Performance of prognostic models incorporating KRAS mutation status to predict survival after resection of colorectal liver metastases

Geoffrey Yuet Mun Wong; Nazim Bhimani; Barend Mol; Connie Diakos; Philip de Reuver; Mark P Molloy; Thomas J Hugh

doi:10.1016/j.hpb.2022.01.003

Performance of prognostic models incorporating KRAS mutation status to predict survival after resection of colorectal liver metastases

HPB (Oxford). 2022 Aug;24(8):1316-1325. doi: 10.1016/j.hpb.2022.01.003. Epub 2022 Jan 12.

Authors

Geoffrey Yuet Mun Wong¹, Nazim Bhimani², Barend Mol², Connie Diakos³, Philip de Reuver⁴, Mark P Molloy⁵, Thomas J Hugh⁶

Affiliations

¹ Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia; Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia. Electronic address: gwon4318@uni.sydney.edu.au.
² Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.
³ Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
⁴ Department of Surgery, Radboud University Medical Centre, Nijmegen, Netherlands.
⁵ Bowel Cancer and Biomarker Research Laboratory, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.
⁶ Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia; Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.

PMID: 35093297
DOI: 10.1016/j.hpb.2022.01.003

Abstract

Background: The Genetic And Morphologic Evaluation (GAME) score and modified clinical score (m-CS) are two novel prognostic models that incorporate KRAS mutation status to predict survival after resection of colorectal liver metastases (CRLM). This retrospective cohort study evaluated the performance of these two models.

Methods: A total of 103 patients who underwent resection of CRLM between 2007 and 2017 and had known KRAS mutation status were included, 39 (37.9%) of whom had KRAS mutated tumours. Complete case analysis of the patients was performed according to the Clinical Risk Score (CRS), m-CS, and GAME score. The primary outcome was overall survival stratified according to low-risk and high-risk scores. Harrell's C-index and Akaike information criterion (AIC) were used to compare the discrimination of the evaluated prognostic models.

Results: The GAME score demonstrated the largest difference in overall survival for patients stratified according to low-risk and high-risk groups. Harrell's C-index values for the CRS, m-CS, and GAME models were 0.583, 0.600, and 0.668, respectively. AIC values for the CRS, m-CS, and GAME models were 441, 439, and 427, respectively.

Conclusion: The GAME score outperforms the CRS and m-CS in predicting overall survival after resection of CRLM in patients with known KRAS mutation status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Colorectal Neoplasms* / pathology
Hepatectomy
Humans
Liver Neoplasms* / genetics
Liver Neoplasms* / secondary
Liver Neoplasms* / surgery
Mutation
Prognosis
Proto-Oncogene Proteins p21(ras) / genetics
Retrospective Studies

Substances

KRAS protein, human
Proto-Oncogene Proteins p21(ras)