Abstract
BACKGROUND: Colorectal cancer (CRC) ranks as the third most prevalent malignancy globally, with incidence rates rising steadily in Algeria. Prognostic assessment of CRC increasingly relies on molecular profiling, particularly mutations in the KRAS gene a critical determinant of resistance to anti-EGFR therapies in metastatic disease. OBJECTIVES: This study investigates the KRAS mutational spectrum and its association with clinicopathological features in CRC patients from Batna, Eastern Algeria. METHODS: In a retrospective analysis of 91 cases, KRAS mutations were identified in 46.2% of tumors (wild-type: 58.3%) using RT-PCR and sequencing. RESULTS: The most frequent alterations localized to codons 12 and 13 (exons 1-2), with p.G12D (c.35G>A) and p.G13D (c.38G>A) predominating. Strikingly, KRAS mutation status showed no significant correlation with age, sex, tumor size, histology, metastatic pattern, or TNM stage suggesting its role as an independent molecular driver rather than a surrogate for conventional prognostic markers. CONCLUSION: These findings underscore the high prevalence of KRAS mutations in Algerian CRC patients and highlight their potential utility in refining therapeutic strategies, particularly for anti-EGFR eligibility. The study provides the first regional dataset from Eastern Algeria, addressing a critical gap in North African oncogenomics.