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© 2015 Harborside Press® Molecular biomarkers are increasingly being utilized as both prognostic and predictive tools in the care of patients with cancer. Testing for alterations in biomarkers is currently considered the standard of care in a growing number of cancers, including breast, lung, leukemia, and colorectal. Recently updated National Comprehensive Cancer Network (NCCN) guidelines recommend testing for alterations in KRAS, NRAS, and BRAF as part of the initial workup for metastatic colorectal cancer (CRC; NCCN, 2015). The presence of KRAS mutation occurs in 35% to 45% of metastatic CRC (Andreyev et al., 2001; Andreyev, Norman, Cunningham, Oates, & Clarke, 1998; Lievre et al., 2006; Neumann, Zeindl-Eberhart, Kirchner, & Jung, 2009; Richman et al., 2009) and has been shown to be associated with a worse prognosis in both metastatic and high-risk stage II/ stage III CRC (Andreyev et al., 2001; Andreyev et al., 1998). The presence of BRAF mutation occurs in about 10% of patients with metastatic CRC and is associated with a poor prognosis (Tie et al., 2011; Tran et al., 2011). The study by Karagkounis et al. (2013), which is discussed by Wei and Samp on page 460, looked at the incidence and prognostic significance of KRAS (codons 12, 13) and BRAF V600E mutations in patients with metastatic CRC undergoing liver metastasectomy. This study found that KRAS mutation was an independent predictor of overall and recurrencefree survival following liver surgery for colorectal metastases.

Molecular Profiling in Resectable Colorectal Liver Metastases: The Role of KRAS Mutation Status in Assessing Prognosis in the Preoperative Setting