摘要
BACKGROUND KRAS mutation status and primary tumor location serve as critical prognostic factors for colorectal liver metastases(CLMs).Emerging evidence suggests a potential interaction between these two variables that may influence clinical outcomes.AIM To investigate the association of KRAS mutations with recurrence in patients with CLM who underwent radiofrequency ablation(RFA)according to the primary tumor location.METHODS This retrospective study analyzed 164 patients with KRAS-determined CLM treated with percutaneous RFA between January 2012 and December 2018.The clinicopathological characteristics,recurrence patterns,and survival outcomes were systematically evaluated.RESULTS A total of 164 patients(mean age:58.0±9.8 years,range:34-83 years)who underwent percutaneous RFA of 325 CLMs(mean size:2.2±1.0 cm,range:0.7-5.0 cm)were included in the study.Eighty-nine(54.3%)patients had wild-type KRAS,and 75(45.7%)patients had mutated KRAS.Compared with wild-type patients,patients with KRAS mutations presented significantly higher local tumor progression rates(30.7%vs 14.6%,P=0.013).Among 126 patients(76.8%)who experienced post-RFA recurrence,61.6%developed intrahepatic metastases,and 53.7%developed extrahepatic metastases.Primary tumor location significantly modified KRASrelated outcomes:Compared with wild-type patients,left-sided colorectal cancer(CRC)patients with KRAS mutations presented higher intrahepatic recurrence rates(77.2%vs 52.5%,P=0.003)and shorter median intrahepatic recurrence-free survival(15 vs 25 months,P=0.007).No significant differences in KRAS expression were detected in right-sided tumors.CONCLUSION KRAS mutation status predicts differential recurrence patterns after CLM ablation,with significant prognostic implications,specifically in left-sided CRCs.These findings underscore the importance of integrating molecular profiling and primary tumor characteristics in therapeutic decision-making for patients with metastatic CRC.
基金
Supported by Capital Health Development Research Project,No.2020-2-2152
National Natural Science Foundation of China,No.82472002.
