The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection
Local recurrence after colorectal liver metastasis (CRLM) resection severely affects survival; however, the required surgical margin width remains controversial. This study investigated the impact of KRAS status on surgical margin width and local recurrence rate (LRR) post-CRLM resection. Overall, 1...
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| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/6/2313 |
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| author | Kentaro Iwaki Satoshi Kaihara Tatsuya Koyama Kai Nakao Shotaro Matsuda Kan Toriguchi Koji Kitamura Nobu Oshima Masato Kondo Hiroki Hashida Hiroyuki Kobayashi Kenji Uryuhara |
| author_facet | Kentaro Iwaki Satoshi Kaihara Tatsuya Koyama Kai Nakao Shotaro Matsuda Kan Toriguchi Koji Kitamura Nobu Oshima Masato Kondo Hiroki Hashida Hiroyuki Kobayashi Kenji Uryuhara |
| author_sort | Kentaro Iwaki |
| collection | DOAJ |
| description | Local recurrence after colorectal liver metastasis (CRLM) resection severely affects survival; however, the required surgical margin width remains controversial. This study investigated the impact of KRAS status on surgical margin width and local recurrence rate (LRR) post-CRLM resection. Overall, 146 resected CRLMs with KRAS status (wild-type KRAS (wtKRAS): 98, KRAS mutant (mKRAS): 48) were included. The LRR for each group, R1 (margin positive) and R0 (margin negative), was analyzed by KRAS status. R0 was further stratified into Ra (margin ≥ 5 mm) and Rb (margin < 5 mm). Patients with local recurrence had significantly worse 5-year overall survival than those without local recurrence (<i>p</i> = 0.0036). The mKRAS LRR was significantly higher than wtKRAS LRR (<i>p</i> = 0.0145). R1 resection resulted in significantly higher LRRs than R0 resection for both wtKRAS and mKRAS (<i>p</i> = 0.0068 and <i>p</i> = 0.0204, respectively), and while no significant difference was observed in the Ra and Rb LRR with wtKRAS, the Rb LRR with mKRAS (33.3%) was significantly higher than Ra LRR (5.9%) (<i>p</i> = 0.0289). Thus, R0 resection is sufficient for CRLM with wtKRAS; however, CRLM with mKRAS requires resection with a margin of at least 5 mm to prevent local recurrence. |
| first_indexed | 2024-03-11T06:22:08Z |
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| id | doaj.art-7af116f933604055b22ad80cd775907a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T06:22:08Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7af116f933604055b22ad80cd775907a2023-11-17T11:51:10ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01126231310.3390/jcm12062313The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis ResectionKentaro Iwaki0Satoshi Kaihara1Tatsuya Koyama2Kai Nakao3Shotaro Matsuda4Kan Toriguchi5Koji Kitamura6Nobu Oshima7Masato Kondo8Hiroki Hashida9Hiroyuki Kobayashi10Kenji Uryuhara11Department of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanDepartment of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0046, JapanLocal recurrence after colorectal liver metastasis (CRLM) resection severely affects survival; however, the required surgical margin width remains controversial. This study investigated the impact of KRAS status on surgical margin width and local recurrence rate (LRR) post-CRLM resection. Overall, 146 resected CRLMs with KRAS status (wild-type KRAS (wtKRAS): 98, KRAS mutant (mKRAS): 48) were included. The LRR for each group, R1 (margin positive) and R0 (margin negative), was analyzed by KRAS status. R0 was further stratified into Ra (margin ≥ 5 mm) and Rb (margin < 5 mm). Patients with local recurrence had significantly worse 5-year overall survival than those without local recurrence (<i>p</i> = 0.0036). The mKRAS LRR was significantly higher than wtKRAS LRR (<i>p</i> = 0.0145). R1 resection resulted in significantly higher LRRs than R0 resection for both wtKRAS and mKRAS (<i>p</i> = 0.0068 and <i>p</i> = 0.0204, respectively), and while no significant difference was observed in the Ra and Rb LRR with wtKRAS, the Rb LRR with mKRAS (33.3%) was significantly higher than Ra LRR (5.9%) (<i>p</i> = 0.0289). Thus, R0 resection is sufficient for CRLM with wtKRAS; however, CRLM with mKRAS requires resection with a margin of at least 5 mm to prevent local recurrence.https://www.mdpi.com/2077-0383/12/6/2313colorectal metastasisliver resectionlocal recurrencesurgical marginKRASwild type |
| spellingShingle | Kentaro Iwaki Satoshi Kaihara Tatsuya Koyama Kai Nakao Shotaro Matsuda Kan Toriguchi Koji Kitamura Nobu Oshima Masato Kondo Hiroki Hashida Hiroyuki Kobayashi Kenji Uryuhara The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection Journal of Clinical Medicine colorectal metastasis liver resection local recurrence surgical margin KRAS wild type |
| title | The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection |
| title_full | The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection |
| title_fullStr | The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection |
| title_full_unstemmed | The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection |
| title_short | The Impact of KRAS Status on the Required Surgical Margin Width for Colorectal Liver Metastasis Resection |
| title_sort | impact of kras status on the required surgical margin width for colorectal liver metastasis resection |
| topic | colorectal metastasis liver resection local recurrence surgical margin KRAS wild type |
| url | https://www.mdpi.com/2077-0383/12/6/2313 |
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