Kras mutation is a marker of worse oncologic outcomes after percutaneous radiofrequency ablation of colorectal liver metastases Journal Article


Authors: Shady, W.; Petre, E. N.; Vakiani, E.; Ziv, E.; Gonen, M.; Brown, K. T.; Kemeny, N. E.; Solomon, S. B.; Solit, D. B.; Sofocleous, C. T.
Article Title: Kras mutation is a marker of worse oncologic outcomes after percutaneous radiofrequency ablation of colorectal liver metastases
Abstract: Background: Kras mutation has been associated with shorter overall survival and time to disease recurrence after resection of colorectal liver metastases (CLM). This study evaluated the prognostic value of Kras mutation in patients with CLM treated by percutaneous radiofrequency ablation (RFA). Methods: This is an IRB waived retrospective analysis of the impact of KRAS mutation status on oncologic outcomes after CLM RFA. The endpoints were overall survival (OS), local tumor progression (LTP) rates, and incidence of new liver, lung, and peritoneal metastases. Survival times were calculated using Kaplan-Meier methodology from the time of RFA. Results: The study enrolled 97 patients. Kras exon 2 mutation was detected in 39% (38/97) of patients. On univariate analysis, Kras mutation (P=0.016) (HR: 1.8; 95% CI: 1.1 - 2.9) was a significant predictor of OS and retained significance on multivariate analysis. Kras mutation was a significant predictor of new liver metastases (P=0.037) (SHR: 2.0; CI: 1.0-3.7) and peritoneal metastases (P=0.015) (sHR: 3.0; 95% CI: 1.2- 7.2) on multivariate analysis. Kras mutation was a significant predictor of LTP after RFA of CLM ablated with margins of 1-5 mm (P=0.018) (SHR: 3.0; 95% CI: 1.2-7.7) with an LTP rate of 80% (12/15) versus 41% (11/27) for wild type. Conclusion: Kras mutation is a significant predictor of overall survival, new liver, and peritoneal metastases after RFA of CLM. A minimal radiographic ablation margin = 6 mm is essential for local tumor control especially for mutant CLM. © Shady et al.
Keywords: colorectal liver metastases; percutaneous radiofrequency ablation; kras mutation; oncologic outcomes
Journal Title: Oncotarget
Volume: 8
Issue: 39
ISSN: 1949-2553
Publisher: Impact Journals  
Date Published: 2017-09-12
Start Page: 66117
End Page: 66127
Language: English
DOI: 10.18632/oncotarget.19806
PROVIDER: scopus
PMCID: PMC5630397
PUBMED: 29029497
DOI/URL:
Notes: Article -- Export Date: 2 November 2017 -- Source: Scopus
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MSK Authors
  1. David Solit
    779 Solit
  2. Mithat Gonen
    1029 Gonen
  3. Karen T Brown
    178 Brown
  4. Stephen Solomon
    422 Solomon
  5. Elena Nadia Petre
    108 Petre
  6. Efsevia Vakiani
    264 Vakiani
  7. Nancy Kemeny
    543 Kemeny
  8. Etay   Ziv
    111 Ziv
  9. Waleed   Shady
    10 Shady