KRAS mutation influences recurrence patterns in patients undergoing hepatic resection of colorectal metastases Journal Article


Authors: Kemeny, N. E.; Chou, J. F.; Capanu, M.; Gewirtz, A. N.; Cercek, A.; Kingham, T. P.; Jarnagin, W. R.; Fong, Y.; DeMatteo, R. P.; Allen, P. J.; Shia, J.; Ang, C.; Vakiani, E.; D'Angelica, M. I.
Article Title: KRAS mutation influences recurrence patterns in patients undergoing hepatic resection of colorectal metastases
Abstract: BACKGROUND: The validity of the KRAS mutation as a predictor of recurrence-free survival (RFS) or overall survival (OS) is unclear. The current study investigated whether the presence of the KRAS mutation decreased RFS or OS in patients with colorectal cancer who underwent liver resection. METHODS: Patients with resected colorectal liver metastases who received adjuvant hepatic arterial infusion plus systemic therapy and for whom KRAS data was available were evaluated. Correlation between KRAS and clinical factors was done using the Fisher exact test. Kaplan-Meier methods were used to estimate the median RFS and OS. RESULTS: A total of 169 patients were evaluated, 118 of whom had KRAS wild-type (WT) and 51 had KRAS mutated (MUT) tumors. The 3-year RFS rate was 46% for patients with KRAS WT (95% confidence interval [95% CI], 35%-56%) and 30% (95% CI, 16%-44%) for patients with KRAS MUT (P 5.005). The 3-year OS rate was 95% (95% CI, 87%-98%) and 81% (95% CI, 62%-95%), respectively, for patients with KRAS WT and KRAS MUT (P 5.07). On multivariate analysis, KRAS remained a significant predictor of RFS (hazard ratio, 1.9). The 3-year cumulative recurrence rate by site of metastases was as follows: 2% versus 13.4% for bone (P≤.01), 2% versus 14.5% for brain (P 5.05), 33.2% versus 58% for lung (P≤.01), and 30% versus 47% for liver (P 5.10) in patients with KRAS WT versus KRAS MUT. CONCLUSIONS: In the current study, among patients with resected colorectal liver metastases who were treated with adjuvant hepatic arterial infusion plus systemic therapy, patients with KRAS MUT were found to have a significantly worse 3-year RFS (30%) compared with KRAS WT (46%) p5.005. The cumulative incidence of bone, brain, and lung metastases was significantly higher for patients with KRAS MUT compared with those with KRAS WT.
Keywords: adjuvant therapy; colorectal cancer; liver metastases; kras mutation; disease recurrence patterns
Journal Title: Cancer
Volume: 120
Issue: 24
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2014-12-15
Start Page: 3965
End Page: 3971
Language: English
DOI: 10.1002/cncr.28954
PROVIDER: scopus
PUBMED: 25155157
PMCID: PMC4574496
DOI/URL:
Notes: Export Date: 2 January 2015 -- Source: Scopus
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MSK Authors
  1. Joanne Fu-Lou Chou
    153 Chou
  2. Ronald P DeMatteo
    597 DeMatteo
  3. Marinela Capanu
    206 Capanu
  4. Jinru Shia
    450 Shia
  5. Peter Allen
    436 Allen
  6. William R Jarnagin
    583 Jarnagin
  7. Yuman Fong
    741 Fong
  8. Celina Su-Ping Ang
    29 Ang
  9. T Peter Kingham
    281 Kingham
  10. Efsevia Vakiani
    162 Vakiani
  11. Nancy Kemeny
    347 Kemeny
  12. Alexandra Gewirtz
    16 Gewirtz