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Conditional Overall Survival After Diagnosis of Non-Metastatic Colon Cancer: Impact of Laterality, MSI, and KRAS Status.
Tran, Catherine G; Goffredo, Paolo; Mott, Sarah L; Suraju, Mohammed O; Kohn, Julia F; Mishra, Aditi; Vauthey, Jean-Nicolas; Hassan, Imran.
Afiliación
  • Tran CG; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Goffredo P; Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN, USA.
  • Mott SL; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA.
  • Suraju MO; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Kohn JF; Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
  • Mishra A; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Vauthey JN; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Hassan I; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. imran-hassan@uiowa.edu.
Ann Surg Oncol ; 31(1): 142-151, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37857983
ABSTRACT

BACKGROUND:

The prognostic relevance of laterality, microsatellite instability (MSI), and KRAS status in colon cancer has been established. However, their effect on conditional overall survival (COS) remains unknown.

METHODS:

COS is the probability of surviving additional years after a time from diagnosis. The National Cancer Database (2010-2017) was queried for adults with non-metastatic colon cancer and known mutation status undergoing curative resection. COS was investigated at 2 years.

RESULTS:

Of 4838 patients, 3716 survived at least 2 years 15% had stage I, 38% stage II, and 46% stage III disease. Fifty-nine percent had a right-sided tumor, 16% were MSI-high, and 37% were mutated KRAS (mKRAS). The proportion of patients alive at 2 years was higher for stage I compared with stage II and III (65 vs. 61 vs. 54%). The 5-year overall survival for stage I-III was 80, 76, and 67% for the initial cohort, and 90, 88, and 86% for those alive at 2 years. After adjustment, higher pathologic T and N stage, tumor deposits, and no chemotherapy were associated with worse COS (p < 0.01). While laterality and MSI status were not associated with COS, mKRAS was independently associated with decreased COS (HR 1.35, 95% CI 1.12-1.62).

CONCLUSION:

Patients with mKRAS had worse COS, suggesting that these mutations confer an aggressive biologic behavior, with patients remaining at higher risk of death 2 years after diagnosis. Routine evaluation of KRAS status should be considered in patients with non-metastatic disease for prognostication and to identify those who might benefit from modified surveillance protocols.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Colon / Inestabilidad de Microsatélites Límite: Adult / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Colon / Inestabilidad de Microsatélites Límite: Adult / Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos