388 Background: Mutations in the KRAS oncogene are present in approximately 30-40% of colorectal adenocarcinomas. Wild-type (WT) KRAS mutational status is recognized to be predictive of tumor response with epidermal growth factor receptor-directed therapies such as cetuximab and panitumumab. Studies evaluating the prognostic value of KRAS status in localized (stage II and III) disease have been contradictory. The prognostic value in metastatic disease, either synchronous or metachronous, is less studied. Methods: Consecutive patients with metastatic colorectal adenocarcinoma underwent tumor testing for KRAS exon 2 (codons 12 and 13) mutations by polymerase chain reaction amplification and direct nucleotide sequencing. The clinical characteristics, treatments, and outcomes of these patients were then retrospectively analyzed, stratified by synchronous or metastatic disease and KRAS mutational status (WT or mutated). Results: For synchronous metastatic disease, KRAS WT patients (n = 39) had median overall survival (OS) of 34.3 months (95% CI, 21.8-58.3). KRAS mutated patients (n = 24) had median OS of 40.3 months (95% CI, 25.7-51.0; log-rank p = 0.55). By Kaplan-Meier survival analysis, 3-year OS was 48.9% (95% CI, 31.1-64.5) for KRAS WT and 51.1% (95% CI, 27.6-70.6) for KRAS mutated patients. Five-year OS was 27.8% (95% CI, 11.6-46.8) for KRAS WT and 9.7% (95% CI, 0.7-33.8) for KRAS mutated patients. For metachronous metastatic disease, from time of development of metastasis, KRAS WT patients (n = 29) had median OS of 33.2 months (95% CI, 28.3-40.7). KRAS mutated patients (n = 16) had median OS of 53.0 months (95% CI, 27.8-not applicable; log-rank p = 0.29). By Kaplan-Meier survival analysis, 3-year OS was 40.1% (95% CI, 19.9-59.7) for KRAS WT and 57.3% (95% CI, 25.0-80.0) for KRAS mutated patients. Five-year OS was 22.9% (95% CI, 7.6-43.2) for KRAS WT and 28.6% (95% CI, 1.7-68.1) for KRAS mutated patients. Conclusions: KRAS mutation status does not influence overall survival in either synchronous or metachronous metastatic colorectal adenocarcinoma. No significant financial relationships to disclose.