Analysis of Clinicopathologic Factors and KRAS Gene Mutation in Epithelial Ovarian Cancer Outcomes

BACKGROUND: Raise of ovarian cancer mortality is caused by high ovarian cancer recurrence. This is related to many prognostic factors. Kirsten-rat sarcoma virus oncogene (KRAS) is a proto-oncogene that regulates proliferation, growth and cell motility. The controversy of some experts regarding KRAS mutations in the prognosis of ovarian cancer makes it interesting to analyze. AIM: The aim of this study is to clarify whether the clinicopathologic factors and KRAS gene mutation affect the recurrence of patients with ovarian cancer in Indonesia. METHODS: The authors conducted a retrospective cohort study. Clinicopathological factors and prognoses were obtained for 205 patients who were histopathologically diagnosed with epithelial ovarian cancer or ovarian borderline malignant tumor, operated from June 2015 to January 2019 at Dr. M. Djamil General Hospital. We gathered 80 patients who were diagnosed with epithelial ovarian cancer since June 2015 until January 2019. These cases were analyzed after 2-year follow-up or recurrence occurred. Survival rate was determined using the Kaplan–Meier method and examined by Log rank test. All analyses were performed using STATA ver. 12.0, with p < 0.05 considered to be significant. RESULTS: Among KRAS mutation group, the 2-year disease free survival rate (2y-DFS) was 31.56% and 47.58% in non-mutation group with significant differences between mutation and non-mutation (p = 0.02). There was a significant difference between early stage ovarian cancer with non-mutation group and advanced stages ovarian cancer with mutation group (p = 0.00). Among combination staging with mutation group, the 2y-DFS was 85.79% in early stage ovarian cancer with non-mutation, 44.44% in early stage with mutation, 10.65% in advanced stage with non-mutation, and 20.00% in advanced stage with mutation. CONCLUSION: The results suggest that staging and KRAS mutation are the most influence prognostic factors for epithelial ovarian cancer. There was a discrepancy of prognosis by staging and mutation between early stage with non-mutation and advanced stage with KRAS mutation.