同步结直肠癌（CRC）的遗传改变对肿瘤学的影响仍不清楚。本研究旨在通过进行系统回顾来比较同步和孤立的CRC之间的遗传改变与肿瘤学相关性。对接受根治切除的CRC患者进行了多中心回顾性分析。遗传分析包括微卫星不稳定性（MSI）检测、RAS（K-ras和N-ras）和BRAF（v-Raf murine sarcoma viral oncogene homolog B1）V600E突变。使用逻辑回归对同步性进行多因素分析，使用Cox比例风险模型在整体存活期（OS）和无病生存期（DFS）进行了级别调整。同步（n=36）和孤立（n=579）CRC具有类似的基线特征。RAS突变与同步CRC相关，而MSI和BRAF无关。在中位随访77.8个月期间，Kaplan-Meier曲线显示，根据MSI高和RAS、BRAF突变，OS和DFS有显著差异。在多变量分析中，RAS和BRAF突变是独立因素（RAS，HR=1.808，95% CI=1.18-2.77，p=0.007；BRAF，HR=2.417，95% CI=1.32-4.41，p=0.004）。老年是OS的独立因素（HR=3.626，95% CI=1.09-12.00，p=0.035）。本研究显示，RAS、BRAF和MSI的突变负荷可能导致同步CRC和孤立CRC之间的肿瘤学结果不同。此外，我们的系统回顾突出了同步CRC的遗传特征和生存结果相对于孤立CRC的数据缺乏和异质性。© 2023 BioMed Central Ltd.，斯普林格自然集团的一部分。

Oncologic impact of genetic alteration across synchronous colorectal cancer (CRC) still remains unclear. This study aimed to compare the oncologic relevance according to genetic alteration between synchronous and solitary CRC with performing systematic review.Multicenter retrospective analysis was performed for CRC patients with curative resection. Genetic profiling was consisted of microsatellite instability (MSI) testing, RAS (K-ras, and N-ras), and BRAF (v-Raf murine sarcoma viral oncogene homolog B1) V600E mutation. Multivariate analyses were conducted using logistic regression for synchronicity, and Cox proportional hazard model with stage-adjusting for overall survival (OS) and disease-free survival (DFS).It was identified synchronous (n = 36) and solitary (n = 579) CRC with similar base line characteristics. RAS mutation was associated to synchronous CRC with no relations of MSI and BRAF. During median follow up of 77.8 month, Kaplan-meier curves showed significant differences according to MSI-high for OS, and in RAS, and BRAF mutation for DFS, respectively. In multivariable analyses, RAS and BRAF mutation were independent factors (RAS, HR = 1.808, 95% CI = 1.18-2.77, p = 0.007; BRAF, HR = 2.417, 95% CI = 1.32-4.41, p = 0.004). Old age was independent factor for OS (HR = 3.626, 95% CI = 1.09-12.00, p = 0.035).This study showed that oncologic outcomes might differ according to mutation burden characterized by RAS, BRAF, and MSI between synchronous CRC and solitary CRC. In addition, our systematic review highlighted a lack of data and much heterogeneity in genetic characteristics and survival outcomes of synchronous CRC relative to that of solitary CRC.© 2023. BioMed Central Ltd., part of Springer Nature.