Anatomical Resections Improve Survival Following Lung Metastasectomy of Colorectal Cancer Harboring KRAS Mutations

Annals of Surgery
Stéphane RenaudJonathan Spicer

Abstract

The aim of this study was to evaluate the benefit of anatomical resection (AR) in lung metastasectomy (LM) of colorectal cancer (CRC) harboring KRAS mutations SUMMARY BACKGROUND DATA:: KRAS mutations are related to high aggressiveness in the lung metastasis of CRC. It is unknown whether AR can lead to better outcomes than can non-AR (NAR) in KRAS patients. We retrospectively reviewed the data from 574 consecutive patients who underwent a LM for CRC. We focused on patients exhibiting 1 lung metastasis who underwent an AR (segmentectomy) or an NAR (wedge) and for whom the KRAS mutational status was known. Overall survival (OS) and time to pulmonary recurrence (TTPR) were analyzed. We included 168 patients, of whom 95 (56.5%) harbored KRAS mutations. An AR was performed in 74 patients (44%). The type of resection did not impact the median OS in wild-type (WT) patients (P = 0.67) but was significantly better following AR in KRAS patients (101 vs 45 months, P = 0.02) according to the multivariate analysis [hazard ratio (HR): 6.524; 95% confidence interval (CI), 2.312-18.405; P < 0.0001). TTPR was not affected by the type of resection in WT patients (P = 0.32) but was significantly better for AR in KRAS patients (50 vs 15 months, P =...Continue Reading

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Citations

Feb 20, 2019·Journal of Surgical Oncology·Georgios A MargonisMatthew J Weiss
Feb 28, 2019·Journal of Surgical Oncology·Joseph D Phillips, Rian M Hasson
May 24, 2019·Expert Review of Respiratory Medicine·Letizia ProcaccioFotios Loupakis
Nov 28, 2019·International Journal of Clinical Oncology·Takamichi IgarashiKen Shirabe
Mar 13, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Katharina JoechleJean-Nicolas Vauthey
Aug 5, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Olli HelminenEero Sihvo
Dec 23, 2020·The Journal of Thoracic and Cardiovascular Surgery·Harvey I Pass

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