The prognostic value of KRAS mutation in locally advanced rectal cancer

Asawa, Palash; Bakalov, Veli; Kancharla, Pragnan; Abel, Stephen; Chahine, Zena; Monga, Dulabh; Kirichenko, Alexander; Wegner, Rodney E.

doi:10.1007/s00384-022-04167-x

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…However, the prognostic efficacy of KRAS in LARC patients is still controversial. A recent study included 784 LARC patients from the NCDB database and reported poorer overall survival in KRAS-mutated patients [ 23 ]. A population-based analysis indicated that KRAS mutation had prognostic value for poor cancer-specific survival in rectal cancer (HR 1.23, p < 0.05) [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

KRAS status predicted by pretreatment MRI radiomics was associated with lung metastasis in locally advanced rectal cancer patients

Xiang,

Li,

Song

et al. 2023

BMC Med Imaging

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Background Mutated KRAS may indicate an invasive nature and predict prognosis in locally advanced rectal cancer (LARC). We aimed to establish a radiomic model using pretreatment T2W MRIs to predict KRAS status and explore the association between the KRAS status or model predictions and lung metastasis. Methods In this retrospective multicentre study, LARC patients from two institutions between January 2012 and January 2019 were randomly divided into training and testing cohorts. Least absolute shrinkage and selection operator (LASSO) regression and the support vector machine (SVM) classifier were utilized to select significant radiomic features and establish a prediction model, which was validated by radiomic score distribution and decision curve analysis. The association between the model stratification and lung metastasis was investigated by Cox regression and Kaplan‒Meier survival analysis; the results were compared by the log-rank test. Results Overall, 103 patients were enrolled (73 and 30 in the training and testing cohorts, respectively). The median follow-up was 38.1 months (interquartile range: 26.9, 49.4). The radiomic model had an area under the curve (AUC) of 0.983 in the training cohort and 0.814 in the testing cohort. Using a cut-off of 0.679 defined by the receiver operating characteristic (ROC) curve, patients with a high radiomic score (RS) had a higher risk for lung metastasis (HR 3.565, 95% CI 1.337, 9.505, p = 0.011), showing similar predictive performances for the mutant and wild-type KRAS groups (HR 3.225, 95% CI 1.249, 8.323, p = 0.016, IDI: 1.08%, p = 0.687; NRI 2.23%, p = 0.766). Conclusions We established and validated a radiomic model for predicting KRAS status in LARC. Patients with high RS experienced more lung metastases. The model could noninvasively detect KRAS status and may help individualize clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

KRAS status predicted by pretreatment MRI radiomics was associated with lung metastasis in locally advanced rectal cancer patients

Xiang,

Li,

Song

et al. 2023

BMC Med Imaging

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“…According to previous reports, approximately 40% of colorectal cancer (CRC) cases are linked to KRAS mutations[ 5 - 7 ], which occur more frequently in the proximal rather than in the distal colon[ 4 , 8 , 9 ]. Clinically, KRAS mutations are associated with resistance to anti-EGFR therapy and poor CRC prognosis[ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Different oncological features of colorectal cancer codon-specific KRAS mutations: Not codon 13 but codon 12 have prognostic value

Ahn,

Kim,

et al. 2023

World J Gastroenterol

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The robotic liver resection (RLR) has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system, however, controversies still exist. Based on the foundation of the previous consensus statement, this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical practice. The guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine (EBM). Relevant literature was reviewed and analyzed by the evidence evaluation group. According to the WHO Handbook for Guideline Development, the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022, a total of 14 recommendations were generated. Among them were 8 recommendations formulated by the GRADE method, and the remaining 6 recommendations were formulated based on literature review and experts’ opinion due to insufficient EBM results. This international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future.

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Somatic pharmacogenomics in the treatment prognosis of locally advanced rectal cancer patients: a narrative review of the literature

Milan,

Navarria,

Cecchin

et al. 2024

Expert Review of Clinical Pharmacology

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The prognostic value of KRAS mutation in locally advanced rectal cancer

Cited by 6 publications

References 28 publications

KRAS status predicted by pretreatment MRI radiomics was associated with lung metastasis in locally advanced rectal cancer patients

KRAS status predicted by pretreatment MRI radiomics was associated with lung metastasis in locally advanced rectal cancer patients

Different oncological features of colorectal cancer codon-specific KRAS mutations: Not codon 13 but codon 12 have prognostic value

Somatic pharmacogenomics in the treatment prognosis of locally advanced rectal cancer patients: a narrative review of the literature

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