Research Papers:

KRAS mutation as a prognostic factor in ampullary adenocarcinoma: a meta-analysis and review

Bum Jun Kim, Hyun Joo Jang _, Jung Han Kim, Hyeong Su Kim and Jin Lee

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Oncotarget. 2016; 7:58001-58006. https://doi.org/10.18632/oncotarget.11156

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Bum Jun Kim1, Hyun Joo Jang2, Jung Han Kim1, Hyeong Su Kim1, Jin Lee2

1Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea

2Division of Gastroenterology, Department of Internal Medicine, Dongtan Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwasung 18450, Republic of Korea

Correspondence to:

Hyun Joo Jang, email: [email protected]

Jung Han Kim, email: [email protected]

Keywords: ampullary adenocarcinoma, KRAS mutation, prognosis, meta-analysis

Received: June 09, 2016     Accepted: July 30, 2016     Published: August 09, 2016


Ampullary adenocarcinoma (A-AC) is a rare malignancy arising from the ampulla of Vater. KRAS mutation is detected in 30–40% of patients with A-AC, but its clinical implication and prognostic value are not well described. We conducted this meta-analysis to investigate the association between KRAS mutation and prognosis in patients with A-AC. We searched Pubmed, MEDLINE, EMBASE, and the Cochrane Library databases for articles including following terms in their titles, abstracts, or keywords: ‘ampullary or periampullary or ampulla of vater’, ‘cancer or carcinoma’, and ‘KRAS’. There were five studies with survival data of patients. A total of 388 patients with A-AC from the 5 studies were included in the overall survival (OS) analysis, and 169 patients from 2 studies were eligible for the relapse-free-survival (RFS) analysis. Out of 388 patients, 175 (45%) had KRAS mutation. There was no association between KRAS mutation and OS (HR = 1.06, 95% CI: 0.87–1.29, P = 0.58). However, there was a significant correlation between KRAS mutation and worse RFS (HR = 2.74, 95% CI: 1.52–4.92, P = 0.0008). In conclusion, this meta-analysis indicates that KRAS mutation is associated with poor RFS, but not with OS in patients with A-AC.

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