Different oncological features of colorectal cancer codon-specific KRAS mutations - Not codon 13 but codon 12 have prognostic value

Sep 24, 2026

Retrospective single-center observational cohort analysis evaluates clinicopathological characteristics and prognostic relevance of codon-specific KRAS mutations in stage I-III colorectal cancer. Patients undergoing surgery from January 2009 to December 2019 were included based on molecular pathology reports. Among 2203 cases, KRAS codons 12, 13, and 61 mutations occurred at 27.7%, 9.1%, and 1.3%. Codon 12 correlated with pathological and recurrence-risk variables, while codon 13 showed no significant clinicopathological associations. Multivariable Cox regression identified codon 12 as an independent recurrence risk factor.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

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| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2023 August 28; 29(32): 4883-4899 DOI: 10.3748/wjg.v29.i32.4883 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Retrospective Cohort Study Different oncological features of colorectal cancer codon-specific KRAS mutations: Not codon 13 but codon 12 have prognostic value Hong-Min Ahn, Duck-Woo Kim, Hyeon Jeong Oh, Hyung Kyung Kim, Hye Seung Lee, Tae Gyun Lee, Hye-Rim Shin, In Jun Yang, Jeehye Lee, Jung Wook Suh, Heung-Kwon Oh, Sung-Bum Kang Specialty type: Oncology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s scientific quality classification Grade A (Excellent): 0 Grade B (Very good): B Grade C (Good): C, C Grade D (Fair): 0 Grade E (Poor): 0 P-Reviewer: Malekpour A, Iran; Wang XL, China; Xie Q, China Received: May 20, 2023 Peer-review started: May 20, 2023 First decision: June 22, 2023 Revised: July 6, 2023 Accepted: July 31, 2023 Article in press: July 31, 2023 Published online: August 28, 2023 Hong-Min Ahn, Duck-Woo Kim, Tae Gyun Lee, Hye-Rim Shin, In Jun Yang, Jeehye Lee, Jung Wook Suh, Heung-Kwon Oh, Sung-Bum Kang, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 13620, South Korea Hyeon Jeong Oh, Hyung Kyung Kim, Department of Pathology, Seoul National University Bundang Hospital, Seongnam 13620, South Korea Hye Seung Lee, Department of Pathology, Seoul National University Hospital, Seoul 03080, South Korea Corresponding author: Duck-Woo Kim, MD, PhD, Professor, Department of Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 13620, South [Korea.](Korea. kdw@snubh.org)[ kdw@snubh.org](Korea. kdw@snubh.org) Abstract BACKGROUND Approximately 40% of colorectal cancer (CRC) cases are linked to Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations. KRAS mutations are associated with poor CRC prognosis, especially KRAS codon 12 mutation, which is associated with metastasis and poorer survival. However, the clinicopathological characteristics and prognosis of KRAS codon 13 mutation in CRC remain unclear. AIM To evaluate the clinicopathological characteristics and prognostic value of codonspecific KRAS mutations, especially in codon 13. METHODS This retrospective, single-center, observational cohort study included patients who underwent surgery for stage I-III CRC between January 2009 and December 2019. Patients with KRAS mutation status confirmed by molecular pathology reports were included. The relationships between clinicopathological characteristics and individual codon-specific KRAS mutations were analyzed. Survival data were analyzed to identify codon-specific KRAS mutations as recurrence-related factors using the Cox proportional hazards regression model. RESULTS WJG [https://www.wjgnet.com](https://www.wjgnet.com) 4883 August 28, 2023 Volume 29 Issue 32 Ahn HM et al. Codon-specific KRAS mutation in CRC Among the 2203 patients, the incidence of KRAS codons 12, 13, and 61 mutations was 27.7%, 9.1%, and 1.3%, respectively. Both KARS codons 12 and 13 mutations showed a tendency to be associated with clinical characteristics, but only codon 12 was associated with pathological features, such as stage of primary tumor (T stage), lymph node involvement (N stage), vascular invasion, perineural invasion, tumor size, and microsatellite instability. KRAS codon 13 mutation showed no associations (77.2% vs 85.3%, P = 0.159), whereas codon 12 was associated with a lower 5-year recurrence-free survival rate (78.9% vs 75.5%, P = 0.025). In multivariable analysis, along with T and N stages and vascular and perineural invasion, only codon 12 (hazard ratio: 1.399; 95% confidence interval: 1.034-1.894; P = 0.030) amon

FAQs

What was the study aim regarding KRAS mutations in colorectal cancer?

To assess clinicopathological characteristics and the prognostic value of codon-specific KRAS mutations, with particular attention to codon 13.

How were patients selected in the retrospective cohort?

Patients with stage I-III colorectal cancer who underwent surgery between January 2009 and December 2019 were included, provided their KRAS mutation status was confirmed by molecular pathology reports.

Which KRAS codon showed independent prognostic relevance for recurrence?

Codon 12 was identified as an independent risk factor for recurrence in multivariable analysis, while codon 13 was less likely to serve as a prognostic biomarker.

Sep 24, 2026

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