Correlation between KRAS mutation status and clinical outcomes in colorectal cancer patients: a retrospective cohort study
DOI:
https://doi.org/10.18203/2349-2902.isj20261562Keywords:
Colorectal cancer, KRAS mutation, Metastasis, Survival, IndonesiaAbstract
Background: Kirsten rat sarcoma (KRAS) mutations are key drivers in colorectal cancer (CRC), but their prognostic impact in stage III disease remains debated. This study evaluated the correlation between KRAS mutations and clinical outcomes in stage III CRC patients.
Methods: A retrospective cohort study was conducted on 48 patients at Dr. Moewardi General Hospital. KRAS status was determined via immunohistochemistry (IHC) (G12D), and outcomes were analyzed using Fisher’s Exact test.
Results: KRAS mutations were prevalent in 66.7% of patients. Distant metastasis occurred in 45.8% of cases, primarily in the liver and lungs. No significant correlation was found between KRAS mutation status and distant metastasis (p=0.735) or mortality (p=0.648).
Conclusions: While KRAS mutations are frequent in stage III CRC patients in this setting, they did not significantly predict metastasis or survival. Prognostic assessments should incorporate broader molecular profiling and clinicopathological factors.
References
Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol. 2019;14(2):89-103.
Binefa G, Rodríguez-Moranta F, Àngel Teule À, Medina-Hayas M. Colorectal cancer: from prevention to personalized medicine. World J Gastroenterol. 2014;20(22):6786-808.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49.
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-91.
Gelband H, Jha P, Sankaranarayanan R, Horton S. Cancer: Disease Control Priorities, Third Edition (Volume 3). Washington (DC): The International Bank for Reconstruction and Development/The World Bank. 2015.
Recio-Boiles A, Cagir B. Colon Cancer. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2021.
Zhu G, Pei L, Jiao H, Liu H, Jiao S. Precision distribution of KRAS mutations in colorectal cancer and their prognostic value. Oncol Lett. 2021;21(1):5.
Lavacchi D, Buttitta E, Di Costanzo F, Mazzoni F, Antonuzzo L. The treatment of BRAF-mutant metastatic colorectal cancer: the current status and future perspectives. Ther Adv Med Oncol. 2022;14:17588359221108688.
Huang L, Guo Z, Wang F, Fu L. KRAS mutation: from undruggable to druggable in cancer. Signal Transduct Target Ther. 2021;6(1):386.
Ji Z, Tian W, Gao W, Pu L, Lian J, Gu L, et al. Clinical Significance of KRAS, BRAF, and PIK3CA Mutations in Colorectal Cancer: A Systematic Review and Meta-Analysis. Front Oncol. 2022;12:853444.
Arrington AK, Heinrich EL, Lee W, Duldulao P, Patel S, Garcia-Aguilar J, et al. Prognostic and predictive roles of KRAS mutation in colorectal cancer. Int J Mol Sci. 2012;13(10):12153-73.
Li W, Qiu T, Zhi W. Prognostic value of KRAS mutation classification in metastatic colorectal cancer. Sci Rep. 2020;10(1):1-9.
Modest DP, Ricard I, Stintzing S. Relation of KRAS/NRAS Mutation Status to Clinical Outcomes in Patients With Metastatic Colorectal Cancer. J Clin Oncol. 2016;34(25):3063-70.
Serebriiskii IG, Connelly C, Frampton G. Comprehensive characterization of RAS mutations in colon and rectal cancer in old and young patients. Nat Commun. 2019;10(1):3722.
Escrig-Sos J, Senent-Vicente FJ, Ferron-Oriola G. The AJCC/UICC TNM staging system for colorectal cancer (8th edition): A review. J Clin Med. 2019;8(5):NA.
van de Haar J, Ma X, Ooft SN, van der Helm PW, Hoes LR, Mainardi S, et al. Codon-specific KRAS mutations predict survival benefit of adjuvant chemotherapy in colorectal cancer patients. Nature Medicine. 2023;29(3):605-14.
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