Prognostic Value of KRAS Mutation for Patients Undergoing Hepatectomy for Advanced Colorectal Cancer
Poster #: 090
Session/Time: A
Author:
Gabrielle Grob, BS
Mentor:
Winifred Lo, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
Over the last two decades, genetic data has increasingly guided clinical decision-making among patients with advanced colorectal cancer. KRAS mutation has been generally understood to portend worse survival. The aim of this study was to analyze the prognostic value of KRAS mutation status on overall survival among patients undergoing hepatectomy for advanced colorectal cancer.
METHODS:
The National Cancer Database was queried for patients aged 18-90 with advanced colorectal cancer who underwent primary tumor resection and liver resection between the years 2018-2021. Kaplan-Meier analysis was used to calculate overall survival and a Cox Proportional Hazards Model analyzed prognostic factors.
RESULTS:
2,882 patients were identified. 80% of patients were white, 13% black, and 7% other races. 53% of patients had wild type KRAS and 47% of patients had mutated KRAS. Patients with mutated KRAS were more likely to be Black, female, and older. Receipt of chemotherapy was similar between wild type and mutated KRAS patients at 94%. 5-year overall survival among patients with wild type KRAS was 57% [53%, 61%] with a median survival of 68 months. This was significantly different from patients with mutated KRAS codon 12, 13, or 61 who had a 5-year overall survival of 43% [37%, 49%] and median survival of 50 months. 5-year overall survival for other mutated KRAS codons was 44% [39%, 50%]. In African American patients, presence of mutated KRAS was also associated with decreased 5-year survival (55% vs 39%). Based on the Cox Proportional Hazards model, female gender, Black race, older age at diagnosis, KRAS mutated codon 12, 13, or 61, and other mutated KRAS codons were associated with higher relative risk of mortality (p<0.001). Receipt of chemotherapy was associated with lower relative risk of mortality with hazard ratio 0.28 (p<0.001).
CONCLUSION:
Patients with advanced colorectal cancer with KRAS mutation had worse overall survival as compared to patients with wild type KRAS which supports recent literature. For the sample as a whole, chemotherapy was shown to significantly lower mortality risk. As the study of cancer genomics continues to evolve, national databases will need to collect more granular data on specific codon mutations in order to optimize treatment planning for patients.
Over the last two decades, genetic data has increasingly guided clinical decision-making among patients with advanced colorectal cancer. KRAS mutation has been generally understood to portend worse survival. The aim of this study was to analyze the prognostic value of KRAS mutation status on overall survival among patients undergoing hepatectomy for advanced colorectal cancer.
METHODS:
The National Cancer Database was queried for patients aged 18-90 with advanced colorectal cancer who underwent primary tumor resection and liver resection between the years 2018-2021. Kaplan-Meier analysis was used to calculate overall survival and a Cox Proportional Hazards Model analyzed prognostic factors.
RESULTS:
2,882 patients were identified. 80% of patients were white, 13% black, and 7% other races. 53% of patients had wild type KRAS and 47% of patients had mutated KRAS. Patients with mutated KRAS were more likely to be Black, female, and older. Receipt of chemotherapy was similar between wild type and mutated KRAS patients at 94%. 5-year overall survival among patients with wild type KRAS was 57% [53%, 61%] with a median survival of 68 months. This was significantly different from patients with mutated KRAS codon 12, 13, or 61 who had a 5-year overall survival of 43% [37%, 49%] and median survival of 50 months. 5-year overall survival for other mutated KRAS codons was 44% [39%, 50%]. In African American patients, presence of mutated KRAS was also associated with decreased 5-year survival (55% vs 39%). Based on the Cox Proportional Hazards model, female gender, Black race, older age at diagnosis, KRAS mutated codon 12, 13, or 61, and other mutated KRAS codons were associated with higher relative risk of mortality (p<0.001). Receipt of chemotherapy was associated with lower relative risk of mortality with hazard ratio 0.28 (p<0.001).
CONCLUSION:
Patients with advanced colorectal cancer with KRAS mutation had worse overall survival as compared to patients with wild type KRAS which supports recent literature. For the sample as a whole, chemotherapy was shown to significantly lower mortality risk. As the study of cancer genomics continues to evolve, national databases will need to collect more granular data on specific codon mutations in order to optimize treatment planning for patients.