Dataset Information

Prognostic impact of high-risk factors and KRAS mutation in patients with stage II deficient mismatch repair colon cancer: a retrospective cohort study.

ABSTRACT:

Background

Deficient mismatch repair (dMMR) is associated with a good prognosis in patients with stage II colon cancer and observation is recommended after surgery in these patients. In contrast, patients with high-risk factors and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation is associated with a poor prognosis in colon cancer. However, the prognosis and treatment of patients with dMMR colon cancer combined with high-risk factors or KRAS mutation remains unclear. This study aimed to evaluate whether patients with dMMR colon cancer combined with high-risk factors or KRAS mutation require further treatment.

Methods

This single-center retrospective study included patients who received radical surgical resection and mismatch repair (MMR) immunohistochemical detection at The Sixth Affiliated Hospital of Sun Yat-sen University between May 2011 and March 2021. The high-risk factors and KRAS mutation were assessed by clinicopathological data and targeted sequencing. Associations with disease-free survival (DFS) were evaluated using multivariable Cox models.

Results

Among the 1,357 patients with stage II colorectal cancer included, 226 of these patients had dMMR. Patients in the dMMR group were more likely to be younger [<50 years: odds ratio (OR) =0.401, 95% CI: 0.288-0.558, P<0.001], with poor differentiation (OR =5.800, 95% CI: 3.437-9.787, P<0.001), no perineural invasion (OR =0.132, 95% CI: 0.047-0.368, P<0.001), and more than 12 excised lymph nodes (OR =0.427, 95% CI: 0.188-0.968, P=0.042). The disease-free survival (DFS) of patients with stage II dMMR colon cancer with high-risk factors was similar to that of patients without high-risk factors (hazard ratio (HR) =1.285, 95% CI: 0.273-6.051, P=0.607). A total of 836 patients had complete data regarding KRAS status. Compared with KRAS wild-type patients, patients with KRAS gene mutation had a trend of poor prognosis in patients with stage II colon cancer (HR=1.483, 95% CI: 0.983-2.239, P=0.061). In addition, dMMR appeared to be a protective factor in patients with KRAS mutation (HR =0.138, 95% CI: 0.019-1.002, P=0.0501).

Conclusions

The survival of patients with stage II dMMR colon cancer with high-risk factors was similar to that of patients without high-risk factors, regardless of the presence of KRAS mutation.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC9279762 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Prognostic impact of high-risk factors and <i>KRAS</i> mutation in patients with stage II deficient mismatch repair colon cancer: a retrospective cohort study.

Zhang Yuting Y Wu Zehua Z Zhang Bin B Hu Huabin H Zhang Jianwei J Chen Yi Y Ding Miaomiao M Cao Yabing Y Deng Yanhong Y

Annals of translational medicine 20220601 12

<h4>Background</h4>Deficient mismatch repair (dMMR) is associated with a good prognosis in patients with stage II colon cancer and observation is recommended after surgery in these patients. In contrast, patients with high-risk factors and Kirsten rat sarcoma viral oncogene homolog (<i>KRAS</i>) mutation is associated with a poor prognosis in colon cancer. However, the prognosis and treatment of patients with dMMR colon cancer combined with high-risk factors or <i>KRAS</i> mutation remains uncle ...[more]

PMID: 35845506

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