Prevalence of colorectal cancer biomarkers and their impact on clinical outcomes in Riyadh, Saudi Arabia

Abstract

Objectives KRAS, NRAS, and BRAF mutations are commonly present in colorectal cancer (CRC). We estimated the frequency of KRAS, NRAS, and BRAF mutations and assessed their impact on survival and other clinical variables among Saudi patients. Design Retrospective cohort study design. Settings Oncology department of a tertiary hospital in Riyadh, Saudi Arabia. We gathered information from 2016 to 2018. Participants Cohort of 248 CRC patients to assess the demographic data, pathological tumour features, response to treatment modalities, disease progression, and metastasis. Statistical analysis used Correlation analysis using the chi-square test. Survival analysis using a Kaplan Meier method. Cox regression analysis to calculate the hazard ratios. Results Demographic data revealed that 84% of patients were diagnosed with CRC above the age of 50 years. Only 27% of patients presented with distant metastasis. KRAS mutations were the most prevalent (49.6%), followed by NRAS mutations (2%) and BRAF mutations (0.4%). Wild type tumours were found among 44.4% of patients. KRAS mutation showed no significant correlation with the site, type, pathological grade, and stage of the tumour. The mean survival time was shorter among patients with KRAS mutations than among patients with wild type KRAS tumours (54.46 vs. 58.02 months). Adjusted analysis showed that the survival time was significantly affected by patients’ age at diagnosis (P = 0.04). Male patients had an increased risk of mortality by 77% (hazard ratio: 1.77). Conclusions Saudi CRC patients had a high frequency of KRAS mutations and a low frequency of BRAF mutations. The KRAS mutation status did not affect the patients’ survival.

KRAS Mutations in Colorectal Cancer: Relationship With Clinicopathological Characteristics and Impact on Clinical Outcomes in Saudi Arabia

“…Despite that, this proportion was higher than those reported in western countries and the Asian region (35-40%) [ 12 - 13 ]. This is in accordance with the mutation rates reported in Saudi Arabia [ 8 , 10 ].…”

“…In the current study, the age and gender of the patients did not significantly affect the mutation status. This finding was also observed in previous studies of KRAS mutations in Saudi Arabia [ 8 - 10 ]. This could be explained on the basis of a low number of study participants (n=51) in the study by Mulla et al [ 9 ].…”

“…However, comparing the current study findings with those of previous studies is interesting. While we observed significant impacts of different clinicopathological variables on the survival of our cohorts, this finding was observed by Alharbi et al [ 8 ] and not observed by Mulla et al and Zekri et al [ 9 - 10 ]. Similar to our findings, Alharbi et al [ 8 ] and Zekri et al [ 10 ], KRAS mutation status did not impact CRC patients’ survival.…”

“…Studies of KRAS mutations among Saudi patients could have similar epidemiologic characteristics [ 8 - 10 ]. However, comparing the current study findings with those of previous studies is interesting.…”

KRAS/NRAS/BRAF Mutation Rate in Saudi Academic Hospital Patients With Colorectal Cancer

“…King Saud bin Abdulaziz University for Health Sciences - Riyadh reported their mutation frequency as follows: KRAS (49.6%), NRAS (2%), and BRAF (0.4%). 44.4% of their patients exhibited wild-type tumors [ 23 ]. At Tibah University - Madinah, the proportion of patients with RAS mutations was 43%.…”