Association of Kirsten Rat Sarcoma Viral Oncogene Homolog Mutation with the Prognosis of Colorectal Cancer in Arab Countries and Saudi Arabia: A systematic review and meta-analysis

Objectives: To quantify the potential impact of Kirsten rat sarcoma (KRAS) mutation on survival outcomes in colorectal cancer (CRC) patients from Arab countries, particularly in Saudi Arabia. As a chief cause of cancer-associated mortality worldwide, CRC shows a rising incidence across Arab countries. Among molecular drivers, KRAS mutation plays a pivotal role in tumor initiation, resistance to therapies, and disease progression. Nonetheless, the prognostic influence of KRAS mutation in Arab populations remains inconclusive.Methods: Key databases were searched to find appropriate publications. Eligible studies evaluated KRAS mutation’s association with overall survival (OS) in CRC patients from Arab nations. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were pooled.Results: Six studies involving 1,366 patients from Saudi Arabia (n = 4), Jordan (n = 1), and Morocco (n = 1) were included. The pooled analysis suggested a non-significant trend toward increased mortality risk among KRAS mutant patients (HR = 1.38, 95% CI: 0.82–2.31, p = 0.22). Subgroup analysis of Saudi patients yielded a similar trend (HR = 1.36, 95% CI: 0.73–2.56, p = 0.34). Heterogeneity was substantial (I² = 80.2% overall; I² = 81.4% in the Saudi subgroup).Conclusion: The KRAS mutation showed a non-significant trend toward poorer prognosis in CRC among Arab populations; however, the evidence remains inconclusive due to heterogeneity and limited study numbers. These findings highlight the need for standardized molecular testing and larger multicenter regional studies to better define the prognostic significance of KRAS mutation in the Arab CRC population.