title: Primary Tumor Resection Offers Higher Survival Advantage in KRAS Mutant Metastatic Colorectal Cancer Patients.
abstract: OBJECTIVE
  Colorectal cancer is the fourth most common cancer diagnosed in the United States, and the third most common cause of death from cancer. Approximately 20% of the patients with colorectal cancer have distant metastasis during diagnosis. Primary tumor resection is controversial in unresectable metastatic colorectal cancer (CRC). We studied the survival effect of primary tumor resection in unresectable metastatic CRC according to kirsten ras (KRAS) mutation status.
  
  
  METHODS
  Seventy eight CRC cases with unresectable metastasis were included in the study. The KRAS status was known in all patients. 34 patients had undergone primary tumor resection before 1st chemotherapy.
  
  
  RESULTS
  ThE median time from primary tumor resection to first chemotherapy was 6 (3-17) weeks. The survival was better in the unresectable metastatic colon patients with resected primary tumor, but it was statistically non-significant (P = 0.07). The median OS was similar (P = 0.91) in the KRAS wild patients with or without primary tumor resection. The median OS was 28 months in KRAS mutant patients with primary tumor resection, 14 months in KRAS mutant patients without primary tumor resection (P = 0.002).
  
  
  CONCLUSIONS
  Primary tumor resection offers survival advantage in KRAS mutant patients, but randomized prospective studies are required.
authors.forename: Hilmi
authors.initials: H
authors.lastname: Kodaz
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.forename: Ilhan
authors.initials: I
authors.lastname: Hacibekiroglu
authors.forename: Esma
authors.initials: E
authors.lastname: Turkmen
authors.forename: Hilmi
authors.initials: H
authors.lastname: Tozkir
authors.forename: Dogan
authors.initials: D
authors.lastname: Albayrak
authors.forename: Sernaz
authors.initials: S
authors.lastname: Uzunoglu
authors.forename: Irfan
authors.initials: I
authors.lastname: Cicin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068818:Cetuximab / Q000008:administration & dosage; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: C117307:KRAS protein, human; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D016283:Proto-Oncogene Proteins p21(ras); D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin