title: The Prognostic Value of Microsatellite Instability,KRAS, BRAFandPIK3CAMutations in Stage II Colon Cancer Patients.
abstract: In the era of personalized cancer medicine, identifying mutations within patient tumors plays an important role in defining high-risk stage II colon cancer patients. The prognostic role ofBRAFV600E mutation, microsatellite instability (MSI) status,KRASmutation andPIK3CAmutation in stage II colon cancer patients is not settled. We retrospectively analyzed 186 patients with stage II colon cancer who underwent an oncological resection but were not treated with adjuvant chemotherapy.KRASmutations,PIK3CAmutation, V600EBRAFmutation and MSI status were determined. Survival analyses were performed. Mutations were found in the patients with each mutation in the following percentages: 23% (MSI), 35% (KRAS), 19% (BRAF) and 11% (PIK3CA). A trend toward worse overall survival (OS) was seen in patients with an MSI (5-year OS 74% versus 82%, adjusted hazard ratio [HR] 1.8, 95% confidence interval [CI] 0.6-4.9) and aKRAS-mutated tumor (5-year OS 77% versus 82%, adjusted HR 1.7, 95% CI 0.8-3.5). MSI andBRAF-mutated tumors tended to correlate with poorer disease-free survival (DFS) (5-year DFS 60% versus 78%, adjusted HR 1.6, 95% CI 0.5-2.1 and 5-year DFS 57% versus 77%, adjusted HR 1.1, 95% CI 0.4-2.6 respectively). In stage II colon cancer patients not treated with adjuvant chemotherapy,BRAFmutation and MSI status both tended to have a negative prognostic effect on disease-free survival.KRASand MSI status also tended to be correlated with worse overall survival.
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, The Netherlands.|Department of Surgery, VieCuri Medical Center, The Netherlands.
authors.forename: F Jeroen
authors.initials: FJ
authors.lastname: Vogelaar
authors.affiliation: Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands.|Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Felice N van
authors.initials: FNV
authors.lastname: Erning
authors.affiliation: Department of Surgery, Leiden University Medical Center, The Netherlands.
authors.forename: Marlies S
authors.initials: MS
authors.lastname: Reimers
authors.affiliation: Department of Pathology, and.
authors.forename: Hans van der
authors.initials: HV
authors.lastname: Linden
authors.affiliation: Department of Internal Medicine, Jeroen Bosch Hospital, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Pruijt
authors.affiliation: Department of Pathology, and.
authors.forename: Adriaan J C van den
authors.initials: AJCVD
authors.lastname: Brule
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, The Netherlands.
authors.forename: Koop
authors.initials: K
authors.lastname: Bosscha