Association Between Specific Mutations inKRASCodon 12 and Colorectal Liver Metastasis

作者：Georgios Antonios Margonis, Yuhree Kim, Gaya Spolverato, Aslam M. Ejaz, Rohan Gupta, David Cosgrove, Robert A. Anders, Georgios Karagkounis, Michael A. Choti, Timothy Michael Pawlik · 发表于：JAMA Surgery · 年份：2015 · DOI：10.1001/jamasurg.2015.0313 · 被引用次数：164 · 研究领域：Colorectal Cancer Treatments and Studies、Hepatocellular Carcinoma Treatment and Prognosis、Liver physiology and pathology

IMPORTANCE: Currently, one of the most commonly available biomarkers in the treatment of patients with colorectal liver metastases (CRLM) is the Kirsten rat sarcoma viral oncogene homolog (KRAS); however, the prognostic implications of specific mutations of the KRAS gene are still not well defined. OBJECTIVE: To investigate the prognostic impact of specific KRAS mutations on patients undergoing liver resection for CRLM. DESIGN, SETTING, AND PARTICIPANTS: This retrospective single-center study was conducted from January 1, 2003, to December 31, 2013. Data about specific KRAS mutations for 331 patients who underwent hepatic resection for CRLM at Johns Hopkins Hospital between 2003 and 2013 were analyzed. Clinicopathological characteristics, perioperative details, and outcomes were stratified by specific KRAS mutation at codons 12 and 13. INTERVENTION: Resection of CRLM. MAIN OUTCOMES AND MEASURES: Overall survival (OS) and recurrence-free survival. RESULTS: A mutated KRAS (mtKRAS) was identified in 91 patients (27.5%). At a median follow-up of 27.4 months, recurrence was observed in 48 patients (52.7%) with mtKRAS and 130 patients (54.2%) with wild-type KRAS (wtKRAS) (P = .82). Median and 5-year survival among patients with mtKRAS was 32.4 months and 32.7%, respectively, vs 58.5 months and 46.9%, respectively, for patients with wtKRAS (P = .02). Patients with KRAS codon 12 mutations had worse OS (hazard ratio [HR], 1.54; 95% CI, 1.05-2.27; P = .03) vs those with wtKRAS, whereas...