title: The Presence of Mutations in the K-RAS Gene Does Not Affect Survival after Resection of Pulmonary Metastases from Colorectal Cancer.
abstract: Introduction. Our objective was to identify mutations in the K-RAS gene in cases of pulmonary metastases from colorectal cancer (CRC) and determine whether their presence was a prognostic factor for survival. Methods. We included all patients with pulmonary metastases from CRC operated on between 1998 and 2010. K-RAS mutations were investigated by direct sequencing of DNA. Differences in survival were explored with the Kaplan-Meier method log-rank tests and multivariate Cox regression analysis. Results. 110 surgical interventions were performed on 90 patients. Factors significantly associated with survival were disease-free interval (P = 0.002), age (P = 0.007), number of metastases (P = 0.001), lymph node involvement (P = 0.007), size of the metastases (P = 0.013), and previous liver metastasis (P = 0.003). Searching in 79 patients, K-RAS mutations were found in 30 cases. We did not find statistically significant differences in survival (P = 0.913) comparing native and mutated K-RAS. We found a higher rate of lung recurrence (P = 0.040) and shorter time to recurrence (P = 0.015) in patients with K-RAS mutations. Gly12Asp mutation was associated with higher recurrence (P = 0.022) and lower survival (P = 0.389). Conclusions. The presence of K-RAS mutations in pulmonary metastases does not affect overall survival but is associated with higher rates of pulmonary recurrence.
authors.affiliation: Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Jon
authors.initials: J
authors.lastname: Zabaleta
authors.affiliation: Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Borja
authors.initials: B
authors.lastname: Aguinagalde
authors.affiliation: Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Izquierdo
authors.affiliation: Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Bazterargui
authors.affiliation: Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Stephany M
authors.initials: SM
authors.lastname: Laguna
authors.affiliation: Department of Pathology, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Maialen
authors.initials: M
authors.lastname: Martin-Arruti
authors.affiliation: Department of Pathology, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Lobo
authors.affiliation: Department of Clinical Epidemiology, Donostia University Hospital, CASPe and CIBER-ESP, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain.
authors.forename: José I
authors.initials: JI
authors.lastname: Emparanza