title: Association between KRAS mutation and lung metastasis in advanced colorectal cancer.
abstract: BACKGROUND
  KRAS mutations have been associated with lung metastases at diagnosis of metastatic colorectal cancer (mCRC), but the impact of this mutation on subsequent development of lung metastasis is unknown. We investigated KRAS mutation as a predictor of lung metastasis development.
  
  
  METHODS
  We retrospectively evaluated data from patients with mCRC whose tumour was tested for KRAS mutation from 2008 to 2010. The relationships of KRAS mutational status with time-to-lung metastasis (TTLM) and overall survival (OS) were analysed.
  
  
  RESULTS
  Of the 494 patients identified, 202 (41%) had tumours with KRAS mutation. KRAS mutations were associated with a shorter TTLM (median 15.2 vs 22.4 months; hazard ratio=1.40; P=0.002) and a two-fold greater odds of developing lung metastases during the disease course in patients with liver-limited mCRC at diagnosis (72 vs 56%, P=0.007). Overall survival did not differ by KRAS status.
  
  
  CONCLUSIONS
  Lung metastasis was more likely to develop during the disease course in patients whose tumour had a KRAS mutation than in those whose tumour did not have a KRAS mutation. This finding may have an impact on decision making for surgical resection of metastatic disease.
authors.affiliation: Department of Radiology and Oncology, Instituto do Cancer do Estado de São Paulo (ICESP) Universidade de São Paulo, São Paulo 01246, Brazil.
authors.forename: A A L
authors.initials: AA
authors.lastname: Pereira
authors.affiliation: Department of Radiology and Oncology, Instituto do Cancer do Estado de São Paulo (ICESP) Universidade de São Paulo, São Paulo 01246, Brazil.
authors.forename: J F M
authors.initials: JF
authors.lastname: Rego
authors.affiliation: Hematology and Oncology Fellow, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: V
authors.initials: V
authors.lastname: Morris
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Overman
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: C
authors.initials: C
authors.lastname: Eng
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Garrett
authors.affiliation: Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Boutin
authors.affiliation: Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: R
authors.initials: R
authors.lastname: Ferrarotto
authors.affiliation: Hematology and Oncology Fellow, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: M
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Z-Q
authors.initials: ZQ
authors.lastname: Jiang
authors.affiliation: Department of Radiology and Oncology, Instituto do Cancer do Estado de São Paulo (ICESP) Universidade de São Paulo, São Paulo 01246, Brazil.
authors.forename: P M
authors.initials: PM
authors.lastname: Hoff
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: J-N
authors.initials: JN
authors.lastname: Vauthey
authors.affiliation: Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: E
authors.initials: E
authors.lastname: Vilar
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: D
authors.initials: D
authors.lastname: Maru
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kopetz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D056726:Genetic Association Studies; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000401:mortality / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D012189:Retrospective Studies; D018631:ras Proteins / Q000235:genetics*
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins