Clinical and Pathological Properties of Patients with Metastatic Colorectal Cancer According to the RAS Mutation Status

Year 2019, Volume: 45 Issue: 2, 131 - 136, 01.08.2019

Mehmet Sezen Murat Araz

https://doi.org/10.32708/uutfd.524758

Cited By: 1

Abstract

We
aimed to compare the clinical and histopathologic features at the time of
diagnosis of patients with metastatic colorectal cancer according to the RAS
mutation status. In this
cross-sectional study, archive records of patients with diagnosing colorectal
cancer who were followed-up and treated at oncology center of an university
hospital in Turkey between 01.04.2012 and 24.08.2017  was analyzed retrospectively. A totally 530
patients' archive records were evaluated. The relationship between the RAS
mutant/wild groups and primary tumor localization, location of metastases at
diagnosis, tumor markers, tumor differentiation grade and overall survival
rates were compared with the literature data. We
found no statistically significant difference between RAS mutant and wild
groups. When overall survival rates were compared with the RAS mutation status,
the overall survival of 2 years in patients with RAS wild type was 59% while
the 2 year overall survival of RAS mutant patients was 27.8% and this
difference was statistically significant (p = 0.004). However, there was no
statistically significant difference between the median survival of patients
receiving bevacizumab or cetuksimab/panitumumab in th efirst line treatment of
RAS wild patients (57.1% versus 70.7%; p=0.221, respectively). In
this study, we determined that RAS mutation status of our patients with
metastatic colorectal cancer is more similar to Western countries and the
clinical and pathological characteristics of patients at the time of diagnosis
are independent of RAS mutation status. However, there is still need broader
participation and prospective trials in this subject.

Keywords

Clinical and pathological properties, Colorectal cancer, RAS mutation

Metastatik Kolorektal Kanserli Hastaların RAS Mutasyon Durumuna Göre Klinik ve Patolojik Özellikleri

Abstract

Bu çalışmada metastatik kolorektal
kanserli hastalarda tanı anındaki histopatolojik ve klinik özelliklerin RAS
mutasyon durumuna göre karşılaştırılması amaçlandı. Bu kesitsel çalışma için, 01.04.2012-24.08.2017 tarihleri arasında
bir üniversite hastanesinin onkoloji merkezinde takip ve tedavisi yapılmış
toplam 530 kolorektal kanser tanısı almış hastanın dosyası retrospektif olarak
incelendi. Çalışmaya 18 yaşından büyük, tanı anında metastatik hastalığa sahip
veya takipleri boyunca metastaz gelişen ve RAS mutasyonu bakılmış 75 hasta
dahil edildi. Rasmutant olan ve olmayan hastaların tümör lokalizasyonu, tanı
anındaki metastaz yerleri, tümör belirteçleri, tümör diferansiyasyon derecesi
ve genel sağkalım süreleri arasındaki farklılıklar analiz edildi. RAS mutasyonu
sıklığı %50.7 olarak saptandı. Klinik ve patolojik özellikler açısından
bakıldığında RAS mutant ve wild gruplar arasında istatistiksel anlamı farklılık
saptamadık. RAS mutasyon durumuna göre genel sağkalım süreleri incelendiğinde,
RAS wild tip olan hastaların 2 yıllık genel sağkalımı% 59 iken, RAS mutant
hastalarımızın 2 yıllık genel sağkalımı %27.8 idi ve bu fark istatiksel olarak
anlamlıydı (p=0.004). Ancak, RAS wild hastaların ilk hat tedavisinde
bevacizumab veya cetuksimab/panitumumab alan hastaların ortalama sağkalımları
arasında (sırasıyla %57.1'e karşı %70.7; p=0.221) istatistiksel fark
saptanmadı. Bu çalışmada, metastatik
kolorektal kanserli hastalarımızın RAS mutasyon durumunun daha ziyade Batılı
ülkelere benzer olduğunu ve hastaların tanı anındaki klinik ve patolojik
özelliklerinin RAS mutasyon durumundan bağımsız olduğunu saptadık. Ancak bu
konuda yapılacak prospektif ve daha geniş katılımlı çalışmalara hala ihtiyaç
duyulmaktadır.

Keywords

Klinik ve patolojik özellikler, Kolorektal kanser, RAS mutasyonu

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