PT  - JOURNAL ARTICLE
AU  - AMAR DESHWAR
AU  - GEORGIOS ANTONIOS MARGONIS
AU  - NIKOLAOS ANDREATOS
AU  - CARLOTTA BARBON
AU  - JAEYUN WANG
AU  - STEFAN BUETTNER
AU  - DORIS WAGNER
AU  - KAZUNARI SASAKI
AU  - ANDREA BEER
AU  - INGER MARIE LØES
AU  - EMMANOUIL PIKOULIS
AU  - CHRISTOS DAMASKOS
AU  - NIKOLAOS GARMPIS
AU  - KARSTEN KAMPHUES
AU  - JIN HE
AU  - KLAUS KACZIREK
AU  - GEORGE POULTSIDES
AU  - PER EYSTEIN LØNNING
AU  - HANS JOERG MISCHINGER
AU  - FEDERICO N. AUCEJO
AU  - MARTIN E. KREIS
AU  - CHRISTOPHER L. WOLFGANG
AU  - MATTHEW J. WEISS
TI  - Double <em>KRAS</em> and <em>BRAF</em> Mutations in Surgically Treated Colorectal Cancer Liver Metastases: An International, Multi-institutional Case Series
DP  - 2018 May 01
TA  - Anticancer Research
PG  - 2891--2895
VI  - 38
IP  - 5
4099  - http://ar.iiarjournals.org/content/38/5/2891.short
4100  - http://ar.iiarjournals.org/content/38/5/2891.full
SO  - Anticancer Res2018 May 01; 38
AB  - Background: While previously believed to be mutually exclusive, concomitant mutation of Kirsten rat sarcoma viral oncogene homolog (KRAS)- and V-raf murine sarcoma b-viral oncogene homolog B1 (BRAF)-mutated colorectal carcinoma (CRC), has been described in rare instances and been associated with advanced-stage disease. The present case series is the first to report on the implications of concurrent KRAS/BRAF mutations among surgically treated patients, and the largest set of patients with surgically treated colorectal liver metastasis (CRLM) and data on KRAS/BRAF mutational status thus far described. Case Series: We present cases from an international, multi-institutional cohort of patients that underwent hepatic resection for CRLM between 2000-2015 at seven tertiary centers. The incidence of KRAS/BRAF mutation in patients with CRLM was 0.5% (4/820). Of these cases, patient 1 (T2N1 primary, G13D/V600E), patient 2 (T3N1 primary, G12V/V600E) and patient 3 (T4N2 primary, G13D/D594N) succumbed to their disease within 485, 236 and 79 days respectively, post-hepatic resection. Patient 4 (T4 primary, G12S/G469S) was alive 416 days after hepatic resection. Conclusion: The present case series suggests that the incidence of concomitant KRAS/BRAF mutations in surgical cohorts may be higher than previously hypothesized, and associated with more variable survival outcomes than expected.