AI Article Synopsis

  • RAS mutation status is a key factor for predicting outcomes after liver metastasis removal in colorectal cancer, but its impact on lung and peritoneal metastases remains unclear.
  • A study of 720 patients from 2005 to 2014 found that RAS mutations were more common in patients with lung and peritoneal metastases than in those with liver metastases.
  • While RAS mutations significantly worsen survival after liver resection, they do not affect overall survival rates for lung and peritoneal metastasectomies, indicating that prognostic value is site-dependent.

Article Abstract

Background: RAS mutation status is an important prognostic factor after resection of liver metastases (LiM) from colorectal cancer (CRC). The prognostic significance of RAS after resection of lung (LuM) and peritoneal (PM) metastases from CRC is unknown.

Methods: Between 2005 and 2014, all consecutive patients with known RAS status who underwent potentially curative resection for LiM, LuM, or PM were evaluated.

Results: A total of 720 patients with known RAS status underwent resection of LiM (n = 468), LuM (n = 102), and PM (n = 150). RAS mutations were identified in 63 and 58% of patients with LuM and PM, respectively, compared with 41% of patients with LiM (p < 0.001). Five-year overall survival (OS) after resection of PM was 45%, compared with 52% after resection of LiM (p = 0.018) and 64% after resection of LuM (p = 0.005). RAS mutations were associated with significantly worse OS after resection of LiM (p < 0.001), but did not affect OS among patients undergoing resection of LuM (p = 0.41) and PM (p = 0.65).

Conclusions: RAS mutations are more prevalent among patients undergoing resection of LuM and PM than LiM but do not affect survival after lung and peritoneal metastasectomy, as they do after hepatectomy. These results suggest that the prognostic significance of RAS mutations after resection of metastatic CRC depends on the specific site of metastases.

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http://dx.doi.org/10.1245/s10434-017-6141-7DOI Listing

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