KRAS mutation influences recurrence patterns in patients undergoing hepatic resection of colorectal metastases. Issue 24 (25th August 2014)

• Record Type: Journal Article
• Authors: Kemeny, Nancy E.; Chou, Joanne F.; Capanu, Marinela; Gewirtz, Alexandra N.; Cercek, Andrea; Kingham, T. Peter; Jarnagin, William R.; Fong, Yuman C.; DeMatteo, Ronald P.; Allen, Peter J.; Shia, Jinru; Ang, Celina; Vakiani, Efsevia; D'Angelica, Michael I.
• Is Part Of: Cancer. Volume 120:Issue 24(2014)
• Page Start: 3965
• Page End: 3971
• Publication Date: 2014-08-25
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28954
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28954-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The validity of the <italic>KRAS</italic> mutation as a predictor of recurrence‐free survival (RFS) or overall survival (OS) is unclear. The current study investigated whether the presence of the <italic>KRAS</italic> mutation decreased RFS or OS in patients with colorectal cancer who underwent liver resection.</p> </sec> <sec id="cncr28954-sec-0002" sec-type="section"> <title>METHODS</title> <p>Patients with resected colorectal liver metastases who received adjuvant hepatic arterial infusion plus systemic therapy and for whom <italic>KRAS</italic> data was available were evaluated. Correlation between <italic>KRAS</italic> and clinical factors was done using the Fisher exact test. Kaplan‐Meier methods were used to estimate the median RFS and OS.</p> </sec> <sec id="cncr28954-sec-0003" sec-type="section"> <title>RESULTS</title> <p>A total of 169 patients were evaluated, 118 of whom had <italic>KRAS</italic> wild‐type (WT) and 51 had <italic>KRAS</italic> mutated (MUT) tumors. The 3‐year RFS rate was 46% for patients with <italic>KRAS</italic> WT (95% confidence interval [95% CI], 35%‐56%) and 30% (95% CI, 16%‐44%) for patients with <italic>KRAS</italic> MUT (<italic>P =</italic>.005). The 3‐year OS rate was 95% (95% CI, 87%‐98%) and 81% (95% CI, 62%‐95%), respectively, for patients with <italic>KRAS</italic> WT and <italic>KRAS</italic> MUT (<italic>P =</italic>.07). On multivariate analysis, <italic>KRAS</italic> 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 (<italic>P</italic>≤.01), 2% versus 14.5% for brain (<italic>P =</italic>.05), 33.2% versus 58% for lung (<italic>P</italic>≤.01), and 30% versus 47% for liver (<italic>P =</italic>.10) in patients with <italic>KRAS</italic> WT versus <italic>KRAS</italic> MUT.</p> </sec> <sec id="cncr28954-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>In the current study, among patients with resected colorectal liver metastases who were treated with adjuvant hepatic arterial infusion plus systemic therapy, patients with <italic>KRAS</italic> MUT were found to have a significantly worse 3‐year RFS (30%) compared with <italic>KRAS</italic> WT (46%) <italic>p</italic>=.005. The cumulative incidence of bone, brain, and lung metastases was significantly higher for patients with <italic>KRAS</italic> MUT compared with those with <italic>KRAS</italic> WT. <bold><italic>Cancer</italic> 2014;120:3965–3971</bold>. © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>