The impact of KRAS gene status on clinical parameters and long-term prognosis of patients with colorectal cancer liver metastases / 中华肝胆外科杂志

ABSTRACT

Objective:To study the relationship between KRAS gene mutation and clinical parameters and prognosis in patients with colorectal cancer liver metastases (CRLM).Methods:To retrospectively study the impact of different KRAS status on the clinical parameters parameters and prognosis of 1 248 patients with CRLM treated from January 2005 to December 2019 at the First Medical Center, Chinese PLA General Hospital. There were 880 male and 368 female, age ranged from 21 to 88, median 56. The single factor and multi-factor logistic regression analyses were used to identify factors relating to KRAS mutation. Survival was analyzed by the Kaplan-Meier method, and survival rate by the log-rank test.Results:There were 729 KRAS gene wild-type patients and 519 mutant patients. The mutation rate was 41.6%(519/1 248). Primary site of tumor in 11 patients were located in the bilateral colon. The KRAS gene mutation rates between the male and female CRLM patients whose CA19-9 level were ≥38 g/L and <38 g/L, with or without diabetes, and whose primary sites were on the right (52.1%, 160/307) or the left colon (38.2%, 355/930) was significantly different (all P<0.05). A single factor logistic regression analysis showed that gender, CA19-9 levels, diabetes and the primary site were associated with KRAS mutations, with significant difference ( P<0.05). Multivariate logistic regression analysis showed that the primary site of tumor was an independent influencing factor of KRAS mutation ( OR=0.557, 95% CI 0.423-0.733, P<0.05). The overall survival rates of KRAS wild-type patients was significantly higher than mutant patients ( P<0.05). Conclusion:Among patients with CRLM, KRAS mutation was more frequently appeared in those patients with right sided colonic cancer. The long-term prognosis of patients with KRAS mutant was significantly worse.