The Prognostic Impact of Primary Tumor Site Differs According to the KRAS Mutational Status: A Study By the International Genetic Consortium for Colorectal Liver Metastasis.

Annals of Surgery
Georgios Antonios MargonisMatthew J Weiss

Abstract

To examine the prognostic impact of tumor laterality in colon cancer liver metastases (CLM) after stratifying by Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutational status. Although some studies have demonstrated that patients with CLM from a right sided (RS) primary cancer fare worse, others have found equivocal outcomes of patients with CLM with RS versus left-sided (LS) primary tumors. Importantly, recent evidence from unresectable metastatic CRC suggests that tumor laterality impacts prognosis only in those with wild-type tumors. Patients with rectal or transverse colon tumors and those with unknown KRAS mutational status were excluded from analysis. The prognostic impact of RS versus LS primary CRC was determined after stratifying by KRAS mutational status. 277 patients had a RS (38.6%) and 441 (61.4%) had a LS tumor. Approximately one-third of tumors (28.1%) harbored KRAS mutations. In the entire cohort, RS was associated with worse 5-year overall survival (OS) compared with LS (39.4% vs 50.8%, P = 0.03) and remained significantly associated with worse OS in the multivariable analysis (hazard ratio 1.45, P = 0.04). In wild-type patients, a worse 5-year OS associated with a RS tumor was evident in univariable an...Continue Reading

References

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Citations

Sep 1, 2020·Annals of Surgical Oncology·Georgios Antonios MargonisMurray F Brennan
Jun 12, 2020·Journal of Surgical Oncology·Katherine BingmerEmily Steinhagen
Jan 1, 2021·Journal of the American College of Surgeons·Diamantis I TsilimigrasTimothy M Pawlik
Oct 7, 2021·Journal of Hepato-biliary-pancreatic Sciences·Neda AminiRichard Andrew Burkhart
Nov 13, 2020·Visceral Medicine·Stefan HeinrichHauke Lang

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