PURPOSE To examine associations of KRAS mutation with tumor deposit status and overall survival in colorectal cancer (CRC) patients. METHODS This retrospective cohort study included patients with incidental CRC diagnosed during 2010-2014 and recorded statuses of KRAS and tumor deposit in the National Cancer Database of the USA. Multivariable logistic regression and time-varying Cox regression analyses were used. RESULTS We included 45,761 CRC patients with KRAS status (24,027 [52.5%] men, 24,240 [53.0%] < 65 years old, 17,338 [37.9%] with KRAS mutation). Adjusted for microsatellite instability, age, pathologic stage and tumor grade, KRAS mutation (versus wild type) was associated with tumor deposit presence (odds ratio = 1.11, 95% CI 1.02-1.20). KRAS mutation was also linked to worse overall survival of CRC patients regardless of tumor deposit status (adjusted Hazard ratio [HR] = 1.20, 95% CI 1.07-1.33 for CRC with tumor deposits, and adjusted HR = 1.24, 95% CI 1.14-1.35 or CRC without) or tumor stage (adjusted HR = 1.32, 95% CI 1.14-1.54 for early-stage and adjusted HR = 1.18, 95% CI 1.10-1.27 for late-stage). Microsatellite instability was associated with better overall survival in CRC without tumor deposit (adjusted HR = 0.89, 95% CI 0.79-0.99), but not in CRC with tumor deposit (adjusted HR = 1.12, 95% CI 0.97-1.30). CONCLUSION KRAS mutation is independently associated with tumor deposit presence and a worse overall survival in CRC patients.

中文翻译：

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KRAS 突变与结直肠癌肿瘤沉积状态和总体生存率的关联。


目的 研究 KRAS 突变与结直肠癌 (CRC) 患者肿瘤沉积状态和总体生存率的关系。方法 这项回顾性队列研究纳入了 2010 年至 2014 年期间诊断出的偶发 CRC 患者，并在美国国家癌症数据库中记录了 KRAS 和肿瘤沉积的状态。使用多变量逻辑回归和时变Cox回归分析。结果 我们纳入了 45,761 名具有 KRAS 状态的 CRC 患者（24,027 [52.5%] 男性，24,240 [53.0%] < 65 岁，17,338 [37.9%] 具有 KRAS 突变）。根据微卫星不稳定性、年龄、病理分期和肿瘤分级进行调整后，KRAS 突变（与野生型相比）与肿瘤沉积物的存在相关（比值比 = 1.11，95% CI 1.02-1.20）。无论肿瘤沉积状态如何，KRAS 突变也与 CRC 患者较差的总生存率相关（对于有肿瘤沉积的 CRC，调整后的风险比 [HR] = 1.20，95% CI 1.07-1.33，调整后的 HR = 1.24，95% CI 1.14- 1.35 或 CRC 无）或肿瘤分期（早期调整后 HR = 1.32，95% CI 1.14-1.54，晚期调整后 HR = 1.18，95% CI 1.10-1.27）。微卫星不稳定性与无肿瘤沉积的 CRC 中较好的总体生存率相关（调整后的 HR = 0.89，95% CI 0.79-0.99），但在有肿瘤沉积的 CRC 中则不然（调整后的 HR = 1.12，95% CI 0.97-1.30）。结论 KRAS 突变与 CRC 患者肿瘤沉积的存在和较差的总生存期独立相关。