Tumor Biology and Surgical Margin Patterns in Colorectal Liver Metastases: Association Between KRAS/BRAF Status and Type of Resection Margin-BRAF-KRAS LiverMet Collaborative Group.

Authors

Cecilia Ferrari, Gian Mario D'Ambrosio, Victor Molina, Simone Famularo, Flavio Milana, Renato Patrone, Nadia Russolillo, Laura Alaimo, Ignacio Roldán-Ortiz, Nicola Nocchi, Charles-Henri Wassmer, Sofia De la Serna, Alejandra García-Botella, Federico Mocchegiani, Silvia Bitto, Mattia Garancini, Fabrizio Romano, Luis Filipe Abreu de Carvalho, Frederik Berrevoet, Riccardo Aurelio Nasto, Guido Fallani, Matteo Serenari, Antonella Delvecchio, Valentina Valle, Mohamad Halloum, Pier Cristoforo Giulianotti, Riccardo Memeo, Matteo Cescon, Roberto Troisi, Kjell De Winter, Cristina Ciulli, Paola Tarchi, Marco Vivarelli, Luis Ignacio Díez Valladares, Christian Toso, Antonio Taddei, Mario Serradilla-Martín, Andrea Ruzzenente, Alessandro Ferrero, Francesco Izzo, Guido Torzilli, Antonio Moral Duarte, Santiago Sánchez Cabús

Published in

Journal of laparoendoscopic & advanced surgical techniques. Part A. Pages 10926429261497618. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Surgical strategies for colorectal liver metastases (CRLM) have progressively evolved toward parenchyma-sparing approaches, increasing the relevance of understanding the relationship between tumor biology and resection margin patterns. In parallel, KRAS and BRAF mutations have emerged as key determinants of tumor behavior in CRLM. The interaction between mutational status and surgical margin type, however, remains insufficiently characterized.
This multicenter retrospective study included patients undergoing curative-intent liver resection for CRLM between 2016 and 2021 across 17 international HPB centers. Clinicopathological variables were compared according to mutational status and margin type.
Among 1078 eligible patients, KRAS-mutated patients more frequently presented synchronous metastases, nodal involvement, and administration of perioperative chemotherapy compared with wild-type patients. Higher tumor burden was associated with both R1 parenchymal (R1P) and R1 vascular (R1V) resections. Within KRAS-mutated patients, synchronous disease and bilobar involvement were more frequently associated with R1P resections.
KRAS/BRAF mutational status is associated with distinct clinicopathological patterns in patients undergoing liver resection for CRLM. Higher tumor burden and biologically aggressive disease features are more frequently associated with R1P and R1V resections, particularly among KRAS-mutated tumors.

PMID:
42864778
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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