Association of RAS mutation location and oncologic outcomes after resection of colorectal liver metastases Journal Article
| Authors: | Saadat, L. V.; Boerner, T.; Goldman, D. A.; Gonen, M.; Frankel, T. L.; Vakiani, E.; Kingham, T. P.; Jarnagin, W. R.; Wei, A. C.; Soares, K. C.; Solit, D. B.; D’Angelica, M. I. |
| Article Title: | Association of RAS mutation location and oncologic outcomes after resection of colorectal liver metastases |
| Abstract: | Background: RAS mutations are prognostic for patients with metastatic colorectal cancer (mCRC). We investigated clinical, pathologic, and survival differences based on RAS exon for patients with colorectal liver metastases (CRLM). Methods: This retrospective, single-center study included patients with R0/R1 resection of CRLM from 1992 to 2016. Patients with unresected extrahepatic disease or liver-first resection were excluded. Overall survival (OS) and recurrence-free survival were assessed and stratified by mutation status and location. Fisher’s exact test, Wilcoxon rank-sum test, and log-rank test were used, where appropriate. Results: A total of 938 mCRC patients were identified with median age of 57 (range 19–91). Of the 445 patients with KRAS mutations, 407 (91%) had a mutation in exon 2, 14 (3%) exon 3, and 24 (5%) exon 4. Median OS was 71.4 months (95% confidence interval [CI] 66.1–76.5). Patients with KRAS mutations had worse OS compared with KRAS wild-type patients (median 55.5 vs. 91.3 months, p < 0.001). While there was no significant difference in OS based on the exon mutated (p = 0.12), 5-year OS was higher for patients with exon 4 mutations [68.8% (95% CI 0.45–0.84)] compared with those with mutations in exon 2 [45.7% (95% CI 0.40–0.51)] or exon 3 [39.1% (95% CI: 0.11–0.68)]. Patients with NRAS mutant tumors also had worse OS compared with NRAS wild-type patients (median 50.9 vs. 73.3 months, p = 0.03). Conclusions: NRAS and KRAS exon 3/4 mutations are present in a minority of mCRC patients. Patients with exon 4 mutant tumors may have a more favorable prognosis, although the difference in oncologic outcomes based on mutated exon appears to be smaller than previously reported. © 2020, Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 28 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2021-02-01 |
| Start Page: | 817 |
| End Page: | 825 |
| Language: | English |
| DOI: | 10.1245/s10434-020-08862-3 |
| PUBMED: | 32683635 |
| PROVIDER: | scopus |
| PMCID: | PMC7854850 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2021 -- Source: Scopus |
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