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Codon 13 KRAS mutation predicts patterns of recurrence in patients undergoing hepatectomy for colorectal liver metastases
Cancer, 2016-09, Vol.122 (17), p.2698-2707
Margonis, Georgios A.
Kim, Yuhree
Sasaki, Kazunari
Samaha, Mario
Amini, Neda
Pawlik, Timothy M.
2016
Details
Autor(en) / Beteiligte
Margonis, Georgios A.
Kim, Yuhree
Sasaki, Kazunari
Samaha, Mario
Amini, Neda
Pawlik, Timothy M.
Titel
Codon 13 KRAS mutation predicts patterns of recurrence in patients undergoing hepatectomy for colorectal liver metastases
Ist Teil von
Cancer, 2016-09, Vol.122 (17), p.2698-2707
Ort / Verlag
United States
Erscheinungsjahr
2016
Link zum Volltext
Quelle
Electronic Journals Library
Beschreibungen/Notizen
BACKGROUND Investigations regarding the impact of tumor biology after surgical management of colorectal liver metastasis have focused largely on overall survival. We investigated the impact of codon‐specific KRAS mutations on the rates and patterns of recurrence in patients after surgery for colorectal liver metastasis (CRLM). METHODS All patients who underwent curative‐intent surgery for CRLM between 2002 and 2015 at Johns Hopkins who had available data on KRAS mutation status were identified. Clinico‐pathologic data, recurrence patterns, and recurrence‐free survival (RFS) were assessed using univariable and multivariable analyses. RESULTS A total of 512 patients underwent resection only (83.2%) or resection plus radiofrequency ablation (16.8%). Although 5‐year overall survival was 64.6%, 284 (55.5%) patients recurred with a median RFS time of 18.1 months. The liver was the initial recurrence site for 181 patients, whereas extrahepatic recurrence was observed in 162 patients. Among patients with an extrahepatic recurrence, 102 (63%) had a lung recurrence. Although overall KRAS mutation was not associated with overall RFS (P = 0.186), it was independently associated with a worse extrahepatic (P = 0.004) and lung RFS (P = 0.007). Among patients with known KRAS codon‐specific mutations, patients with codon 13 KRAS mutation had a worse 5‐year extrahepatic RFS (P = 0.01), whereas codon 12 mutations were not associated with extrahepatic (P = 0.11) or lung‐specific recurrence rate (P = 0.24). On multivariable analysis, only codon 13 mutation independently predicted worse overall extrahepatic RFS (P = 0.004) and lung‐specific RFS (P = 0.023). CONCLUSIONS Among patients undergoing resection of CRLM, overall KRAS mutation was not associated with RFS. KRAS codon 13 mutations, but not codon 12 mutations, were associated with a higher risk for overall extrahepatic recurrence and lung‐specific recurrence. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2698–2707. © 2016 American Cancer Society. Overall KRAS mutation is not associated with recurrence‐free survival in patients who undergo resection of CRLM. However, KRAS codon 13 mutations are associated with a higher risk for overall extrahepatic recurrence and lung‐specific recurrence.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.30085
Titel-ID: cdi_proquest_miscellaneous_1815696481
Format
–
Schlagworte
Aged
,
Biomarkers, Tumor - genetics
,
codon‐specific mutation
,
colorectal liver metastasis
,
Colorectal Neoplasms - genetics
,
Colorectal Neoplasms - pathology
,
Colorectal Neoplasms - surgery
,
Female
,
Follow-Up Studies
,
Hepatectomy
,
Humans
,
KRAS mutation
,
Liver Neoplasms - genetics
,
Liver Neoplasms - secondary
,
Liver Neoplasms - surgery
,
Male
,
Middle Aged
,
Mutation - genetics
,
Neoplasm Recurrence, Local - genetics
,
Neoplasm Recurrence, Local - pathology
,
Neoplasm Recurrence, Local - surgery
,
Neoplasm Staging
,
Prognosis
,
Proto-Oncogene Proteins p21(ras) - genetics
,
recurrence patterns
,
Retrospective Studies
,
Survival Rate
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