Ann Hepatobiliary Pancreat Surg.  2022 May;26(2):125-132. 10.14701/ahbps.21-127.

Can the presence of KRAS mutations guide the type of liver resection during simultaneous resection of colorectal liver metastasis?

• Choi M
• Han DH
• Choi JS
• Choi GH

• KMID: 2530090
• DOI: http://doi.org/10.14701/ahbps.21-127

Abstract

Backgrounds/Aims
It is generally accepted that non-anatomical resection (NAR) in colorectal liver metastasis (CRLM) has comparable safety and efficacy compared to anatomical resection (AR); however, there are reports that AR may have better outcomes in KRAS mutated CRLM. This study aimed to determine the effects of KRAS mutations and surgical techniques on survival outcomes in CRLM patients.
Methods
Two hundred fifty patients who underwent hepatic resection of CRLM with known KRAS mutational status between 2007 and 2018 were analyzed. A total of 94 KRAS mutated CRLM and 156 KRAS wild-type CRLM were subdivided by surgical approach and compared for short- and long-term outcomes.
Results
In both KRAS wild-type and mutated type, there was no difference in estimated blood loss, postoperative complications, and 30-day mortality. There was no difference in disease-free survival (DFS) between AR and NAR in both groups (p = 0.326, p = 0.954, respectively). Finally, there was no difference in intrahepatic DFS between AR and NAR groups in both the KRAS groups (p = 0.165, p = 0.516, respectively).
Conclusions
The presence of KRAS mutation may not be a significant factor when deciding the approach in simultaneous resection of CRLM.

Keyword

KRAS; Neoplasm metastasis; Hepatectomy; Liver

Figure

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  Fig. 1 Study flow diagram. CRC, colorectal cancer; AR, anatomical resection; NAR, non-anatomical resection.

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  Fig. 2 Disease-free survival in entire cohort grouped according to type of resection. AR, anatomical resection; NAR, non-anatomical resection.

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  Fig. 3 (A) Disease-free survival in patients with KRAS wild-type tumors grouped according to type of resection. (B) Disease-free survival in patients with KRAS mutated tumors grouped according to type of resection. AR, anatomical resection; NAR, non-anatomical resection.

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  Fig. 4 (A) Intrahepatic disease-free survival in patients with KRAS wild-type tumors grouped according to type of resection. (B) Intrahepatic disease-free survival in patients with KRAS mutated tumors grouped according to type of resection. AR, anatomical resection; NAR, non-anatomical resection.

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