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. 2024 May 31:14:1396285.
doi: 10.3389/fonc.2024.1396285. eCollection 2024.

Assessing the prognostic value of KRAS mutation combined with tumor size in stage I-II non-small cell lung cancer: a retrospective analysis

Ella A Eklund  1   2   3 , Ali Mourad  1   2 , Clotilde Wiel  1 , Sama I Sayin  3 , Henrik Fagman  4   5 , Andreas Hallqvist  3   6 , Volkan I Sayin  1   2
Affiliations

Assessing the prognostic value of KRAS mutation combined with tumor size in stage I-II non-small cell lung cancer: a retrospective analysis

Ella A Eklund et al. Front Oncol. .

Abstract

Background: KRAS mutation status is a well-established independent prognostic factor in advanced non-small cell lung cancer (NSCLC), yet its role in early-stage disease is unclear. Here, we investigate the prognostic value of combining survival data on KRAS mutation status and tumor size in stage I-II NSCLC.

Methods: We studied the combined impact of KRAS mutational status and tumor size on overall survival (OS) in patients with stage I-II NSCLC. We performed a retrospective study including 310 diagnosed patients with early (stage I-II) NSCLCs. All molecularly assessed patients diagnosed with stage I-II NSCLC between 2016-2018 in the Västra Götaland Region of western Sweden were screened in this multi-center retrospective study. The primary study outcome was overall survival.

Results: Out of 310 patients with stage I-II NSCLC, 37% harbored an activating mutation in the KRAS gene. Our study confirmed staging and tumor size as prognostic factors. However, KRAS mutational status was not found to impact OS and there was no difference in the risk of death when combining KRAS mutational status and primary tumor size.

Conclusions: In our patient cohort, KRAS mutations in combination with primary tumor size did not impact prognosis in stage I-II NSCLC.

Keywords: KRAS; clinical outcome; lung cancer; stage I and II; tumor size.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient selection. Flow chart showing patient selection for the study.
Figure 2
Figure 2
Impact of KRAS mutational status on overall survival in Stage I and II NSCLC. Kaplan-Meier estimates comparing overall survival between (A, B) all patients, (C, D) Stage I and (E, F) Stage II patients with no mutation in KRAS (wildtype, KRAS WT), with all KRAS mutations (KRAS MUT), only KRAS-G12C mutations (KRAS MUT G12C) and KRAS mutations other than G12C (KRAS MUT not G12C).
Figure 3
Figure 3
Impact of KRAS mutational status on overall survival across TNM-stages in NSCLC. Kaplan-Meier estimates comparing overall survival between (A, B) T1, (C, D) T2 and (E, F) T3 patients with no mutation in KRAS (wildtype, KRAS WT), with all KRAS mutations (KRAS MUT), only KRAS-G12C mutations (KRAS MUT G12C) and KRAS mutations other than G12C (KRAS MUT not G12C).
Figure 4
Figure 4
KRAS mutations are associated with smaller tumor size at diagnosis. Primary tumor size from (A) CT scans and (B) resection specimens (PAD) in patients with no mutation in KRAS (wildtype, KRAS WT) or with KRAS mutations (KRAS MUT). Forest plot of multivariable COX regression analysis for patients with tumor size from (C) CT scan and (D) resection specimens (PAD).
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