RGD Reference Report - SMAD4 gene mutation predicts poor prognosis in patients undergoing resection for colorectal liver metastases. - Rat Genome Database

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SMAD4 gene mutation predicts poor prognosis in patients undergoing resection for colorectal liver metastases.

Authors: Mizuno, Takashi  Cloyd, Jordan M  Vicente, Diego  Omichi, Kiyohiko  Chun, Yun Shin  Kopetz, Scott E  Maru, Dipen  Conrad, Claudius  Tzeng, Ching-Wei D  Wei, Steven H  Aloia, Thomas A  Vauthey, Jean-Nicolas 
Citation: Mizuno T, etal., Eur J Surg Oncol. 2018 May;44(5):684-692. doi: 10.1016/j.ejso.2018.02.247. Epub 2018 Mar 7.
RGD ID: 18937000
Pubmed: PMID:29551247   (View Abstract at PubMed)
DOI: DOI:10.1016/j.ejso.2018.02.247   (Journal Full-text)


INTRODUCTION: Dorsophilia protein, mothers against decapentaplegic homolog 4 (SMAD4) is a key mediator in the transforming growth factor (TGF)-β signaling pathway and SMAD4 gene mutations are thought to play a critical role in colorectal cancer (CRC) progression. However, little is known about its influence on survival in patients undergoing resection for colorectal liver metastases (CLM).
METHODS: Between 2005 and 2015, all patients with known SMAD4 mutation status who underwent resection of CLM were identified. Patients with SMAD4 mutation were compared to those with SMAD4 wild type. Next, the prognostic value of SMAD4 mutation was validated in a separate cohort of patients with synchronous stage IV CRC who underwent systemic therapy alone.
RESULTS: Of 278 patients, 37 (13%) were SMAD4 mutant while 241 (87%) were wild type. Overall survival (OS) after hepatic resection was worse in SMAD4-mutant patients compared to SMAD4 wild type (OS rate at 3 years, 62% vs. 82%; P < 0.0001). Independent predictors for worse OS were poor differentiation (hazard ratio [HR] 2.586; P = 0.007), multiple tumors (HR 1.970; P = 0.01), diameter greater than 3 cm (HR 1.752; P = 0.017), R1 margin status (HR 2.452; P = 0.014), RAS mutation (HR 2.044; P = 0.002), and SMAD4 mutation (HR 2.773; P < 0.0001). Among 237 patients in the validation cohort, SMAD4-mutations were significantly associated with worse 3-year OS rate (22% vs. 38%; P = 0.012) and was an independent predictor for worse OS (HR, 1.647; P = 0.032).
CONCLUSION: SMAD4 mutation is independently associated with worse outcomes among patients undergoing resection of CLM.



RGD Manual Disease Annotations    Click to see Annotation Detail View

  
Object SymbolSpeciesTermQualifierEvidenceWithNotesSourceOriginal Reference(s)
SMAD4HumanLiver Metastasis treatmentIAGP associated with colorectal carcinoma and DNA:mutations: :RGD 
Smad4RatLiver Metastasis treatmentISOSMAD4 (Homo sapiens)associated with colorectal carcinoma and DNA:mutations: :RGD 
Smad4MouseLiver Metastasis treatmentISOSMAD4 (Homo sapiens)associated with colorectal carcinoma and DNA:mutations: :RGD 

Objects Annotated

Genes (Rattus norvegicus)
Smad4  (SMAD family member 4)

Genes (Mus musculus)
Smad4  (SMAD family member 4)

Genes (Homo sapiens)
SMAD4  (SMAD family member 4)


Additional Information