The prognostic value of KRAS mutations in patients with colorectal cancer

Inoue,Yasuhiro; Saigusa,Susumu; Iwata,Takashi; Okugawa,Yoshinaga; Toiyama,Yuji; Tanaka,Koji; Uchida,Keiichi; Mohri,Yasuhiko; Kusunoki,Masato

doi:10.3892/or.2012.1974

The prognostic value of KRAS mutations in patients with colorectal cancer

Authors:
- Yasuhiro Inoue
- Susumu Saigusa
- Takashi Iwata
- Yoshinaga Okugawa
- Yuji Toiyama
- Koji Tanaka
- Keiichi Uchida
- Yasuhiko Mohri
- Masato Kusunoki
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Affiliations: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie 514-8507, Japan
Published online on: August 21, 2012 https://doi.org/10.3892/or.2012.1974
Pages: 1579-1584

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Abstract

Our aim was to evaluate the KRAS genotypes of Japanese colorectal cancer (CRC) patients and to assess the effect of these genotypes on clinical outcome. A total of 99 patients with stage I-IV CRC who underwent resection were prospectively studied for KRAS mutations by direct sequencing. KRAS mutations were found in 37 (37.4%) of 99 patients. Of these, 11.1% were the KRAS p.G13D mutation and the remaining 26.2% were other KRAS mutations. The cumulative 5-year survival rates for patients with wild-type KRAS, KRAS 12 and KRAS p.G13D mutations were 81.4, 61.4 and 42.0%, respectively (P=0.0397). The KRAS genotype had no effect on stage IV patient prognosis without anti-epithelial growth factor receptor (EGFR) antibody therapy. However, in stage I-III patients significant or trends in prognostic factors for disease-free survival (DFS) were pathological T stage, lymphatic vessel involvement and KRAS p.G13D. Multivariate analysis identified T4 pathological stage (P=0.0076) and the KRAS p.G13D mutation (P=0.0499) as the most significant independent prognostic factors associated with DFS. In Japanese CRC patients KRAS p.G13D had prognostic impact on DFS in stage I-III disease, while the prognosis of stage IV patients without anti-EGFR antibody therapy was unaffected by KRAS status.

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