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Retrospective Cohort Study
Copyright: ©Author(s) 2026.
World J Gastrointest Oncol. Jun 15, 2026; 18(6): 117308
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.117308
Table 1 Association between KRAS mutation status and clinicopathological features, n (%)
Clinicopathological feature
Total (n = 87)
KRAS mutant (n = 39)
KRAS wild-type (n = 48)
χ² value
P value
Tumor location4.640.098
Left colon21 (24.14)7 (17.95)14 (29.17)
Rectum46 (52.87)19 (48.72)27 (56.25)
Right colon20 (22.99)13 (33.33)7 (14.58)
Differentiation grade4.520.034
Well/moderate72 (82.76)36 (92.31)36 (75.00)
Poor15 (17.24)3 (7.69)12 (25.00)
Lymphovascular invasion2.860.091
Absent51 (58.62)19 (48.72)32 (66.67)
Present36 (41.38)20 (51.28)16 (33.33)
Perineural Invasion17.132< 0.001
Absent75 (86.21)27 (69.23)48 (100.00)
Present12 (13.79)12 (30.77)0 (0.00)
Preoperative pathology0.060.811
Adenocarcinoma (non-special)82 (94.25)36 (92.31)46 (95.83)
Mucinous adenocarcinoma5 (5.75)3 (7.69)2 (4.17)
T stage2.600.107
T1 + T25 (5.75)0 (0.00)5 (10.42)
T3 + T482 (94.25)39 (100.00)43 (89.58)
N stage11.31< 0.001
N012 (13.79)0 (0.00)12 (25.00)
N1 + N275 (86.21)39 (100.00)36 (75.00)
M stage7.220.007
M071 (81.61)27 (69.23)44 (91.67)
M116 (18.39)12 (30.77)4 (8.33)
Tumor number17.13< 0.001
Solitary75 (86.21)27 (69.23)48 (100.00)
Multiple (≥ 2)12 (13.79)12 (30.77)0 (0.00)
Maximum tumor diameter21.39< 0.001
< 5 cm32 (36.78)4 (10.26)28 (58.33)
≥ 5 cm55 (63.22)35 (89.74)20 (41.67)
Preoperative tumor markers16.29< 0.001
Normal65 (74.71)21 (53.85)44 (91.67)
Elevated22 (25.29)18 (46.15)4 (8.33)
Microsatellite0.030.872
Microsatellite stable81 (93.10)37 (94.87)44 (91.67)
Microsatellite instability6 (6.90)2 (5.13)4 (8.33)
Table 2 Association between PIK3CA mutation status and clinicopathological features, n (%)
Clinicopathological feature
Total (n = 87)
PIK3CA mutant (n = 12)
PIK3CA wild-type (n = 75)
χ² value
P value
Tumor location-0.134
Left colon21 (24.14)6 (50.00)15 (20.00)
Rectum46 (52.87)4 (33.33)42 (56.00)
Right colon20 (22.99)2 (16.67)18 (24.00)
Differentiation grade1.670.197
Well/moderate72 (82.76)12 (100.00)60 (80.00)
Poor15 (17.24)0 (0.00)15 (20.00)
Lymphovascular invasion0.090.769
Absent51 (58.62)8 (66.67)43 (57.33)
Present36 (41.38)4 (33.33)32 (42.67)
Perineural invasion1.080.298
Absent75 (86.21)12 (100.00)63 (84.00)
Present12 (13.79)0 (0.00)12 (16.00)
Preoperative pathology-0.533
Adenocarcinoma (non-special)82 (94.25)11 (91.67)71 (94.67)
Mucinous adenocarcinoma5 (5.75)1 (8.33)4 (5.33)
T stage-1.000
T1 + T25 (5.75)0 (0.00)5 (6.67)
T3 + T482 (94.25)12 (100.00)70 (93.33)
N stage2.770.096
N075 (86.21)8 (66.67)67 (89.33)
N1 + N212 (13.79)4 (33.33)8 (10.67)
M stage1.880.171
M071 (81.61)12 (100.00)59 (78.67)
M116 (18.39)0 (0.00)16 (21.33)
Tumor number2.770.096
Solitary75 (86.21)8 (66.67)67 (89.33)
Multiple (≥ 2)12 (13.79)4 (33.33)8 (10.67)
Maximum tumor diameter6.370.012
< 5 cm32 (36.78)0 (0.00)32 (42.67)
≥ 5 cm55 (63.22)12 (100.00)43 (57.33)
Preoperative tumor markers0.110.739
Normal65 (74.71)8 (66.67)57 (76.00)
Elevated22 (25.29)4 (33.33)18 (24.00)
Microsatellite-0.590
Microsatellite stable81 (93.10)12 (100.00)69 (92.00)
Microsatellite instability6 (6.90)0 (0.00)6 (8.00)
Table 3 Association between FBXW7 mutation status and clinicopathological features, n (%)
Clinicopathological feature
Total (n = 87)
FBXW7 mutant (n = 24)
FBXW7 wild-type (n = 63)
χ² value
P value
Tumor location14.20< 0.001
Left colon21 (24.14)4 (16.67)17 (26.98)
Rectum46 (52.87)20 (83.33)26 (41.27)
Right colon20 (22.99)0 (0.00)20 (31.75)
Differentiation grade0.011.000
Well/moderate72 (82.76)20 (83.33)52 (82.54)
Poor15 (17.24)4 (16.67)11 (17.46)
Lymphovascular invasion0.880.347
Absent51 (58.62)16 (66.67)35 (55.56)
Present36 (41.38)8 (33.33)28 (44.44)
Perineural invasion0.020.895
Absent75 (86.21)20 (83.33)55 (87.30)
Present12 (13.79)4 (16.67)8 (12.70)
Preoperative pathology0.020.901
Adenocarcinoma (non-special)82 (94.25)22 (91.67)60 (95.24)
Mucinous adenocarcinoma5 (5.75)2 (8.33)3 (4.76)
T stage0.820.365
T1 + T25 (5.75)0 (0.00)5 (7.94)
T3 + T482 (94.25)24 (100.00)58 (92.06)
N stage0.020.895
N012 (13.79)4 (16.67)8 (12.70)
N1 + N275 (86.21)20 (83.33)55 (87.30)
M stage3.650.056
M071 (81.61)16 (66.67)55 (87.30)
M116 (18.39)8 (33.33)8 (12.70)
Tumor number3.820.051
Solitary75 (86.21)24 (100.00)51 (80.95)
Multiple (≥ 2)12 (13.79)0 (0.00)12 (19.05)
Maximum tumor diameter5.770.016
< 5 cm32 (36.78)4 (16.67)28 (44.44)
≥ 5 cm55 (63.22)20 (83.33)35 (55.56)
Preoperative tumor markers2.870.090
Normal65 (74.71)21 (87.50)44 (69.84)
Elevated22 (25.29)3 (12.50)19 (30.16)
Microsatellite1.200.274
Microsatellite stable81 (93.10)24 (100.00)57 (90.48)
Microsatellite instability6 (6.90)0 (0.00)6 (9.52)
Table 4 Association between TP53 mutation status and clinicopathological features, n (%)
Clinicopathological feature
Total (n = 87)
TP53 mutant (n = 56)
TP53 wild-type (n = 31)
χ² value
P value
Tumor location1.860.394
Left colon21 (24.14)11 (19.64)10 (32.26)
Rectum46 (52.87)32 (57.14)14 (45.16)
Right colon20 (22.99)13 (23.21)7 (22.58)
Differentiation grade1.930.165
Well/moderate72 (82.76)44 (78.57)28 (90.32)
Poor15 (17.24)12 (21.43)3 (9.68)
Lymphovascular invasion10.630.001
Absent51 (58.62)40 (71.43)11 (35.48)
Present36 (41.38)16 (28.57)20 (64.52)
Perineural invasion6.010.014
Absent75 (86.21)44 (78.57)31 (100.00)
Present12 (13.79)12 (21.43)0 (0.00)
Preoperative pathology0.070.786
Adenocarcinoma (non-special)82 (94.25)52 (92.86)30 (96.77)
Mucinous adenocarcinoma5 (5.75)4 (7.14)1 (3.23)
T stage1.520.218
T1 + T25 (5.75)5 (8.93)0 (0.00)
T3 + T482 (94.25)51 (91.07)31 (100.00)
N stage0.001.000
N012 (13.79)8 (14.29)4 (12.90)
N1 + N275 (86.21)48 (85.71)27 (87.10)
M stage1.760.184
M071 (81.61)48 (85.71)23 (74.19)
M116 (18.39)8 (14.29)8 (25.81)
Tumor number4.380.036
Solitary75 (86.21)52 (92.86)23 (74.19)
Multiple (≥ 2)12 (13.79)4 (7.14)8 (25.81)
Maximum tumor diameter2.490.114
< 5 cm32 (36.78)24 (42.86)8 (25.81)
≥ 5 cm55 (63.22)32 (57.14)23 (74.19)
Preoperative tumor markers13.60< 0.001
Normal65 (74.71)49 (87.50)16 (51.61)
Elevated22 (25.29)7 (12.50)15 (48.39)
Microsatellite8.820.003
Microsatellite stable81 (93.10)56 (100.00)25 (80.65)
Microsatellite instability6 (6.90)0 (0.00)6 (19.35)
Table 5 Association between genetic mutations, clinicopathological features and prognosis (3-year survival), n (%)
Variable
Total (n = 87)
Death (n = 32)
Survival (n = 55)
χ² value
P value
Gender0.170.681
Female24 (27.59)8 (25.00)16 (29.09)
Male63 (72.41)24 (75.00)39 (70.91)
Age3.150.076
< 60 years20 (22.99)4 (12.50)16 (29.09)
≥ 60 years67 (77.01)28 (87.50)39 (70.91)
KRAS mutation6.390.011
Mutant39 (44.83)20 (62.50)19 (34.55)
Wild-type48 (55.17)12 (37.50)36 (65.45)
PIK3CA mutation0.001.000
Mutant12 (13.79)4 (12.50)8 (14.55)
Wild-type75 (86.21)28 (87.50)47 (85.45)
FBXW7 mutation2.490.115
Mutant24 (27.59)12 (37.50)12 (21.82)
Wild-type63 (72.41)20 (62.50)43(78.18)
TP53 mutation2.490.114
Mutant56 (64.37)24 (75.00)32 (58.18)
Wild-type31 (35.63)8 (25.00)23 (41.82)
Diabetes12.32< 0.001
Absent71 (81.61)20 (62.50)51 (92.73)
Present16 (18.39)12 (37.50)4 (7.27)
Hypertension6.390.011
Absent48 (55.17)12 (37.50)36 (65.45)
Present39 (44.83)20 (62.50)19 (34.55)
Hyperlipidemia1.170.279
Absent71 (81.61)28 (87.50)43 (78.18)
Present16 (18.39)4 (12.50)12 (21.82)
Smoking1.170.280
Absent63 (72.41)21 (65.62)42 (76.36)
Present24 (27.59)11 (34.38)13 (23.64)
Alcohol use2.460.116
Absent62 (71.26)26 (81.25)36 (65.45)
Present25 (28.74)6 (18.75)19 (34.55)
Tumor location0.940.625
Left colon21 (24.14)8 (25.00)13 (23.64)
Rectum46 (52.87)15 (46.88)31 (56.36)
Right colon20 (22.99)9 (28.12)11 (20.00)
Differentiation grade0.800.372
Well/moderate72 (82.76)28 (87.50)44 (80.00)
Poor15 (17.24)4 (12.50)11 (20.00)
Lymphovascular invasion5.600.018
Absent51 (58.62)24 (75.00)27 (49.09)
Present36 (41.38)8 (25.00)28 (50.91)
Perineural invasion0.001.000
Absent75 (86.21)28 (87.50)47 (85.45)
Present12 (13.79)4 (12.50)8 (14.55)
Preoperative pathology0.001.000
Adenocarcinoma (non-special)82 (94.25)30 (93.75)52 (94.55)
Mucinous adenocarcinoma5 (5.75)2 (6.25)3 (5.45)
T stage1.640.201
T1 + T25 (5.75)0 (0.00)5 (9.09)
T3 + T482 (94.25)32 (100.00)50 (90.91)
N stage6.370.012
N012 (13.79)0 (0.00)12 (21.82)
N1 + N275 (86.21)32 (100.00)43 (78.18)
M stage1.470.225
M071 (81.61)24 (75.00)47 (85.45)
M116 (18.39)8 (25.00)8 (14.55)
Surgical approach5.930.015
Laparoscopic60 (68.97)17 (53.12)43 (78.18)
Open27 (31.03)15 (46.88)12 (21.82)
Tumor number3.960.047
Solitary75 (86.21)24 (75.00)51 (92.73)
Multiple (≥ 2)12 (13.79)8 (25.00)4 (7.27)
Maximum tumor diameter3.020.082
< 5 cm32 (36.78)8 (25.00)24 (43.64)
≥ 5 cm55 (63.22)24 (75.00)31 (56.36)
Preoperative tumor markers4.000.046
Absent65 (74.71)20 (62.50)45 (81.82)
Present22 (25.29)12 (37.50)10 (18.18)
Microsatellite0.380.535
Microsatellite stable81 (93.10)31 (96.88)50 (90.91)
Microsatellite instability6 (6.90)1 (3.12)5 (9.09)
Table 6 Association between genetic mutations, clinicopathological features and prognosis (5-year survival), n (%)
Variable
Total (n = 87)
Death (n = 51)
Survival (n = 36)
χ² value
P value
Gender8.740.003
Female24 (27.59)8 (15.69)16 (44.44)
Male63 (72.41)43 (84.31)20 (55.56)
Age1.990.159
< 60 years20 (22.99)9 (17.65)11 (30.56)
≥ 60 years67 (77.01)42 (82.35)25 (69.44)
KRAS mutation12.69< 0.001
Mutant39 (44.83)31 (60.78)8 (22.22)
Wild-type48 (55.17)20 (39.22)28 (77.78)
PIK3CA mutation2.560.110
Mutant12 (13.79)4 (7.84)8 (22.22)
Wild-type75 (86.21)47 (92.16)28 (77.78)
FBXW7 mutation1.020.314
Mutant24 (27.59)12 (23.53)12 (33.33)
Wild-type63 (72.41)39 (76.47)24 (66.67)
TP53 mutation0.140.707
Mutant56 (64.37)32 (62.75)24 (66.67)
Wild-type31 (35.63)19 (37.25)12 (33.33)
Diabetes2.170.141
Absent71 (81.61)39 (76.47)32 (88.89)
Present16 (18.39)12 (23.53)4 (11.11)
Hypertension3.280.070
Absent48 (55.17)24 (47.06)24 (66.67)
Present39 (44.83)27 (52.94)12 (33.33)
Hyperlipidemia0.600.438
Absent71 (81.61)43 (84.31)28 (77.78)
Present16 (18.39)8 (15.69)8 (22.22)
Smoking2.040.153
Absent63 (72.41)34 (66.67)29 (80.56)
Present24 (27.59)17 (33.33)7 (19.44)
Alcohol use12.48< 0.001
Absent62 (71.26)29 (56.86)33 (91.67)
Present25 (28.74)22 (43.14)3 (8.33)
Tumor location6.070.048
Left colon21 (24.14)13 (25.49)8 (22.22)
Rectum46 (52.87)22 (43.14)24 (66.67)
Right colon20 (22.99)16 (31.37)4 (11.11)
Differentiation grade12.79< 0.001
Well/moderate72 (82.76)36 (70.59)36 (100.00)
Poor15 (17.24)15 (29.41)0 (0.00)
Lymphovascular invasion5.090.024
Absent51 (58.62)35 (68.63)16 (44.44)
Present36 (41.38)16 (31.37)20 (55.56)
Perineural invasion0.090.769
Absent75 (86.21)43 (84.31)32 (88.89)
Present12 (13.79)8 (15.69)4 (11.11)
Preoperative pathology0.280.595
Adenocarcinoma (non-special)82 (94.25)47 (92.16)35 (97.22)
Mucinous adenocarcinoma5 (5.75)4 (7.84)1 (2.78)
T stage5.170.023
T1 + T25 (5.75)0 (0.00)5 (13.89)
T3 + T482 (94.25)51 (100.00)31 (86.11)
N stage17.02< 0.001
N012 (13.79)0 (0.00)12 (33.33)
N1 + N275 (86.21)51 (100.00)24 (66.67)
M stage2.170.141
M071 (81.61)39 (76.47)32 (88.89)
M116 (18.39)12 (23.53)4 (11.11)
Surgical approach2.230.136
Laparoscopic60 (68.97)32 (62.75)28 (77.78)
Open27 (31.03)19 (37.25)8 (22.22)
Tumor number7.950.005
Solitary75 (86.21)39 (76.47)36 (100.00)
Multiple (≥ 2)12 (13.79)12 (23.53)0 (0.00)
Maximum tumor diameter9.310.002
< 5 cm32 (36.78)12 (23.53)20 (55.56)
≥ 5 cm55 (63.22)39 (76.47)16 (44.44)
Preoperative tumor markers9.340.002
Absent65 (74.71)32 (62.75)33 (91.67)
Present22 (25.29)19 (37.25)3 (8.33)
Microsatellite0.760.382
Microsatellite stable81 (93.10)49 (96.08)32 (88.89)
Microsatellite instability6 (6.90)2 (3.92)4 (11.11)
Table 7 Cox regression analysis of KRAS, PIK3CA, FBXW7, and TP53 gene mutation status along with other high-risk factors
VariableBSEWalddfSignificanceExp(B)95%CI for Exp(B)
Lower bound
Upper bound
Gender-1.2190.4766.54210.0110.2960.1160.752
Age-0.4320.431.00710.3160.6490.2791.509
KRAS mutant1.2720.33614.3131< 0.0013.5671.8466.893
PIK3CA mutant-1.3450.5326.39110.0110.260.0920.739
FBXW7 mutant0.6190.3972.42310.121.8570.8524.046
TP53 mutant0.5160.3372.34410.1261.6760.8653.246


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