Bin-Bin Jiang, Ji-Chen Wang, Kun Yan, Zhong-Yi Zhang, Song Wang, Wei Wu, Wei Yang
{"title":"KRAS基因对接受射频消融的左、右结直肠肝转移复发的差异影响。","authors":"Bin-Bin Jiang, Ji-Chen Wang, Kun Yan, Zhong-Yi Zhang, Song Wang, Wei Wu, Wei Yang","doi":"10.4240/wjgs.v17.i8.108418","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>KRAS</i> mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases (CLMs). Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.</p><p><strong>Aim: </strong>To investigate the association of <i>KRAS</i> mutations with recurrence in patients with CLM who underwent radiofrequency ablation (RFA) according to the primary tumor location.</p><p><strong>Methods: </strong>This retrospective study analyzed 164 patients with <i>KRAS</i>-determined CLM treated with percutaneous RFA between January 2012 and December 2018. The clinicopathological characteristics, recurrence patterns, and survival outcomes were systematically evaluated.</p><p><strong>Results: </strong>A total of 164 patients (mean age: 58.0 ± 9.8 years, range: 34-83 years) who underwent percutaneous RFA of 325 CLMs (mean size: 2.2 ± 1.0 cm, range: 0.7-5.0 cm) were included in the study. Eighty-nine (54.3%) patients had wild-type <i>KRAS</i>, and 75 (45.7%) patients had mutated <i>KRAS</i>. Compared with wild-type patients, patients with <i>KRAS</i> mutations presented significantly higher local tumor progression rates (30.7% <i>vs</i> 14.6%, <i>P</i> = 0.013). Among 126 patients (76.8%) who experienced post-RFA recurrence, 61.6% developed intrahepatic metastases, and 53.7% developed extrahepatic metastases. Primary tumor location significantly modified <i>KRAS</i>-related outcomes: Compared with wild-type patients, left-sided colorectal cancer (CRC) patients with <i>KRAS</i> mutations presented higher intrahepatic recurrence rates (77.2% <i>vs</i> 52.5%, <i>P</i> = 0.003) and shorter median intrahepatic recurrence-free survival (15 <i>vs</i> 25 months, <i>P</i> = 0.007). No significant differences in <i>KRAS</i> expression were detected in right-sided tumors.</p><p><strong>Conclusion: </strong><i>KRAS</i> mutation status predicts differential recurrence patterns after CLM ablation, with significant prognostic implications, specifically in left-sided CRCs. These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 8","pages":"108418"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427044/pdf/","citationCount":"0","resultStr":"{\"title\":\"Differential effects of the <i>KRAS</i> gene on recurrence in right- <i>vs</i> left-sided colorectal liver metastases undergoing radiofrequency ablation.\",\"authors\":\"Bin-Bin Jiang, Ji-Chen Wang, Kun Yan, Zhong-Yi Zhang, Song Wang, Wei Wu, Wei Yang\",\"doi\":\"10.4240/wjgs.v17.i8.108418\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><i>KRAS</i> mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases (CLMs). Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.</p><p><strong>Aim: </strong>To investigate the association of <i>KRAS</i> mutations with recurrence in patients with CLM who underwent radiofrequency ablation (RFA) according to the primary tumor location.</p><p><strong>Methods: </strong>This retrospective study analyzed 164 patients with <i>KRAS</i>-determined CLM treated with percutaneous RFA between January 2012 and December 2018. The clinicopathological characteristics, recurrence patterns, and survival outcomes were systematically evaluated.</p><p><strong>Results: </strong>A total of 164 patients (mean age: 58.0 ± 9.8 years, range: 34-83 years) who underwent percutaneous RFA of 325 CLMs (mean size: 2.2 ± 1.0 cm, range: 0.7-5.0 cm) were included in the study. Eighty-nine (54.3%) patients had wild-type <i>KRAS</i>, and 75 (45.7%) patients had mutated <i>KRAS</i>. Compared with wild-type patients, patients with <i>KRAS</i> mutations presented significantly higher local tumor progression rates (30.7% <i>vs</i> 14.6%, <i>P</i> = 0.013). Among 126 patients (76.8%) who experienced post-RFA recurrence, 61.6% developed intrahepatic metastases, and 53.7% developed extrahepatic metastases. Primary tumor location significantly modified <i>KRAS</i>-related outcomes: Compared with wild-type patients, left-sided colorectal cancer (CRC) patients with <i>KRAS</i> mutations presented higher intrahepatic recurrence rates (77.2% <i>vs</i> 52.5%, <i>P</i> = 0.003) and shorter median intrahepatic recurrence-free survival (15 <i>vs</i> 25 months, <i>P</i> = 0.007). No significant differences in <i>KRAS</i> expression were detected in right-sided tumors.</p><p><strong>Conclusion: </strong><i>KRAS</i> mutation status predicts differential recurrence patterns after CLM ablation, with significant prognostic implications, specifically in left-sided CRCs. These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.</p>\",\"PeriodicalId\":23759,\"journal\":{\"name\":\"World Journal of Gastrointestinal Surgery\",\"volume\":\"17 8\",\"pages\":\"108418\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427044/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4240/wjgs.v17.i8.108418\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v17.i8.108418","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：KRAS突变状态和原发肿瘤位置是结直肠癌肝转移（CLMs）的关键预后因素。新出现的证据表明，这两个变量之间的潜在相互作用可能会影响临床结果。目的：探讨KRAS基因突变与射频消融（RFA）治疗CLM患者复发的关系。方法：本回顾性研究分析了2012年1月至2018年12月164例经皮RFA治疗的kras - CLM患者。系统评估临床病理特征、复发模式和生存结果。结果：164例患者（平均年龄：58.0±9.8岁，范围：34 ~ 83岁）接受了325例clm（平均尺寸：2.2±1.0 cm，范围：0.7 ~ 5.0 cm）的经皮RFA。89例（54.3%）患者为KRAS野生型，75例（45.7%）患者为KRAS突变型。与野生型患者相比，KRAS突变患者的局部肿瘤进展率明显更高（30.7% vs 14.6%, P = 0.013）。126例（76.8%）rfa后复发患者中，61.6%发生肝内转移，53.7%发生肝外转移。原发肿瘤位置显著改变KRAS相关结局：与野生型患者相比，KRAS突变的左侧结直肠癌（CRC）患者肝内复发率更高（77.2% vs 52.5%, P = 0.003），中位肝内无复发生存期更短（15个月vs 25个月，P = 0.007）。KRAS在右侧肿瘤中的表达差异无统计学意义。结论：KRAS突变状态预测CLM消融后的不同复发模式，具有重要的预后意义，特别是在左侧crc中。这些发现强调了在转移性结直肠癌患者的治疗决策中整合分子谱和原发肿瘤特征的重要性。
Differential effects of the KRAS gene on recurrence in right- vs left-sided colorectal liver metastases undergoing radiofrequency ablation.
Background: KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases (CLMs). Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.
Aim: To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation (RFA) according to the primary tumor location.
Methods: This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018. The clinicopathological characteristics, recurrence patterns, and survival outcomes were systematically evaluated.
Results: A total of 164 patients (mean age: 58.0 ± 9.8 years, range: 34-83 years) who underwent percutaneous RFA of 325 CLMs (mean size: 2.2 ± 1.0 cm, range: 0.7-5.0 cm) were included in the study. Eighty-nine (54.3%) patients had wild-type KRAS, and 75 (45.7%) patients had mutated KRAS. Compared with wild-type patients, patients with KRAS mutations presented significantly higher local tumor progression rates (30.7% vs 14.6%, P = 0.013). Among 126 patients (76.8%) who experienced post-RFA recurrence, 61.6% developed intrahepatic metastases, and 53.7% developed extrahepatic metastases. Primary tumor location significantly modified KRAS-related outcomes: Compared with wild-type patients, left-sided colorectal cancer (CRC) patients with KRAS mutations presented higher intrahepatic recurrence rates (77.2% vs 52.5%, P = 0.003) and shorter median intrahepatic recurrence-free survival (15 vs 25 months, P = 0.007). No significant differences in KRAS expression were detected in right-sided tumors.
Conclusion: KRAS mutation status predicts differential recurrence patterns after CLM ablation, with significant prognostic implications, specifically in left-sided CRCs. These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.
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