<i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It?
Background: Genetic evaluation is essential in assessing colorectal cancer (CRC) and colorectal liver metastasis (CRLM). The aim of this study was to determine the pragmatic value of <i>KRAS</i> on oncological outcomes after CRLM according to the ESMO recommendations and to query whether...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/10/3/472 |
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| author | Olga Morató Maria Villamonte Patricia Sánchez-Velázquez Eva Pueyo-Périz Luís Grande Benedetto Ielpo Edoardo Rosso Alessandro Anselmo Fernando Burdío |
| author_facet | Olga Morató Maria Villamonte Patricia Sánchez-Velázquez Eva Pueyo-Périz Luís Grande Benedetto Ielpo Edoardo Rosso Alessandro Anselmo Fernando Burdío |
| author_sort | Olga Morató |
| collection | DOAJ |
| description | Background: Genetic evaluation is essential in assessing colorectal cancer (CRC) and colorectal liver metastasis (CRLM). The aim of this study was to determine the pragmatic value of <i>KRAS</i> on oncological outcomes after CRLM according to the ESMO recommendations and to query whether it is necessary to request <i>KRAS</i> testing in each situation. Methods: A retrospective cohort of 126 patients who underwent surgery for hepatic resection for CRLM between 2009 and 2020 were reviewed. The patients were divided into three categories: wild-type <i>KRAS</i>, mutated <i>KRAS</i> and impractical <i>KRAS</i> according to their oncological variables. The impractical (not tested) <i>KRAS</i> group included patients with metachronous tumours and negative lymph nodes harvested. Disease-free survival (DFS), overall survival (OS) and hepatic recurrence-free survival (HRFS) were calculated by the Kaplan–Meier method, and a multivariable analysis was conducted using the Cox proportional hazards regression model. Results: Of the 108 patients identified, 35 cases had <i>KRAS</i> wild-type, 50 cases had a <i>KRAS</i> mutation and the remaining 23 were classified as impractical <i>KRAS</i>. Significantly longer medians for OS, HRFS and DFS were found in the impractical <i>KRAS</i> group. In the multivariable analyses, the <i>KRAS</i> mutational gene was the only variable that was maintained through OS, HRFS and DFS. For HRFS (HR: 13.63; 95% confidence interval (CI): 1.35–100.62; <i>p</i> = 0.010 for <i>KRAS</i>), for DFS (HR: 10.06; 95% CI: 2.40–42.17; <i>p</i> = 0.002 for <i>KRAS</i>) and for OS (HR: 4.55%; 95% CI: 1.37–15.10; <i>p</i> = 0.013). Conclusion: Our study considers the possibility of unnecessary <i>KRAS</i> testing in patients with metachronous tumours and negative lymph nodes harvested. Combining the genetic mutational profile (i.e., <i>KRAS</i> in specific cases) with tumour characteristics helps patient selection and achieves the best prognosis after CRLM resection. |
| first_indexed | 2024-03-09T19:46:50Z |
| format | Article |
| id | doaj.art-ebbe8d81334d4853a8bdb1a7867ea291 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T19:46:50Z |
| publishDate | 2022-03-01 |
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| spelling | doaj.art-ebbe8d81334d4853a8bdb1a7867ea2912023-11-24T01:22:05ZengMDPI AGHealthcare2227-90322022-03-0110347210.3390/healthcare10030472<i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It?Olga Morató0Maria Villamonte1Patricia Sánchez-Velázquez2Eva Pueyo-Périz3Luís Grande4Benedetto Ielpo5Edoardo Rosso6Alessandro Anselmo7Fernando Burdío8Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainUnité des Maladies de l’Appareil Digestif et Endocrine, Department of Surgery and Robotics, Centre Hospitalier de Luxembourg, L-1210 Luxembourg, LuxembourgHPB and Transplant Unit, Department of Surgery, Policlinico Tor Vergata, 00173 Rome, ItalyDepartment of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Hospital del Mar, Medical Research Institute (IMIM), University Pompeu Fabra, 08003 Barcelona, SpainBackground: Genetic evaluation is essential in assessing colorectal cancer (CRC) and colorectal liver metastasis (CRLM). The aim of this study was to determine the pragmatic value of <i>KRAS</i> on oncological outcomes after CRLM according to the ESMO recommendations and to query whether it is necessary to request <i>KRAS</i> testing in each situation. Methods: A retrospective cohort of 126 patients who underwent surgery for hepatic resection for CRLM between 2009 and 2020 were reviewed. The patients were divided into three categories: wild-type <i>KRAS</i>, mutated <i>KRAS</i> and impractical <i>KRAS</i> according to their oncological variables. The impractical (not tested) <i>KRAS</i> group included patients with metachronous tumours and negative lymph nodes harvested. Disease-free survival (DFS), overall survival (OS) and hepatic recurrence-free survival (HRFS) were calculated by the Kaplan–Meier method, and a multivariable analysis was conducted using the Cox proportional hazards regression model. Results: Of the 108 patients identified, 35 cases had <i>KRAS</i> wild-type, 50 cases had a <i>KRAS</i> mutation and the remaining 23 were classified as impractical <i>KRAS</i>. Significantly longer medians for OS, HRFS and DFS were found in the impractical <i>KRAS</i> group. In the multivariable analyses, the <i>KRAS</i> mutational gene was the only variable that was maintained through OS, HRFS and DFS. For HRFS (HR: 13.63; 95% confidence interval (CI): 1.35–100.62; <i>p</i> = 0.010 for <i>KRAS</i>), for DFS (HR: 10.06; 95% CI: 2.40–42.17; <i>p</i> = 0.002 for <i>KRAS</i>) and for OS (HR: 4.55%; 95% CI: 1.37–15.10; <i>p</i> = 0.013). Conclusion: Our study considers the possibility of unnecessary <i>KRAS</i> testing in patients with metachronous tumours and negative lymph nodes harvested. Combining the genetic mutational profile (i.e., <i>KRAS</i> in specific cases) with tumour characteristics helps patient selection and achieves the best prognosis after CRLM resection.https://www.mdpi.com/2227-9032/10/3/472<i>KRAS</i> oncogenecolorectal liver metastasestumour burden scoresynchronic tumours |
| spellingShingle | Olga Morató Maria Villamonte Patricia Sánchez-Velázquez Eva Pueyo-Périz Luís Grande Benedetto Ielpo Edoardo Rosso Alessandro Anselmo Fernando Burdío <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? Healthcare <i>KRAS</i> oncogene colorectal liver metastases tumour burden score synchronic tumours |
| title | <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? |
| title_full | <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? |
| title_fullStr | <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? |
| title_full_unstemmed | <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? |
| title_short | <i>KRAS</i> Assessment Following ESMO Recommendations for Colorectal Liver Metastases. Is It Always Worth It? |
| title_sort | i kras i assessment following esmo recommendations for colorectal liver metastases is it always worth it |
| topic | <i>KRAS</i> oncogene colorectal liver metastases tumour burden score synchronic tumours |
| url | https://www.mdpi.com/2227-9032/10/3/472 |
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