (HR 2.78, 95% CI 1.25-6.36, P = 0.013). At a median follow-up of 25 months, 56 patients (76%) had developed recurrence, 16 (89%) with midgut origin and 40 (71%) with hindgut origin (P = 0.133). Recurrent disease was treated with local therapy in 20 patients (36%), 2 (13%) with midgut origin and 18 (45%) with hindgut origin (P = 0.022).
  
  
  CONCLUSIONS
  Compared to CLM from hindgut origin tumors, CLM from midgut origin tumors were associated with worse survival after ablation, which was partly attributable to the fact that patients with hindgut origin were more frequently candidates for local therapy at recurrence.
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: S
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: B C
authors.initials: BC
authors.lastname: Odisio
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: S Y
authors.initials: SY
authors.lastname: Huang
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Kopetz
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ahrar
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Y S
authors.initials: YS
authors.lastname: Chun
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: C
authors.initials: C
authors.lastname: Conrad
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Aloia
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: S
authors.initials: S
authors.lastname: Harmoush
authors.affiliation: Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Hicks
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: jvauthey@mdanderson.org.
authors.forename: J-N
authors.initials: JN
authors.lastname: Vauthey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation; D044682:Colon, Ascending / Q000196:embryology / Q000473:pathology*; D044683:Colon, Descending / Q000196:embryology / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D018631:ras Proteins / Q000235:genetics
chemical_list: D018631:ras Proteins
keywords: Ablation; Colorectal liver metastases; Embryonic origin of primary colon cancer; Primary colon cancer; Survival in patients