Background: KRAS mutations have been associated with lung metastases at diagnosis of metastatic colorectal cancer (mCRC), but the impact of this mutation on subsequent development of lung metastasis is unknown. We investigated KRAS mutation as a predictor of lung metastasis development. Methods: We retrospectively evaluated data from patients with mCRC whose tumour was tested for KRAS mutation from 2008 to 2010. The relationships of KRAS mutational status with time-to-lung metastasis (TTLM) and overall survival (OS) were analysed. Results: Of the 494 patients identified, 202 (41%) had tumours with KRAS mutation. KRAS mutations were associated with a shorter TTLM (median 15.2 vs 22.4 months; hazard ratio=1.40; P =0.002) and a two-fold greater odds of developing lung metastases during the disease course in patients with liver-limited mCRC at diagnosis (72 vs 56%, P =0.007). Overall survival did not differ by KRAS status. Conclusions: Lung metastasis was more likely to develop during the disease course in patients whose tumour had a KRAS mutation than in those whose tumour did not have a KRAS mutation. This finding may have an impact on decision making for surgical resection of metastatic disease.
展开▼
机译：背景：在转移性结直肠癌（mCRC）的诊断中，KRAS突变与肺转移有关，但是该突变对随后的肺转移发展的影响尚不清楚。我们调查了KRAS突变作为肺转移发展的预测因子。方法：我们回顾性分析了2008年至2010年间接受过KRAS突变检测的mCRC患者的数据。分析了KRAS突变状态与肺转移时间（TTLM）和总生存期（OS）的关系。结果：在确定的494例患者中，有202例（41％）患有KRAS突变肿瘤。在确诊为肝功能受限的mCRC患者中，KRAS突变与更短的TTLM（中位数15.2 vs 22.4个月;危险比= 1.40; P = 0.002）和在病程中发生肺转移的可能性高两倍有关（72 vs 56％，P = 0.007）。总生存率没有因KRAS状态而异。结论：在肿瘤病程中，具有KRAS突变的患者比无KRAS突变的患者更容易发生肺转移。这一发现可能对转移性疾病的手术切除的决策产生影响。
展开▼
