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RAS Mutation Status Confers Prognostic Relevance in Patients Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Cancer. J Surg Res 2019 08;240:130-135

Date

04/01/2019

Pubmed ID

30928770

DOI

10.1016/j.jss.2019.02.050

Scopus ID

2-s2.0-85063410472   2 Citations

Abstract

BACKGROUND: Metastatic colorectal cancer (mCRC) with peritoneal carcinomatosis is an increasingly prevalent disease that carries significant mortality if left untreated. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in this patient population is associated with improved outcomes but high morbidity. We sought to study the prognostic significance of the known genomic driver, RAS, in patients with mCRC undergoing CRS/HIPEC to allow for improved assessment of risk-benefit ratio in this patient population.

METHODS: Patients undergoing CRS/HIPEC for mCRC between 2010 and 2017 at our institution were identified. Patient demographics, RAS mutation status, perioperative morbidity, overall survival (OS), and relapse-free survival (RFS) were evaluated.

RESULTS: Forty-seven patients met inclusion criteria. RAS mutant versus RAS wild-type groups were well matched with no difference in the clinicopathologic factors between groups. RAS mutation was associated with decreased RFS but no difference in OS.

CONCLUSIONS: RAS mutation is an independent marker of early recurrence in patients undergoing CRS/HIPEC for mCRC and may identify patients who do not derive benefit from this high-risk procedure.

Author List

Morgan Z, Chow BE, Strong EA, Tsai S, Christians K, Mogal H, Gamblin TC, Clarke CN

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Callisia N. Clarke MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Susan Tsai MD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy, Cancer, Regional Perfusion
Colorectal Neoplasms
Cytoreduction Surgical Procedures
Disease-Free Survival
Female
GTP Phosphohydrolases
Humans
Hyperthermia, Induced
Male
Membrane Proteins
Middle Aged
Mutation
Neoplasm Recurrence, Local
Patient Selection
Peritoneal Neoplasms
Prognosis
Proto-Oncogene Proteins B-raf
Proto-Oncogene Proteins p21(ras)
Retrospective Studies
Risk Assessment