Journal article
The Impact of KRAS Mutation on the Presentation and Prognosis of Non-Metastatic Colon Cancer: an Analysis from the National Cancer Database
Journal of gastrointestinal surgery, Vol.24(6), pp.1402-1410
06/01/2020
DOI: 10.1007/s11605-020-04543-4
PMID: 32128676
Abstract
Introduction Approximately 40% of colorectal cancers have a KRAS mutation. The prognostic significance of KRAS mutations in patients with non-metastatic colon cancer has not been well elucidated. The National Cancer Database (NCDB) was used to analyze factors associated with KRAS mutation as well as its impact on the presentation and survival of patients with stages I-III colon cancer. Methods The NCDB was queried to identify patients diagnosed with stages I-III adenocarcinoma of the colon from 2004 to 2015. Results A total of 19,877 patients with known KRAS status were identified: mutation rates were 33% in stage I, 35% in stage II, and 38% in stage III patients (p < 0.01). On multivariable analysis, black race and right-sided location were independently associated with KRAS-mutated cancers (all p < 0.01). On univariate analysis for overall survival (OS), KRAS mutation was not significantly associated with a worse 5-year OS for stages I and II patients (p = 0.60 and 0.88, respectively). However, stage III KRAS-mutated colon cancers had a lower OS as compared with KRAS wild type cancers both on univariate and multivariable analysis. Right-sided colon cancers were independently associated with a worse prognosis compared with left-sided lesions (p < 0.01). Conclusions KRAS-mutated colon cancers were more frequently observed in black patients, right-sided locations, and higher-stage tumors. These mutations had a negative prognostic impact for stage III patients, suggesting that the incorporation of genotypic data into colon cancer staging may help to guide systemic therapy and prognostication of colon cancer patients.
Details
- Title: Subtitle
- The Impact of KRAS Mutation on the Presentation and Prognosis of Non-Metastatic Colon Cancer: an Analysis from the National Cancer Database
- Creators
- Aaron Scott - University of Iowa Hospitals and ClinicsPaolo Goffredo - University of Iowa Hospitals and ClinicsTimothy Ginader - University of IowaJennifer Hrabe - University of Iowa Hospitals and ClinicsIrena Gribovskaja-Rupp - University of IowaMuneera R. Kapadia - University of IowaRonald J. Weigel - University of Iowa Hospitals and ClinicsImran Hassan - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of gastrointestinal surgery, Vol.24(6), pp.1402-1410
- Publisher
- Springer Nature
- DOI
- 10.1007/s11605-020-04543-4
- PMID
- 32128676
- ISSN
- 1091-255X
- eISSN
- 1873-4626
- Number of pages
- 9
- Language
- English
- Date published
- 06/01/2020
- Academic Unit
- Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Biochemistry and Molecular Biology
- Record Identifier
- 9984288627902771
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