Molecular Medicine

, Volume 21, Issue 1, pp 1038–1046 | Cite as

The Prognostic Value of Microsatellite Instability, KRAS, BRAF and PIK3CA Mutations in Stage II Colon Cancer Patients

  • F. Jeroen Vogelaar
  • Felice N. van Erning
  • Marlies S. Reimers
  • Hans van der Linden
  • Hans Pruijt
  • Adriaan J. C. van den Brule
  • Koop Bosscha
Research Article


In the era of personalized cancer medicine, identifying mutations within patient tumors plays an important role in defining high-risk stage II colon cancer patients. The prognostic role of BRAF V600E mutation, microsatellite instability (MSI) status, KRAS mutation and PIK3CA mutation in stage II colon cancer patients is not settled. We retrospectively analyzed 186 patients with stage II colon cancer who underwent an oncological resection but were not treated with adjuvant chemotherapy. KRAS mutations, PIK3CA mutation, V600E BRAF mutation and MSI status were determined. Survival analyses were performed. Mutations were found in the patients with each mutation in the following percentages: 23% (MSI), 35% (KRAS), 19% (BRAF) and 11% (PIK3CA). A trend toward worse overall survival (OS) was seen in patients with an MSI (5-year OS 74% versus 82%, adjusted hazard ratio [HR] 1.8, 95% confidence interval [CI] 0.6–4.9) and a KRAS-mutated tumor (5-year OS 77% versus 82%, adjusted HR 1.7, 95% CI 0.8–3.5). MSI and BRAF-mutated tumors tended to correlate with poorer disease-free survival (DFS) (5-year DFS 60% versus 78%, adjusted HR 1.6, 95% CI 0.5–2.1 and 5-year DFS 57% versus 77%, adjusted HR 1.1, 95% CI 0.4–2.6 respectively). In stage II colon cancer patients not treated with adjuvant chemotherapy, BRAF mutation and MSI status both tended to have a negative prognostic effect on disease-free survival. KRAS and MSI status also tended to be correlated with worse overall survival.



The authors wish to thank W Voogd and I de Vrije for excellent technical support performing the mutation analyses.


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Authors and Affiliations

  • F. Jeroen Vogelaar
    • 1
    • 2
  • Felice N. van Erning
    • 3
    • 4
  • Marlies S. Reimers
    • 5
  • Hans van der Linden
    • 6
  • Hans Pruijt
    • 7
  • Adriaan J. C. van den Brule
    • 6
  • Koop Bosscha
    • 1
  1. 1.Department of SurgeryJeroen Bosch Hospital’s HertogenboschThe Netherlands
  2. 2.Department of SurgeryVieCuri Medical CenterVenrayThe Netherlands
  3. 3.Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL)EindhovenThe Netherlands
  4. 4.Department of Public HealthErasmus MC University Medical CentreRotterdamThe Netherlands
  5. 5.Department of SurgeryLeiden University Medical CenterLeidenThe Netherlands
  6. 6.Department of PathologyJeroen Bosch HospitalHertogenboschThe Netherlands
  7. 7.Department of Internal MedicineJeroen Bosch HospitalHertogenboschThe Netherlands

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