The association of KRAS mutation with primary tumor location and survival in patients undergoing resection of colorectal cancers and synchronous liver metastases.
Chin Clin Oncol
; 8(5): 46, 2019 Oct.
Article
de En
| MEDLINE
| ID: mdl-31500429
ABSTRACT
BACKGROUND:
Recent evidence suggests that a mutation in the KRAS gene has a significant impact on the clinical behavior and prognosis of patients with metastatic colorectal cancer. The KRAS mutation (m-KRAS) has been associated with decreased survival among patient undergoing treatment with a curative and palliative intent. This is believed to be secondary to a reduced response to anti-EGFR chemotherapy agents and a more intrinsically aggressive biology. The aims of this study were to identify risk factors for m-KRAS in patients with curatively resected colorectal cancer and synchronous liver metastases and to assess its association with disease-specific survival (DSS).METHODS:
The Surveillance, Epidemiology and End Results (SEER) Database was surveyed for patients undergoing resection of colorectal cancer and synchronous liver metastases from 2010 to 2015.RESULTS:
A total of 806 patients were included, of which 40% hadm-KRAS. Right-sided primary lesions (OR 2.56, 95% CI 1.90-3.44, P<0.001) and African-American ethnicity (OR 1.58, 95% CI 1.05-2.40, P=0.03) were independently associated with m-KRAS on multivariable analysis. Compared to wild-type KRAS (wt-KRAS), m-KRAS was associated with decreased 3- and 5-year DSS (59% vs. 50% and 29% vs. 21%, respectively, P=0.024). After adjusting for confounders, a decreased DSS was observed in patients with right-sided lesions (HR 1.68, 95% CI 1.32-2.12, P<0.001), while m-KRAS was associated with a trend toward decreased DSS (HR 1.15, 95% CI 0.91-1.46, P=0.24).CONCLUSIONS:
In patients undergoing surgical resection of colorectal cancer and synchronous liver metastases, m-KRAS was associated with right-sided lesions and African-American ethnicity. Compared to wt-KRAS, m-KRAS was associated with a reduced DSS. Additionally, right-sided lesions were an independent negative prognostic factor for DSS.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs colorectales
/
Protéines proto-oncogènes p21(ras)
/
Tumeurs du foie
Type d'étude:
Prognostic_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Chin Clin Oncol
Année:
2019
Type de document:
Article
Pays d'affiliation:
Italie