Serenari M, et al. - Researchers here assessed the prognostic significance of Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations in patients who undergo Associating Liver Partition and Portal vein occlusion for Staged hepatectomy (ALPPS). Findings suggested KRAS mutation as an independent predictor of poor survival after ALPPS. The finding seemed to optimize patient selection, both avoiding futile surgical indication and maximizing the benefit for patients with extensive disease who are otherwise subjected to high-risk aggressive surgery.

Methods

• 26 patients underwent ALPPS for CRLM from June 2011 to March 2016.
• In accordance to the Clavien-Dindo classification, researchers classified complications.
• They performed bi- and multivariate cox analyses to evaluate variables potentially associated with survival.

Results

• Findings revealed morbidity grade ≥3a and 90-day mortality of 38.5 and 0%, respectively.
• Researchers followed the patients for a median period of 21.5 months (interquartile range 9.6-35.6) from the time of discharge.
• One- and 3-year overall survival (OS) of 83.4 and 48.9% were observed, respectively.
• Patients with mutated (MT) KRAS had a median OS of 15.3 vs. 38.3 months for those with wild-type (WT) KRAS (p < 0.0001).
• Median disease-free survival was 7.9; for MT and WT KRAS, 5.6 vs. 12.3 months, respectively (p = 0.023).
• Findings suggested KRAS mutation as an independent risk factor for OS (hazard ratio 7.15, 95% CI 1.50-34.11; p = 0.014).