Impact of mutant RAS on prognosis of patients after hepatic resection for colorectal cancer liver metastases

Abstract

Objective To study the impact of RAS status on prognosis of patients after liver resection for colorectal cancer liver metastases (CRLM). Methods The data of 545 consecutive CRLM patients who underwent liver resection at the Hepatopancreatobiliary Surgery Department I, Peking University Cancer Hospital between January 1st, 2008 and December 31st, 2016, were retrospectively reviewed. According to the inclusion and exclusion criteria, 356 patients were eventually included into this study. There were 232 males and 124 females, with ages ranging from 21 to 83 years. The clinical and follow-up data of patients with wild-type and mutant RAS were compared. Survival was estimated by the Kaplan-Meier method, and the difference was compared by the log-rank test. Factors influencing survival of these patients were assessed by univariate and multivariate Cox regression analyses. Results There were 247 patients with wild-type RAS and 109 patients with mutant RAS, respectively. The median overall survival of patients with wild-type and mutant RAS were 74 and 30 months respectively. Compared with mutant RAS patients, wild-type RAS patients had significantly better cumulative survival and disease free survival rates (both P 5 cm (HR=1.717, 95%CI: 1.102-2.637), and mutant RAS (HR=1.836, 95%CI: 1.322-2.550) were independent risk factors for patients with colorectal cancer liver metastases after hepatic resection. Conclusion Mutant RAS was a poor prognostic factor of survival after liver resection in CRLM patients Key words: Colorectal neoplasms; Hepatectomy; Liver metastases; RAS gene