Is it possible to predict recurrence after metastasectomy in metastatic liver cancers with molecular parameters? Retrospective study

In this planned thesis study, it is aimed to define a strong biomarker that can be used in routine practice by investigating the genetic and epigenetic signaling pathways that cause recurrence and short survival during follow-up in metastatic liver cancers (mCC) originating from colorectal tumors. In the current thesis study, the activity of stem cell markers, RAS, PIK3CA, P53, mTOR, VEGF signaling pathways and EMT mechanism were investigated using real-time PCR in mCCs and primary colorectal cancers determined in accordance with patient selection criteria. Using the web-based Sabiosciences PCR-Data Analysis program, fold changes expressing changes in mRNA expression level between groups were determined. In the study, 85 primary colorectal cancer cases were evaluated. CCT development was observed in 21 cases (24.7%). After metastasectomy, recurrence was detected in 9 of 21 cases. The mean overall survival was determined as 84 months. Disease-free survival was also found to be 51 months on average. Stem cell CD44, SNAIL, TWIST, MEK and mTOR expressions from EMT were found to be effective in the development of mKK. High expressions of CD44, mTOR and SNAIL were shown to be effective in the development of recurrence after metastasectomy. In this study, it was determined that the high expressions of CD44, mTOR and SNAIL in primary colorectal tumors are biomarker candidates that can be used to predict future mCC and even recurrence after metastasectomy in mCCs. Key Words: Liver metastasis, metastasectomy, siganling pathways, RT-PCR, colorectal cancer