Prognostic Relevance of KRAS Mutational Status in Patients with Resectable Colorectal Liver Metastases and Concurrent Extrahepatic Disease

Margonis, Georgios Antonios; Amini, Neda; Andreatos, Nikolaos; Deshwar, Amar; Rezaee, Neda; Buettner, Stefan; Wang, Jane; Sasaki, Kazunari; Wolfgang, Christopher L.; Weiss, Matthew J.

doi:10.1016/j.jamcollsurg.2017.07.866

Cited by 2 publications

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“…In comparison, the present study reported a frequency of 49.5%. Of note, our 2017 study corroborates the authors’ findings, as we found a similarly high rate of KRAS mutations (42.5%) in patients with concurrent EHD 2 . Although the incidence of RAS mutations in such small samples (n = 109 for the study by Lillemoe et al and n = 40 for our study) may be subject to significant random variations, these findings suggest that RAS (or KRAS specifically) mutated tumors may have a propensity to spread outside the liver.…”

supporting

confidence: 90%

“…Of note, our group presented a study at the 2017 Clinical Congress of the American College of Surgeons that addressed the same question. Our study was entitled “Prognostic relevance of KRAS mutational status in patients with resectable colorectal liver metastases and concurrent extrahepatic disease.” 2 Specifically, in a group of 40 patients who underwent surgery for CRLM and concurrent EHD at Johns Hopkins, we demonstrated that KRAS, which is the most frequently mutated RAS isoform, remained prognostic (TP53 status was not available for analysis). In fact, the risk of death for those with KRAS mutated tumors and EHD was particularly high [hazard ratio (HR): 2.86, 1.04–7.86].…”

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confidence: 94%

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Comment on “RAS/TP53 co-Mutation is Associated With Worse Survival After Concurrent Resection of Colorectal Liver Metastases and Extrahepatic Disease”

2021

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Quality of Life Questionnaire Lung Module 13 (LC13), and Functional Assessment of Cancer Therapy lung cancer specific module. Although both tools have acceptable feasibility and validity, they are not interchangeable and their variable emphasis on different aspects of QOL has affected their clinical utility in patients with lung cancer. 2 The European Organization for Research and Treatment of Cancer modules were also validated in a cohort of patients with inoperable lung cancer, their use, therefore, is limited amongst resectable lung cancer patients as in our analysis. 3,4 Our aim -to evaluate the prevalence, trajectory, and predictors of the most common cancer-associated symptoms -was best served by the Edmonton Symptom Assessment System (ESAS). The ESAS is a well-validated cancer PROM that offered meaningful population level information from over 14 million users in the province of Ontario. 5 Other practical limitations to population-wide implementation of diseasespecific PROMs include balancing the need to obtain additional information and overburdening patients with additional questionnaires at the time of their clinic visit. It is also challenging to classify patients based on disease-site in the context of a populationwide symptom screening initiative. We acknowledge that the clinic-based nature of ESAS screening does not capture symptom burden of patients who are managed outside of a regional cancer center and/or hospitalized patients. Accurate measurement also hinges on highly variable patient factors, including language and culture. The burgeoning interest in PROMs is expected to galvanize national and provincial agencies, such as the Canadian Institute for Health Information, the US National Institutes of Health and Cancer Care Ontario, to standardize and improve ways to measure patient reported outcomes remotely and across various clinical settings.Second, the classification of procedures to define our cohort is important. We utilized Canadian Classification of Health Interventions codes, which were developed and validated and now maintained by the Canadian Institute for Health Information to facilitate the capture of health care interventions. 6 These codes are based on the generic type of procedure performed and entered into the database by expert thirdparty coders. We included all patients undergoing sublobar resection (ie, any partial lobar excision), lobar resection (ie, any total lobar excision including sleeve lobectomy), and pneumonectomy. There are strict standards, which mandate coders to specify

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confidence: 90%

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confidence: 94%

Comment on “RAS/TP53 co-Mutation is Associated With Worse Survival After Concurrent Resection of Colorectal Liver Metastases and Extrahepatic Disease”

2021

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“…Also, the effect of primary tumor site on prognosis differs with the status of RAS mutation. Margonis et al 44 reported that right-sided primary tumor was associated with a worse 5-year OS (43.7% vs. 55.5%) in their KRAS wild-type patients who underwent curative-intent resection for CRLM. However, primary tumor site had no impact on 5-year OS in their KRAS-mutated patients.…”

Section: Molecular Status and Metastasectomy Of Crlmmentioning

confidence: 99%

“…However, primary tumor site had no impact on 5-year OS in their KRAS-mutated patients. 44 In a study of 227 patients undergoing simultaneous curative-intent surgery for synchronous CRLM, right-sided and KRAS-mutated CRLM patients showed the worst OS and DFS, while left-sided and KRAS wild-type CRLM patients had the best OS and DFS. 45…”

Section: Molecular Status and Metastasectomy Of Crlmmentioning

confidence: 99%

Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases

Wang

Xin

Wang

2023

Clin Colon Rectal Surg

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Although surgical resection could provide better survival for patients with colorectal cancer liver metastases (CRLM), the recurrence rate after resection of CRLM remains high. The progress of genome sequencing technologies has greatly improved the molecular understanding of colorectal cancer. In the era of genomics and targeted therapy, genetic mutation analysis is of great significance to guide systemic treatment and identify patients who can benefit from resection of CRLM. RAS and BRAF mutations and microsatellite instability/deficient deoxyribonucleic acid (DNA) mismatch repair status have been incorporated into current clinical practice. Other promising molecular biomarkers such as coexisting gene mutations and circulating tumor DNA are under active investigation. This study aimed to review the prognostic significance of molecular biomarkers in patients with CRLM undergoing metastasectomy based on the current evidence.

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Prognostic Relevance of KRAS Mutational Status in Patients with Resectable Colorectal Liver Metastases and Concurrent Extrahepatic Disease

Cited by 2 publications

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Comment on “RAS/TP53 co-Mutation is Associated With Worse Survival After Concurrent Resection of Colorectal Liver Metastases and Extrahepatic Disease”

Comment on “RAS/TP53 co-Mutation is Associated With Worse Survival After Concurrent Resection of Colorectal Liver Metastases and Extrahepatic Disease”

Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases

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