Prognostic Value of KRAS Gene Mutation on Survival of Patients with Peritoneal Metastases of Colorectal Adenocarcinoma

Díez-Alonso, Manuel; Mendoza‐Moreno, Fernando; Gómez-Sanz, Remedios; Matías‐García, Belén; Ovejero-Merino, Enrique; Molina, Raquel; Soto-Schütte, Sonia; Juan, Alberto San; Gutiérrez‐Calvo, Alberto

doi:10.1155/2021/3946875

Cited by 6 publications

(9 citation statements)

References 24 publications

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“…Younger patients (65 years) with intermediate stages (T3N1) and with an intermediate PCI (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) more frequently developed peritoneal metastasis during follow-up. This observation may be attributed to the fact that these patients had longer surveillance times and could make an early diagnosis of peritoneal metastasis in cases of recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Comparison of PCI values demonstrated that patients with the presence of SPM had a higher PCI (>20) (57 patients, 43.1%), while those with MPM had intermediate PCI values (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) (46 patients, 42.5%) (p = 0.014).…”

Section: Patient and Tumor Characteristics Categorized By Spm/mpm Tim...mentioning

confidence: 99%

“…Kaplan-Meir estimation of OS at 36 months after diagnosis was 32% (median: 21 months; 95% CI: [16][17][18][19][20][21][22][23][24][25]. The results of the univariate survival analysis are shown in Table 2.…”

Section: Long-term Survivalmentioning

confidence: 99%

“…However, the influence of other factors, such as pT stage, the presence of pN+ adenopathy, incomplete tumor resection, poor tumor differentiation or mucinous component, is not well understood. In a previous study of 149 patients, we found that patients with PM diagnosed at follow-up have higher overall survival (OS) than those with PM detected synchronously with the primary tumor [ 16 ]. However, other publications have reported higher OS for patients with PM synchronously detected with the primary tumor [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors of Survival in Patients with Peritoneal Metastasis from Colorectal Cancer

Mendoza‐Moreno

Díez-Alonso

Matías‐García

et al. 2022

JCM

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Objectives: The aim of this study was to analyze the prognostic factors of survival in patients with peritoneal metastasis (PM) from colorectal cancer (CRC). The type of relationship between survival and the PM time of detection was used to determine whether it was synchronous with the primary tumor or metachronous. Patients and Methods: Retrospective observational study. It included patients treated for colorectal adenocarcinoma diagnosed between January 2005 and December 2019 who presented PM at the time of diagnosis or during follow-up. Variables, such as sex, age, differentiation grade, positive adenopathy (pN+), tumor size (pT), tumor location, mucinous component, peritoneal carcinomatosis index (PCI), and KRAS mutational status, were analyzed. Results: During the study period, 1882 patients were surgically treated for CRC in our hospital. Of these, 240 patients (12.8%) were included in the study after evidence of PM. The mean age was 67 ± 12 years (range: 32–92 years), and 114 patients were female (47.5%). The mean follow-up was 20 ± 13 months (median 12 months). The Kaplan–Meier survival at 36 months was higher in patients with metachronous PM (24% vs. 8%; p = 0.002), WT-KRAS tumors (31% vs. 15%; p < 0.001), N0 stage (30% vs. 19%; p < 0.001), T3 stage tumors (18% vs. 19% in T4A and 3% in T4B; p > 0.001), and tumors with classic adenocarcinoma histology (18% vs. 8%; p = 0.011). Patients with a PCI of 1–10 showed a likelihood of survival at 36 months of 56%, which was longer than that found in patients with a PCI of 11–20 (8%) or a PCI of >20 (0%) (p < 0.001). In the multiple regression analysis, the factors with an independent prognostic value were: poor grade of differentiation (HR 1.995; 95% CI: 1.294–3.077), KRAS mutation (HR 1.751; 95% CI: 1.188–2.581), PCI 11–20 (HR: 9.935; 95% CI: 5.204–18.966) and PCI > 20 (HR: 4.011; 95% CI: 2.291–7.023). Conclusions: PCI should continue as the as the most useful prognostic indicator in order to assess prognostic estimations as well as therapeutic and surgical decisions, but tumor grade and KRAS mutational status may help in the treatment decision process by providing complementary information. The time of PM detection did not achieve statistical significance in the multiple regression analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Patient and Tumor Characteristics Categorized By Spm/mpm Tim...mentioning

confidence: 99%

Section: Long-term Survivalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Factors of Survival in Patients with Peritoneal Metastasis from Colorectal Cancer

Mendoza‐Moreno

Díez-Alonso

Matías‐García

et al. 2022

JCM

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“…Recent research highlights that prognostic information on the Kirsten Rat Sarcoma Virus (KRAS) mutation is critical for patient survival. It has also been identified that the most prolonged survival rate of patients with KRAS mutation at 36 months was only 24 percent (72). In this case, integrating artificial intelligence (AI) helps evaluate all the complex heterogeneous tumor information and patterns acquired from biomarker sensing NPs to devise an accurate treatment plan and aid in the faster detection of mutations, classifying mutated and non-mutated biomarkers, better drug and protein interaction for greater drug efficacy and improved drug delivery.…”

Section: Predicting Anticancer Drug Synergymentioning

confidence: 99%

Nanoparticles and convergence of artificial intelligence for targeted drug delivery for cancer therapy: Current progress and challenges

Das

Chandra

2023

Front. Med. Technol.

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Cancer is a life-threatening disease, resulting in nearly 10 million deaths worldwide. There are various causes of cancer, and the prognostic information varies in each patient because of unique molecular signatures in the human body. However, genetic heterogeneity occurs due to different cancer types and changes in the neoplasms, which complicates the diagnosis and treatment. Targeted drug delivery is considered a pivotal contributor to precision medicine for cancer treatments as this method helps deliver medication to patients by systematically increasing the drug concentration on the targeted body parts. In such cases, nanoparticle-mediated drug delivery and the integration of artificial intelligence (AI) can help bridge the gap and enhance localized drug delivery systems capable of biomarker sensing. Diagnostic assays using nanoparticles (NPs) enable biomarker identification by accumulating in the specific cancer sites and ensuring accurate drug delivery planning. Integrating NPs for cancer targeting and AI can help devise sophisticated systems that further classify cancer types and understand complex disease patterns. Advanced AI algorithms can also help in biomarker detection, predicting different NP interactions of the targeted drug, and evaluating drug efficacy. Considering the advantages of the convergence of NPs and AI for targeted drug delivery, there has been significantly limited research focusing on the specific research theme, with most of the research being proposed on AI and drug discovery. Thus, the study's primary objective is to highlight the recent advances in drug delivery using NPs, and their impact on personalized treatment plans for cancer patients. In addition, a focal point of the study is also to highlight how integrating AI, and NPs can help address some of the existing challenges in drug delivery by conducting a collective survey.

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Cytoreductive surgery without intra-peritoneal chemotherapy for metachronous colorectal peritoneal metastases

Ota,

Fukunaga,

Mukai

et al. 2024

World J Surg Onc

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Background Cytoreductive surgery and chemotherapy reportedly improve the prognosis of patients with metachronous peritoneal metastases. However, the types of peritoneal metastases indicated for cytoreductive surgery remains unclear. Therefore, we aimed to clarify the category of cases for which cytoreductive surgery would be effective and report the prognosis associated with cytoreductive surgery for metachronous peritoneal metastases. Methods This study included 52 consecutive patients who underwent cytoreductive surgery for metachronous peritoneal metastases caused by colorectal cancer between January 2005 and December 2018 and fulfilled the selection criteria. The median follow-up period was 54.9 months. Relapse-free survival was calculated as the time from cytoreductive surgery of metachronous peritoneal metastases to recurrence. Overall survival was defined as the time from cytoreductive surgery of metachronous peritoneal metastases to death or the end of the follow-up period. Results The 5-year relapse-free survival rate was 30.0% and the 5-year overall survival rate was 72.3%. None of the patients underwent hyperthermic intraperitoneal chemotherapy. The analysis indicated no potential risk factors for 5-year relapse-free survival. However, for 5-year overall survival, the multivariate analysis revealed that time to diagnosis of metachronous peritoneal metastases of < 2 years after primary surgery (hazard ratio = 4.1, 95% confidence interval = 2.0–8.6, p = 0.0002) and number of metachronous peritoneal metastases ≥ 3 (hazard ratio = 9.8, 95% confidence interval = 2.3–42.3, p = 0.002) as independent factors associated with a poor prognosis. Conclusions Long intervals of more than 2 years after primary surgery and 2 or less metachronous peritoneal metastases were good selection criteria for cytoreductive surgery for metachronous peritoneal metastases from colorectal cancer.

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Prognostic Value of KRAS Gene Mutation on Survival of Patients with Peritoneal Metastases of Colorectal Adenocarcinoma

Cited by 6 publications

References 24 publications

Prognostic Factors of Survival in Patients with Peritoneal Metastasis from Colorectal Cancer

Prognostic Factors of Survival in Patients with Peritoneal Metastasis from Colorectal Cancer

Nanoparticles and convergence of artificial intelligence for targeted drug delivery for cancer therapy: Current progress and challenges

Cytoreductive surgery without intra-peritoneal chemotherapy for metachronous colorectal peritoneal metastases

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