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KRAS-mutation status in relation to colorectal cancer survival: the joint impact of correlated tumour markers.

Phipps, A I and Buchanan, D D and Makar, K W and Win, A K and Baron, J A and Lindor, N M and Potter, J D and Newcomb, P A (2013) KRAS-mutation status in relation to colorectal cancer survival: the joint impact of correlated tumour markers. British journal of cancer, 108 (8). pp. 1757-64. ISSN 1532-1827

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Background:Mutations in the Kirsten Ras (KRAS) oncogene are common in colorectal cancer (CRC). The role of KRAS-mutation status as a prognostic factor, however, is unclear. We evaluated the relationship between KRAS-mutation status and CRC survival, considering heterogeneity in this association by tumour and patient characteristics.Methods:The population-based study included individuals diagnosed with CRC between 1998-2007 in Western Washington State. Tumour specimens were tested for KRAS exon 2 mutations, the BRAF p.V600E mutation, and microsatellite instability (MSI). We used Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between KRAS-mutation status and disease-specific and overall survival. Stratified analyses were conducted by age, sex, tumour site, stage, and MSI. We conducted additional analyses combining KRAS-mutation, BRAF-mutation, and MSI status.Results:Among 1989 cases, 31% had KRAS-mutated CRC. Kirsten Ras (KRAS)-mutated CRC was associated with poorer disease-specific survival (HR=1.37, 95% CI: 1.13-1.66). This association was not evident in cases who presented with distant-stage CRC. Cases with KRAS-wild-type/BRAF-wild-type/MSI-high CRC had the most favourable prognosis; those with CRC exhibiting a KRAS- or BRAF-mutation and no MSI had the poorest prognosis. Patterns were similar for overall survival.Conclusion:Kirsten Ras (KRAS)-mutated CRC was associated with statistically significantly poorer survival after diagnosis than KRAS-wild-type CRC.

Item Type: Article or Abstract
DOI: 10.1038/bjc.2013.118
PubMed ID: 23511557
Grant Numbers: RFA #CA-95-011, U01 CA074794, R01CA076366, R25CA94880, K05CA152715
Fred Hutch Divisions: Public Health Sciences
Depositing User: Library Staff
Date Deposited: 22 May 2013 19:31
Last Modified: 22 May 2013 19:31

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