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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2015

01-01-2015 | Colorectal Cancer

KRAS Mutation is Associated with Worse Prognosis in Stage III or High-risk Stage II Colon Cancer Patients Treated with Adjuvant FOLFOX

Authors: Dae-Won Lee, MD, Kyung Ju Kim, MD, Sae-Won Han, MD, PhD, Hyun Jung Lee, MD, Ye Young Rhee, MD, Jeong Mo Bae, MD, Nam-Yun Cho, MS, Kyung-Hun Lee, MD, Tae-Yong Kim, MD, Do-Youn Oh, MD, PhD, Seock-Ah Im, MD, PhD, Yung-Jue Bang, MD, PhD, Seung-Yong Jeong, MD, PhD, Kyu Joo Park, MD, PhD, Jae-Gahb Park, MD, PhD, Gyeong Hoon Kang, MD, PhD, Tae-You Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2015

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Abstract

Background

Although KRAS mutation has a predictive role in stage IV colorectal cancer (CRC) patients treated with anti-EGFR therapy, there have been controversies in the prognostic impact of KRAS mutation in stage II or III disease. The purpose of this study was to assess the prognostic impact of KRAS and BRAF mutation in patients treated with adjuvant 5-fluorouracil/leucovorin/oxaliplatin (FOLFOX).

Methods

KRAS exon 2 and BRAF codon 600 were analyzed in patients with stage II and III CRC who underwent curative resection followed by adjuvant FOLFOX. Clinicopathologic features and disease-free survival (DFS) were compared.

Results

Among a total of 437 patients, mutational data of KRAS and BRAF were available in 388 and 433 patients, respectively. KRAS mutation (codon 12 and 13) and BRAF V600E mutation was found in 26.5 and 3.7 % of patients. DFS was significantly worse in the KRAS mutant patients compared to KRAS wild type patients (3-year DFS 79 and 92 %, p = 0.006). Multivariate analysis revealed KRAS mutation as an independent negative prognostic factor for DFS (adjusted hazard ratio 2.30, 95 % confidence interval 1.23–4.32). Among the various subtypes of KRAS mutation, G13D (3-year DFS 76 %, p = 0.008) was significantly associated with poor DFS, while G12D was not associated with prognosis (3-year DFS 86 %, p = 0.61). There was no association between BRAF mutation and DFS.

Conclusions

KRAS mutation has an adverse prognostic impact on stage II or III CRC treated with adjuvant FOLFOX.
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Metadata
Title
KRAS Mutation is Associated with Worse Prognosis in Stage III or High-risk Stage II Colon Cancer Patients Treated with Adjuvant FOLFOX
Authors
Dae-Won Lee, MD
Kyung Ju Kim, MD
Sae-Won Han, MD, PhD
Hyun Jung Lee, MD
Ye Young Rhee, MD
Jeong Mo Bae, MD
Nam-Yun Cho, MS
Kyung-Hun Lee, MD
Tae-Yong Kim, MD
Do-Youn Oh, MD, PhD
Seock-Ah Im, MD, PhD
Yung-Jue Bang, MD, PhD
Seung-Yong Jeong, MD, PhD
Kyu Joo Park, MD, PhD
Jae-Gahb Park, MD, PhD
Gyeong Hoon Kang, MD, PhD
Tae-You Kim, MD, PhD
Publication date
01-01-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3826-z

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