Discordance of KRAS Mutational Status between Primary Tumors and Liver Metastases in Colorectal Cancer: Impact on Long-Term Survival Following Radical Resection

Francesco Ardito, Maria Vellone, Giampaolo Tortora, Maurizio Martini, Felice Giuliante, Francesco Razionale, Lisa Salvatore, Tonia Cenci, Michele Basso, Elena Panettieri, Maria Alessandra Calegari

Research output: Contribution to journalArticle

Abstract

If KRAS mutation status of primary colorectal tumor is representative of corresponding colorectal liver metastases (CRLM) mutational pattern, is controversial. Several studies have reported different rates of KRAS discordance, ranging from 4 to 32%. Aim of this study is to assess the incidence of discordance and its impact on overall survival (OS) in a homogenous group of patients. KRAS mutation status was evaluated in 107 patients resected for both primary colorectal tumor and corresponding CRLM at the same institution, between 2007 and 2018. Discordance rate was 15.9%. Its incidence varied according to the time interval between the two mutation analyses (p = 0.025; Pearson correlation = 0.2) and it was significantly higher during the first 6 months from the time of primary tumor evaluation. On multivariable analysis, type of discordance (wild‐type in primary tumor, mutation in CRLM) was the strongest predictor of poor OS (p < 0.001). At multivariable logistic regression analysis, the number of CRLM >3 was an independent risk factor for the risk of KRAS discordance associated with the worst prognosis (OR = 4.600; p = 0.047). Results of our study suggested that, in the era of precision medicine, possibility of KRAS discordance should be taken into account within multidisciplinary management of patients with metastatic colorectal cancer.
Original languageEnglish
Pages (from-to)2148-2163
Number of pages16
JournalCancers
Volume13
DOIs
Publication statusPublished - 2021

Keywords

  • KRAS mutation status
  • colorectal liver metastases
  • colorectal tumor
  • precision medicine

Fingerprint

Dive into the research topics of 'Discordance of KRAS Mutational Status between Primary Tumors and Liver Metastases in Colorectal Cancer: Impact on Long-Term Survival Following Radical Resection'. Together they form a unique fingerprint.

Cite this