Table of Contents
ISRN Surgery
Volume 2014, Article ID 157586, 7 pages
http://dx.doi.org/10.1155/2014/157586
Clinical Study

The Presence of Mutations in the K-RAS Gene Does Not Affect Survival after Resection of Pulmonary Metastases from Colorectal Cancer

1Thoracic Surgery Service, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain
2Department of Pathology, Donostia University Hospital, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain
3Department of Clinical Epidemiology, Donostia University Hospital, CASPe and CIBER-ESP, Paseo Dr. Beguiristain s/n, 20014 Donostia, Gipuzkoa, Spain

Received 3 September 2013; Accepted 5 November 2013; Published 4 February 2014

Academic Editors: D. Galetta and J. A. Tovar

Copyright © 2014 Jon Zabaleta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Our objective was to identify mutations in the K-RAS gene in cases of pulmonary metastases from colorectal cancer (CRC) and determine whether their presence was a prognostic factor for survival. Methods. We included all patients with pulmonary metastases from CRC operated on between 1998 and 2010. K-RAS mutations were investigated by direct sequencing of DNA. Differences in survival were explored with the Kaplan-Meier method log-rank tests and multivariate Cox regression analysis. Results. 110 surgical interventions were performed on 90 patients. Factors significantly associated with survival were disease-free interval , age , number of metastases , lymph node involvement , size of the metastases , and previous liver metastasis . Searching in 79 patients, K-RAS mutations were found in 30 cases. We did not find statistically significant differences in survival comparing native and mutated K-RAS. We found a higher rate of lung recurrence and shorter time to recurrence in patients with K-RAS mutations. Gly12Asp mutation was associated with higher recurrence and lower survival . Conclusions. The presence of K-RAS mutations in pulmonary metastases does not affect overall survival but is associated with higher rates of pulmonary recurrence.