Abstract
BackgroundColorectal cancer (CRC) originating from the right-sided or left-sided colon is distinct clinicopathological entity. The KRAS status and its prognostic value in CRC remain controversial. This study aimed to investigate the association of KRAS status with clinicopathological features and prognostic value in CRC.Methods178 colon cancer and 145 rectal cancer patients were enrolled. KRAS mutation test was performed on paraffin-embedded tumor samples using PCR methods. The colon cancer was divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Studies that reported the association of KRAS mutation with CRC clinical features and prognosis in databases were searched prior to 2018. The data of the present study was combined with the data of published studies using meta-analysis methods.ResultsNo significant difference between colon cancer and rectal cancer regarding the KRAS status. The KRAS mutation was much frequent in RCC than in LCC (p = 0.010). 17 studies with 11,385 colon cancer patients were selected, the pooled results of our data and previous published data showed that KRAS mutation was more frequent in RCC compared with in LCC (p < 0.01); KRAS mutation was not associated with the prognosis in RCC patient; however, KRAS mutation indicated a poor prognosis in LCC patients compared with KRAS wild type (p < 0.01).ConclusionKRAS status has no difference between colon cancer and rectal cancer. KRAS mutation was more frequent in RCC than in LCC, and associated with a poor prognosis in LCC patients, but not in RCC patients.
Highlights
Colorectal cancer (CRC) originating from the right-sided or left-sided colon is distinct clinicopathological entity
The pooled results showed that Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation was much more frequent in right-sided colon cancer (RCC) compared with left-sided colon cancer (LCC) (OR = 1.68, 95%CI = 1.50–1.88, p < 0.01), and no significant heterogeneity across the studies (I2 = 34.3%, p = 0.082)
By dividing the CRC based on the KRAS status, we did not observe the difference between KRAS mutation and wild type regarding the clinicopathological features, but found that RCC harboring more KRAS mutation compared with LCC (46.4% vs. 37.5%)
Summary
Colorectal cancer (CRC) originating from the right-sided or left-sided colon is distinct clinicopathological entity. The KRAS status and its prognostic value in CRC remain controversial. This study aimed to investigate the association of KRAS status with clinicopathological features and prognostic value in CRC. Colorectal cancer (CRC) is the third most common malignancy globally, accounting for approximately 10.0% of all new cancer cases [1]. The colon cancer can further be classified into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) divided at the site of splenic flexure of colon. Anti-epidermal growth factor receptor (EGFR) antibody has been showed to be an effective therapy in the treatment of CRC patients. Many studies reported the clinicopathological features of CRC, and some studies further analyzed the
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