Meta-analysis of the prognostic value of KRAS and TP53 mutations in cholangiocarcinoma

Introduction: KRAS and TP53 mutations are among the most common genetic mutations in cholangiocarcinoma. Objective: This study aimed to explore the potential impact of these mutations on the survival prognosis of cholangiocarcinoma patients through a meta-analysis. Methods: A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CNKI, and Wanfang databases for cohort studies published up to April 2025 that investigated the relationship between KRAS and TP53 mutations and patient prognosis. Two researchers independently performed the literature screening and data extraction. Meta-analysis was conducted using RevMan 5.4 and Stata 17.0, with assessment of publication bias. Results: Twelve studies were included, involving a total of 1,126 patients, with 167 cases of KRAS mutations and 176 cases of TP53 mutations. The results showed that both KRAS and TP53 mutations were significantly associated with poorer survival prognosis in cholangiocarcinoma patients. For KRAS (hazard ratio (HR)=7.26; 95% confidence interval (CI): 6.10 – 9.81; p<0.05) and TP53 (HR=18.13; 95% CI: 11.24 – 25.32; p<0.05), the presence of mutations predicted an adverse prognosis. Conclusion: While these findings suggest that KRAS and TP53 mutations are associated with worse survival in cholangiocarcinoma, the limited number and quality of the included studies warrant further high-quality research to validate these associations.