1. Prognostic Implication of KRAS Status after Hepatectomy for Colorectal Liver Metastases Varies According to Primary Colorectal Tumor Location
- Author
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Yuhree Kim, Stefan Buettner, Nikolaos Andreatos, Kazunari Sasaki, Ana Wilson, Gaya Spolverato, Faiz Gani, Neda Amini, Timothy M. Pawlik, and Georgios A. Margonis
- Subjects
Male ,Oncology ,Colorectal cancer ,medicine.medical_treatment ,medicine.disease_cause ,0302 clinical medicine ,Cecum ,Liver Neoplasms ,Hazard ratio ,RAS MUTATION ,MUTATION STATUS ,Middle Aged ,CHEMOTHERAPY ,Prognosis ,Primary tumor ,CETUXIMAB ,Colon, Descending ,Survival Rate ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,SURVIVAL ,Female ,030211 gastroenterology & hepatology ,KRAS ,Colon, Transverse ,medicine.medical_specialty ,HEPATIC RESECTION ,Rectum ,Disease-Free Survival ,Descending colon ,BRAF ,Proto-Oncogene Proteins p21(ras) ,03 medical and health sciences ,Colon, Sigmoid ,Internal medicine ,DISTAL ,medicine ,Hepatectomy ,Humans ,RECURRENCE ,Survival rate ,Aged ,KeyWords Plus:SIDED COLON-CANCER ,Rectal Neoplasms ,business.industry ,medicine.disease ,digestive system diseases ,Mutation ,Surgery ,business - Abstract
Right-sided and left-sided colorectal cancer (CRC) is known to differ in their molecular carcinogenic pathways. We sought to investigate the variable prognostic implication of KRAS mutation after hepatectomy for colorectal liver metastases (CRLM) according to the site of primary CRC. A total of 426 patients who underwent a curative-intent hepatic resection and whose KRAS status was available were identified. Clinicopathologic characteristics and long-term outcomes were stratified by KRAS status (wild type vs. mutant type) and primary tumor location (right-sided vs. left-sided). Cecum, right and transverse colon were defined as right-sided, whereas left colon and rectum were defined as left-sided. Among patients with a right-sided CRC, 5-year recurrence-free survival (RFS) and overall survival (OS) were not correlated with KRAS status (wild type: 30.8 and 47.2 % vs. mutant type: 38.5 and 49.1 %, respectively) (both P > 0.05). Specifically, mutant-type KRAS was not associated with either RFS or OS on multivariable analysis (hazard ratio [HR] 1.51, 95 % confidence interval [CI] 0.73–3.14, P = 0.23 and HR 1.03, 95 % CI 0.51–2.08, P = 0.95, respectively). In contrast, among patients who underwent resection of CRLM from a left-sided primary CRC, 5-year RFS and OS were worse among patients with mutant-type KRAS (wild type: 23.7 and 57.2 % vs. mutant type: 19.6 and 38.2 %, respectively) (both P
- Published
- 2016