Effect of KRAS mutation status on clinicopathological characteristics and over survival in patients wtih rectal cancer

Background KRAS mutations in rectal cancer are associated with a conflict prognosis. This study aimed to assess the clinicopathological characteristics of mutated KRAS and to explore the impact of specific KRAS mutation sites on patient survival. Methods The research retrospectively analyzed a cohort of 293 patients who received surgical treatment for rectal adenocarcinoma between May 2015 and December 2023. The patients were categorized into two groups according to their KRAS status: wild-type KRAS (wKRAS) and mutant KRAS (mKRAS), with performing research on mKRAS G12D and mKRAS G13D mutation. Results The mKRAS group included 100 patients (51.8%) and had no significantly difference in age,sex,distance from anus,TNM,LVI,TD,PNI,CEA level than that in wKRAS group.KRAS ^G12D group had significantly more poorer differenation caner tissue(9/34,26.5% vs. 10/93,10.7%,p = 0.046), PNI(24/34,70.6%vs.42/93,45.2%,p = 0.016)and higher TD(8/34,23.5% vs.8/93,8.6%,p = 0.035) respectively,p < 0.05. Compared with the wKRAS group, the OS of mKRAS group was worse ,but had no significant difference(p = 0.0866). In comparison to the wKRAS group, the overall survival duration was notably reduced in the KRAS ^G12D group (p = 0.0482), whereas no significant difference was observed in the KRAS ^G13D group (p = 0.1848). Additionally, a COX survival analysis was conducted, revealing that KRAS ^G12D , along with higher TNM stage, lymphovascular invasion (LVI), tumor differentiation (TD), and perineural invasion (PNI), were all associated with a decrease in survival time for patients with rectal cancer; however, these factors did not reach statistical significance (p > 0.05). Conclusion The overall survival duration for wKRAS was superior to that of mKRAS; however, the difference between the two groups was not statistically significant. In contrast, the survival time for KRAS ^G12D was significantly poorer than that for wKRAS, while no such difference was observed forKRAS ^G13D .