Lung adenocarcinoma: Predictive value of KRAS mutation status in assessing local recurrence in patients undergoing image-guided ablation Journal Article


Authors: Ziv, E.; Erinjeri, J. P.; Yarmohammadi, H.; Boas, F. E.; Petre, E. N.; Gao, S.; Shady, W.; Sofocleous, C. T.; Jones, D. R.; Rudin, C. M.; Solomon, S. B.
Article Title: Lung adenocarcinoma: Predictive value of KRAS mutation status in assessing local recurrence in patients undergoing image-guided ablation
Abstract: Purpose: To establish the relationship between KRAS mutation status and local recurrence after image-guided ablation of lung adenocarcinoma. Materials and Methods: This study consisted of a HIPAA-compliant institutional review board-approved retrospective review of 56 primary lung adenocarcinomas in 54 patients (24 men, 30 women; median age, 72 years; range, 54-87 years) treated with percutaneous image-guided ablation and with available genetic mutational analysis. KRAS mutation status and additional clinical and technical variables-Eastern Cooperative Oncology Group (ECOG) status, smoking history, stage at diagnosis, status (new primary or not), history of radiation, history of surgery, prior systemic treatment, modality of ablation, size of nodule, ablation margin, and presence of ground-glass appearance-were recorded and evaluated in relation to time to local recurrence, which was calculated from the time of ablation to the first radiographic evidence of recurrence. Predictors of outcome were identified by using a proportional hazards model for both univariate and multivariate analysis, with death as a competing risk. Results: Technical success was 100%. Of the 56 ablated tumors, 37 (66%) were wild type for KRAS and 19 (34%) were KRAS mutants. The 1-year and 3-year cumulative incidences of recurrence were 20% and 35% for wild-type KRAS compared with 40% and 63% for KRAS mutant tumors. KRAS mutation status was a significant predictor of local recurrence at both univariate (P = .05; subdistribution hazard ratio [sHR], 2.32) and multivariate (P = .006; sHR, 3.75) analysis. At multivariate analysis, size (P = .026; sHR, 2.54) and ECOG status (P = .012; sHR, 2.23) were also independent significant predictors, whereas minimum margin (P = .066) was not. Conclusion: The results of this study show that there is a relationship between KRAS mutation status and local recurrence after image-guided ablation of lung adenocarcinoma. Specifically, KRAS mutation status of the ablated lesion is a significant predictor of time to local recurrence, independent of size and margin.
Journal Title: Radiology
Volume: 282
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2017-01-01
Start Page: 251
End Page: 258
Language: English
DOI: 10.1148/radiol.2016160003
PROVIDER: scopus
PMCID: PMC5207123
PUBMED: 27440441
DOI/URL:
Notes: Article -- Export Date: 2 February 2017 -- Source: Scopus
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MSK Authors
  1. Stephen Solomon
    424 Solomon
  2. Joseph Patrick Erinjeri
    203 Erinjeri
  3. Elena Nadia Petre
    108 Petre
  4. Charles Rudin
    489 Rudin
  5. David Randolph Jones
    417 Jones
  6. Franz Edward Boas
    77 Boas
  7. Etay   Ziv
    112 Ziv
  8. Waleed   Shady
    10 Shady
  9. Song   Gao
    3 Gao