Journal article
KRAS Testing, Tumor Location, and Survival in Patients With Stage IV Colorectal Cancer: SEER 2010-2013
Journal of the National Comprehensive Cancer Network, Vol.15(12), pp.1484-1493
12/2017
DOI: 10.6004/jnccn.2017.7011
PMCID: PMC7458121
PMID: 29223986
Abstract
mutations and tumor location have been associated with response to targeted therapy among patients with stage IV colorectal cancer (CRC) in various trials. This study performed the first population-based examination of associations between
mutations, tumor location, and survival, and assessed factors associated with documented
testing.
Patients with stage IV adenocarcinoma of the colon/rectum diagnosed from 2010 to 2013 were extracted from SEER data. Analyses of patient characteristics,
testing, and tumor location were conducted using logistic regression. Cox proportional hazards models assessed relationships between
mutations, tumor location, and risk of all-cause death.
Of 22,542 patients, 30% received
testing, and 44% of these had mutations. Those tested tended to be younger, married, and metropolitan area residents, and have private insurance or Medicare. Rates of
testing also varied by registry (range, 20%-46%). Patients with right-sided colon cancer (vs left-sided) tended to be older, female, and black; have mucinous,
-mutant tumors; and have a greater risk of death (hazard ratio [HR], 1.27; 95% CI, 1.22-1.32).
mutations were not associated with greater risk of death in the overall population; however, they were associated with greater risk of death among patients with left-sided colon cancer (HR, 1.19; 95% CI, 1.05-1.33).
This large population-based study showed that among patients initially diagnosed with stage IV CRC, right-sided colon cancer was associated with greater risk of death compared with left-sided cancer, and
mutations were only associated with risk of death in left-sided colon cancer. An unexpected finding was that among patients with stage IV disease, right-sided cancer was more commonly seen in black patients versus whites. Future studies should further explore these associations and determine the role of biology versus treatment differences. In addition, use of
testing is increasing, but there is wide geographic variation wherein disparities related to insurance coverage and rurality may warrant further study.
Details
- Title: Subtitle
- KRAS Testing, Tumor Location, and Survival in Patients With Stage IV Colorectal Cancer: SEER 2010-2013
- Creators
- Mary E Charlton - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IowaAmanda R Kahl - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IowaAlissa A Greenbaum - Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, New MexicoJordan J Karlitz - Division of Gastroenterology, School of Medicine, Tulane University, New Orleans, LouisianaChi Lin - University of Nebraska Medical CenterCharles F Lynch - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IowaVivien W Chen - Louisiana Tumor Registry and Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
- Resource Type
- Journal article
- Publication Details
- Journal of the National Comprehensive Cancer Network, Vol.15(12), pp.1484-1493
- DOI
- 10.6004/jnccn.2017.7011
- PMID
- 29223986
- PMCID
- PMC7458121
- NLM abbreviation
- J Natl Compr Canc Netw
- ISSN
- 1540-1405
- eISSN
- 1540-1413
- Publisher
- United States
- Grant note
- P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 12/2017
- Academic Unit
- Health Management and Policy; Epidemiology
- Record Identifier
- 9983995058602771
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