TY - JOUR
T1 - RAS Mutations Predict Radiologic and Pathologic Response in Patients Treated with Chemotherapy Before Resection of Colorectal Liver Metastases
AU - Mise, Yoshihiro
AU - Zimmitti, Giuseppe
AU - Shindoh, Junichi
AU - Kopetz, Scott
AU - Loyer, Evelyne M.
AU - Andreou, Andreas
AU - Cooper, Amanda B.
AU - Kaur, Harmeet
AU - Aloia, Thomas A.
AU - Maru, Dipen M.
AU - Vauthey, Jean Nicolas
N1 - Publisher Copyright:
© 2014, Society of Surgical Oncology.
PY - 2015
Y1 - 2015
N2 - Background: RAS mutations have been reported to be a potential prognostic factor in patients with colorectal liver metastases (CLM). However, the impact of RAS mutations on response to chemotherapy remains unclear. The purpose of this study was to investigate the correlation between RAS mutations and response to preoperative chemotherapy and their impact on survival in patients undergoing curative resection of CLM.Methods: RAS mutational status was assessed and its relation to morphologic response and pathologic response was investigated in 184 patients meeting inclusion criteria. Predictors of survival were assessed. The prognostic impact of RAS mutational status was then analyzed using two different multivariate models, including either radiologic morphologic response (model 1) or pathologic response (model 2).Results: Optimal morphologic response and major pathologic response were more common in patients with wild-type RAS (32.9 and 58.9 %, respectively) than in patients with RAS mutations (10.5 and 36.8 %; P = 0.006 and 0.015, respectively). Multivariate analysis confirmed that wild-type RAS was a strong predictor of optimal morphologic response [odds ratio (OR), 4.38; 95 % CI 1.45–13.15] and major pathologic response (OR, 2.61; 95 % CI 1.17–5.80). RAS mutations were independently correlated with both overall survival and recurrence free-survival (hazard ratios, 3.57 and 2.30, respectively, in model 1, and 3.19 and 2.09, respectively, in model 2). Subanalysis revealed that RAS mutational status clearly stratified survival in patients with inadequate response to preoperative chemotherapy.Conclusions: RAS mutational status can be used to complement the current prognostic indicators for patients undergoing curative resection of CLM after preoperative modern chemotherapy.
AB - Background: RAS mutations have been reported to be a potential prognostic factor in patients with colorectal liver metastases (CLM). However, the impact of RAS mutations on response to chemotherapy remains unclear. The purpose of this study was to investigate the correlation between RAS mutations and response to preoperative chemotherapy and their impact on survival in patients undergoing curative resection of CLM.Methods: RAS mutational status was assessed and its relation to morphologic response and pathologic response was investigated in 184 patients meeting inclusion criteria. Predictors of survival were assessed. The prognostic impact of RAS mutational status was then analyzed using two different multivariate models, including either radiologic morphologic response (model 1) or pathologic response (model 2).Results: Optimal morphologic response and major pathologic response were more common in patients with wild-type RAS (32.9 and 58.9 %, respectively) than in patients with RAS mutations (10.5 and 36.8 %; P = 0.006 and 0.015, respectively). Multivariate analysis confirmed that wild-type RAS was a strong predictor of optimal morphologic response [odds ratio (OR), 4.38; 95 % CI 1.45–13.15] and major pathologic response (OR, 2.61; 95 % CI 1.17–5.80). RAS mutations were independently correlated with both overall survival and recurrence free-survival (hazard ratios, 3.57 and 2.30, respectively, in model 1, and 3.19 and 2.09, respectively, in model 2). Subanalysis revealed that RAS mutational status clearly stratified survival in patients with inadequate response to preoperative chemotherapy.Conclusions: RAS mutational status can be used to complement the current prognostic indicators for patients undergoing curative resection of CLM after preoperative modern chemotherapy.
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U2 - 10.1245/s10434-014-4042-6
DO - 10.1245/s10434-014-4042-6
M3 - Article
C2 - 25227306
AN - SCOPUS:84924934023
SN - 1068-9265
VL - 22
SP - 834
EP - 842
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 3
ER -