ASO Author Reflections: Poorest Survival Outcomes in Patients with Right Colon Cancer with KRAS Mutation After Simultaneous Curative-Intent Surgery for Colorectal Cancer Liver Metastases

Excerpt

Tumor location and KRAS mutational status have been extensively analyzed as prognostic markers in patients with colorectal cancer (CRC). Poor survival in patients with right-sided and KRAS mutant type (KRAS-mt) tumors was first studied in unresectable metastatic CRC.1,2 Afterwards, the prognostic impact thereof was investigated in patients with colorectal cancer liver metastases (CRLM) undergoing resection.3,4 Sakai et al. reported that KRAS-mt was independently associated with survival outcomes after hepatic resection of CRLM among patients with a left-sided primary CRC.3 This study was expanded to include nine tertiary academic centers from the United States, Europe, and Japan via the International Genetic Consortium for Colorectal Liver Metastasis. In this study, right-sided tumors were associated with worse survival only in patients with wild-type KRAS (KRAS-wt) status. They also reported that right-sided tumors and KRAS-mt were independently associated with shorter survival outcomes in the entire cohort.4 We wondered whether previous research on the prognostic impact of these features in patients with CRLM could be applied to patients undergoing simultaneous curative-intent surgery (SCIS) for synchronous CRLM.5 If deemed potential prognostic factors, primary tumor location and KRAS mutational status could assist in identifying patient groups at risk for poor survival outcomes after SCIS. …