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. 2017 Jun 5;17(1):403.
doi: 10.1186/s12885-017-3381-7.

The prognostic significance of KRAS and BRAF mutation status in Korean colorectal cancer patients

Daeyoun David Won  1 , Jae Im Lee  2 , In Kyu Lee  1 , Seong-Taek Oh  2 , Eun Sun Jung  3 , Sung Hak Lee  4
Affiliations

The prognostic significance of KRAS and BRAF mutation status in Korean colorectal cancer patients

Daeyoun David Won et al. BMC Cancer. .

Abstract

Background: BRAF and KRAS mutations are well-established biomarkers in anti-EGFR therapy. However, the prognostic significance of these mutations is still being examined. We determined the prognostic value of BRAF and KRAS mutations in Korean colorectal cancer (CRC) patients.

Methods: From July 2010 to September 2013, 1096 patients who underwent surgery for CRC at Seoul St. Mary's Hospital were included in the analysis. Resected specimens were examined for BRAF, KRAS, and microsatellite instability (MSI) status. All data were reviewed retrospectively.

Results: Among 1096 patients, 401 (36.7%) had KRAS mutations and 44 (4.0%) had BRAF mutations. Of 83 patients, 77 (92.8%) had microsatellite stable (MSS) or MSI low (MSI-L) status while 6 (7.2%) patients had MSI high (MSI-H) status. Patients with BRAF mutation demonstrated a worse disease-free survival (DFS, HR 1.990, CI 1.080-3.660, P = 0.02) and overall survival (OS, HR 3.470, CI 1.900-6.330, P < 0.0001). Regarding KRAS status, no significant difference was noted in DFS (P = 0.0548) or OS (P = 0.107). Comparing the MSS/MSI-L and MSI-H groups there were no significant differences in either DFS (P = 0.294) or OS (P = 0.557).

Conclusions: BRAF mutation, rather than KRAS, was a significant prognostic factor in Korean CRC patients at both early and advanced stages. The subgroup analysis for MSI did not show significant differences in clinical outcome. BRAF should be included in future larger prospective biomarker studies on CRC.

Keywords: BRAF mutation; Colorectal cancer; KRAS mutation; MSI.

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Figures

Fig. 1
Fig. 1
Tumor distribution according to KRAS and BRAF mutation status. a Male patients, b Female patients and c All patients
Fig. 2
Fig. 2
Kaplan-Meier curves for disease-free survival and overall survival according to KRAS or BRAF mutation status. a Disease-free survival (DFS) according to KRAS status, b DFS according to BRAF status, c Overall survival (OS) according to KRAS status and d OS according to BRAF status
Fig. 3
Fig. 3
Kaplan-Meier curves for DFS and OS according to KRAS mutation status in combination with BRAF. a DFS according to KRAS mutation status in combination with BRAF and b OS according to KRAS mutation status in combination with BRAF
Fig. 4
Fig. 4
Kaplan-Meier curves for DFS and OS according to KRAS or BRAF status in CRC patients with different stage. a DFS according to KRAS or BRAF status in CRC patients with stage I, b OS according to KRAS or BRAF status in CRC patients with stage I, c DFS according to KRAS or BRAF status in CRC patients with stage II and III, d OS according to KRAS or BRAF status in CRC patients with stage II and III, e DFS according to KRAS or BRAF status in CRC patients with stage IV and f OS according to KRAS or BRAF status in CRC patients with stage IV
Fig. 5
Fig. 5
Kaplan-Meier curves for DFS and OS according to MSI status. a DFS according to MSI status and b OS according to MSI status
See this image and copyright information in PMC

References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90. doi: 10.3322/caac.20107. - DOI - PubMed
    1. Shin A, Kim KZ, Jung KW, Park S, Won YJ, Kim J, et al. Increasing trend of colorectal cancer incidence in Korea, 1999-2009. Cancer res Treat. 2012;44:219–226. doi: 10.4143/crt.2012.44.4.219. - DOI - PMC - PubMed
    1. Jung KW, Won YJ, Oh CM, Kong HJ, Cho H, Lee DH, et al. Prediction of cancer incidence and mortality in Korea, 2015. Cancer res Treat. 2015;47:142–148. doi: 10.4143/crt.2015.066. - DOI - PMC - PubMed
    1. Cancer Genome Atlas N. Comprehensive molecular characterization of human colon and rectal cancer. Nature. 2012;487:330–7. - PMC - PubMed
    1. Arrington AK, Heinrich EL, Lee W, Duldulao M, Patel S, Sanchez J, et al. Prognostic and predictive roles of KRAS mutation in colorectal cancer. Int J Mol Sci. 2012;13:12153–12168. doi: 10.3390/ijms131012153. - DOI - PMC - PubMed

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