Limited Prognostic Value of KRAS in Patients Undergoing Hepatectomy for Colorectal Liver Metastases View Full Text


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Article Info

DATE

2021-12-01

AUTHORS

Yoshinori Takeda, Yoshihiro Mise, Yu Takahashi, Hiromichi Ito, Yosuke Inoue, Ryuji Yoshioka, Yoshihiro Ono, Akio Saiura

ABSTRACT

BackgroundRAS mutation status is considered a powerful prognostic factor in patients undergoing hepatectomy for colorectal liver metastases (CLM). However, whether its prognostic power is robust regardless of administration of preoperative chemotherapy or tumor burden remains unclear.MethodsConsecutive patients who underwent initial hepatectomy for CLM from April 2010 through March 2017 in two hospitals were included. The prognostic value of KRAS was compared based on whether patients received preoperative chemotherapy and their tumor burden score (TBS).ResultsWe included 409 patients (median follow-up 38 months). In the preoperative chemotherapy group, patients with mutant KRAS (mt-KRAS) CLM had poorer overall survival (OS) than those with wild KRAS (wt-KRAS; 5-year OS: 37.7% vs 53.8%, p = 0.024), although their OS was not different from patients undergoing upfront surgery. Similarly, patients with mt-KRAS had poorer OS than those with wt-KRAS in TBS of 3–9 (5-year OS: 33.1% vs 63.2%, p = 0.001), although their OS was not different from patients with TBS < 3 or ≥ 9. In multivariate analysis, mt-KRAS was an independent prognostic factor of OS among patients receiving preoperative chemotherapy (hazard ratio [HR] 1.61, 95% confidence interval [CI]: 1.034–2.491; p = 0.035) and patients with TBS of 3–9 (HR 1.836, 95% CI 1.176–2.866; p = 0.008). However, it was not a prognostic factor in patients who underwent upfront surgery or with TBS > 3 or ≥ 9. ConclusionsIn patients undergoing hepatectomy for CLM, the prognostic value of KRAS depends on their history of preoperative chemotherapy or tumor burden. More... »

PAGES

2383-2391

References to SciGraph publications

  • 2016-03-25. RAS Mutation Predicts Positive Resection Margins and Narrower Resection Margins in Patients Undergoing Resection of Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2016-05-20. Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2018-05-21. RAS Mutation is Associated with Unsalvageable Recurrence Following Hepatectomy for Colorectal Cancer Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2015-06-16. Effect of KRAS Mutation on Long-Term Outcomes of Patients Undergoing Hepatic Resection for Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2015-05-05. BRAF and RAS mutations as prognostic factors in metastatic colorectal cancer patients undergoing liver resection in BRITISH JOURNAL OF CANCER
  • 2012-07-21. Poor prognosis of KRAS or BRAF mutant colorectal liver metastasis without microsatellite instability in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2016-01-19. KRAS Mutation Status Predicts Site-Specific Recurrence and Survival After Resection of Colorectal Liver Metastases Irrespective of Location of the Primary Lesion in ANNALS OF SURGICAL ONCOLOGY
  • 2014-09-17. RAS Mutations Predict Radiologic and Pathologic Response in Patients Treated with Chemotherapy Before Resection of Colorectal Liver Metastases in ANNALS OF SURGICAL ONCOLOGY
  • 2017-10-25. Impact of RAS Mutations in Metastatic Colorectal Cancer After Potentially Curative Resection: Does Site of Metastases Matter? in ANNALS OF SURGICAL ONCOLOGY
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    http://scigraph.springernature.com/pub.10.1245/s10434-021-11015-9

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34851437


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