Purpose The Kirsten rat sarcoma viral oncogene (KRAS) is the most frequently mutated oncogene in human cancers. Significant advancements have been made in targeted therapy and immunotherapy for this gene in recent years, underscoring the importance of comprehensively understanding the genomic landscape of KRAS across various cancer types. Methods Using next-generation sequencing (NGS) technology and a panel of 520 genes, KRAS mutations, tumor mutation burden (TMB), and microsatellite instability (MSI-H) status were investigated. Results An analysis of 10,820 tumor samples found KRAS mutations in 19.97% of cases. Pancreatic cancer showed the highest prevalence of KRAS mutations at 73.51%, while colorectal at 41.45%, uterine at 21.23%, and lung cancer at 11.24%. KRAS G12D mutation is most common in pancreatic, colorectal, and gastric cancers, while KRAS G12V mutation is predominant in uterine cancer, and KRAS G12C mutation is most frequent in lung cancer. Significant correlations were found between TMB and KRAS G13D/G12V mutations in colorectal cancer. KRAS G13D notably affected TMB in uterus cancer, while KRAS G12C mutation was linked to high TMB in lung cancer. Moreover, statistical analysis revealed a significant association between KRAS G13D/G12V mutations and MSI-H in colorectal cancer. Conclusions KRAS mutations were most frequent in cancers of the digestive, female reproductive, and respiratory systems. Specific KRAS mutations are associated with TMB and MSI in various cancer types.
12 September 2019 in World Journal of Surgical Oncology
Purpose: To compare the peri-operative outcomes of females undergoing laparoscopic intracorporeal urinary diversions (ICUD) and extracorporeal urinary diversions (ECUD) after laparoscopic radical cystectomies (LRC).Patients and methods: Thirty-eight females who underwent LRCs and urinary diversions from February 2008 to October 2018 were divided into two groups: the ECUD group (19 patients) and the ICUD group (19 patients). We retrospectively analysed the patients in terms of patients’ demographics, peri-operative outcomes, and oncological follow-ups.Results: There were significant differences in the mean operative times between ECUDs and ICUDs (364.6 vs. 297.1 min,p = 0.007), transfusion rates (37% vs. 5%,p = 0.042), time to flatus (5 vs. 3 days,p = 0.020), time to ambulation (2 vs. 1 days,p = 0.022), and duration of postoperative hospital stays (22 vs. 13 days,p = 0.002). The mean lymph node yield was 12.9 in the ECUD group and 18.6 in the ICUD group (p = 0.140). Seven out of 19 patients (37%) in the ECUD group and 6 out of 19 patients (32%) in the ICUD group had positive lymph nodes (p > 0.9). Two out of 19 ECUD patients (11%) and 4 of 19 ICUD patients (21%) had positive surgical margins (p = 0.660). Although there were no differences in major complications at 30 days and in all complications at 90 days, the Clavien grade II complications were significantly different at 30 days (ECUD 8, ICUD 2;p = 0.026). The mean follow-up times were 48.7 months (ECUD group) and 26.4 months (ICUD group). There were no statistically significant differences in estimated glomerular filtration rates postoperatively (p = 0.516). Seven patients had disease metastases (ECUD 2 out of 19, ICUD 5 out of 19;p = 0.405) and 5 died (ECUD 3 out of 19, ICUD 2 out of 19;p > 0.9).Conclusions: ICUDs benefit females by having smaller incisions, faster recoveries, and decreased complication rates.