title: KRAS and BRAF mutations are prognostic biomarkers in patients undergoing lung metastasectomy of colorectal cancer.
abstract: BACKGROUND
  We evaluated KRAS (mKRAS (mutant KRAS)) and BRAF (mBRAF (mutant BRAF)) mutations to determine their prognostic potential in assessing patients with colorectal cancer (CRC) for lung metastasectomy.
  
  
  METHODS
  Data were reviewed from 180 patients with a diagnosis of CRC who underwent a lung metastasectomy between January 1998 and December 2011.
  
  
  RESULTS
  Molecular analysis revealed mKRAS in 93 patients (51.7%), mBRAF in 19 patients (10.6%). In univariate analyses, overall survival (OS) was influenced by thoracic nodal status (median OS: 98 months for pN-, 27 months for pN+, P<0.0001), multiple thoracic metastases (75 months vs 101 months, P=0.008) or a history of liver metastases (94 months vs 101 months, P=0.04). mBRAF had a significantly worse OS than mKRAS and wild type (WT) (P<0.0001). The 5-year OS was 0% for mBRAF, 44% for mKRAS and 100% for WT, with corresponding median OS of 15, 55 and 98 months, respectively (P<0.0001). In multivariate analysis, WT BRAF (HR: 0.005 (95% CI: 0.001-0.02), P<0.0001) and WT KRAS (HR: 0.04 (95% CI: 0.02-0.1), P<0.0001) had a significant impact on OS.
  
  
  CONCLUSIONS
  mKRAS and mBRAF seem to be prognostic factors in patients with CRC who undergo lung metastasectomy. Further studies are necessary.
authors: 1] Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France [2] EA 3430: Tumoral progression and micro-environment, Translational and epidemiological approaches, Strasbourg University, Strasbourg 67000, France.
authors: S
authors: S
authors: Renaud
authors: 1] EA 3430: Tumoral progression and micro-environment, Translational and epidemiological approaches, Strasbourg University, Strasbourg 67000, France [2] Department of General and Digestive Surgery, Hôpital de Hautepierre, Strasbourg University Hospital, Strasbourg 67000, France.
authors: B
authors: B
authors: Romain
authors: Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France.
authors: P-E
authors: PE
authors: Falcoz
authors: Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France.
authors: A
authors: A
authors: Olland
authors: Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France.
authors: N
authors: N
authors: Santelmo
authors: Department of General and Digestive Surgery, Hôpital de Hautepierre, Strasbourg University Hospital, Strasbourg 67000, France.
authors: C
authors: C
authors: Brigand
authors: Department of General and Digestive Surgery, Hôpital de Hautepierre, Strasbourg University Hospital, Strasbourg 67000, France.
authors: S
authors: S
authors: Rohr
authors: EA 3430: Tumoral progression and micro-environment, Translational and epidemiological approaches, Strasbourg University, Strasbourg 67000, France.
authors: D
authors: D
authors: Guenot
authors: Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France.
authors: G
authors: G
authors: Massard
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000556:secondary / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D012189:Retrospective Studies; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins