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Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma
BACKGROUND: Lymph node involvement is one of the important prognostic factors for early-stage lung cancer. However, in lymph node-negative (N0) lung cancer the recurrent rate may be as high as 30%. We aimed to study potential prognostic factors including clinicopathological factors and epidermal gro...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372192/ https://www.ncbi.nlm.nih.gov/pubmed/35966323 http://dx.doi.org/10.21037/tcr-21-2633 |
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author | Pakvisal, Nussara Chantranuwat, Poonchavist Vinayanuwattikun, Chanida Sitthideatphaiboon, Piyada Teerapakpinyo, Chinachote Shuangshoti, Shanop Benjacholamas, Vichai Pornpattanarak, Nopporn Sriuranpong, Virote |
author_facet | Pakvisal, Nussara Chantranuwat, Poonchavist Vinayanuwattikun, Chanida Sitthideatphaiboon, Piyada Teerapakpinyo, Chinachote Shuangshoti, Shanop Benjacholamas, Vichai Pornpattanarak, Nopporn Sriuranpong, Virote |
author_sort | Pakvisal, Nussara |
collection | PubMed |
description | BACKGROUND: Lymph node involvement is one of the important prognostic factors for early-stage lung cancer. However, in lymph node-negative (N0) lung cancer the recurrent rate may be as high as 30%. We aimed to study potential prognostic factors including clinicopathological factors and epidermal growth factor receptor (EGFR) mutation status in this lung cancer population. METHODS: We retrospectively reviewed the medical records and pathological examinations of patients with completely resected N0 pulmonary adenocarcinoma treated in our institute between 2009 and 2016. We used Cobas(®) test to determine EGFR mutation status. Recurrence-free survival (RFS) was analyzed by univariable and multivariable Cox regression analyses. RESULTS: We recruited 220 patients with median duration of follow up 5 years. Majority of these patients were in stage I (80%) and did not receive adjuvant therapy (86%). There were 53% with EGFR mutations which comprised of exon 19 deletion 51% and L858R 43%. Recurrence occurred in 64 out of 220 patients (29%). The median time to recurrence was 2.1 years. Statistically significant prognostic factors in both univariate and multivariate analyses included tumor size ≥4 centimeter (cm) (HR: 1.94; 95% CI: 1.03–3.67), visceral pleural invasion (HR: 2.53; 95% CI: 1.34–4.79), tumor necrosis (HR: 2.45; 95% CI: 1.13–5.31) and bronchial resection margin <2 cm (HR: 1.96; 95% CI: 1.10–3.51). However, presence of sensitizing EGFR mutation was not found to be a significant prognostic factor (HR: 1.20; 95% CI: 0.66–2.18; P=0.56). CONCLUSIONS: In N0 surgically resected lung adenocarcinoma, there were significant pathological prognostic factors including tumor 4 cm or more, visceral pleural invasion, tumor necrosis and bronchial resection margin less than 2 cm. Mutation of EGFR is not a significant prognostic factor to determine the risk of recurrence in this population and their risks shall be determined by the other poor prognostic factors. |
format | Online Article Text |
id | pubmed-9372192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-93721922022-08-13 Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma Pakvisal, Nussara Chantranuwat, Poonchavist Vinayanuwattikun, Chanida Sitthideatphaiboon, Piyada Teerapakpinyo, Chinachote Shuangshoti, Shanop Benjacholamas, Vichai Pornpattanarak, Nopporn Sriuranpong, Virote Transl Cancer Res Original Article BACKGROUND: Lymph node involvement is one of the important prognostic factors for early-stage lung cancer. However, in lymph node-negative (N0) lung cancer the recurrent rate may be as high as 30%. We aimed to study potential prognostic factors including clinicopathological factors and epidermal growth factor receptor (EGFR) mutation status in this lung cancer population. METHODS: We retrospectively reviewed the medical records and pathological examinations of patients with completely resected N0 pulmonary adenocarcinoma treated in our institute between 2009 and 2016. We used Cobas(®) test to determine EGFR mutation status. Recurrence-free survival (RFS) was analyzed by univariable and multivariable Cox regression analyses. RESULTS: We recruited 220 patients with median duration of follow up 5 years. Majority of these patients were in stage I (80%) and did not receive adjuvant therapy (86%). There were 53% with EGFR mutations which comprised of exon 19 deletion 51% and L858R 43%. Recurrence occurred in 64 out of 220 patients (29%). The median time to recurrence was 2.1 years. Statistically significant prognostic factors in both univariate and multivariate analyses included tumor size ≥4 centimeter (cm) (HR: 1.94; 95% CI: 1.03–3.67), visceral pleural invasion (HR: 2.53; 95% CI: 1.34–4.79), tumor necrosis (HR: 2.45; 95% CI: 1.13–5.31) and bronchial resection margin <2 cm (HR: 1.96; 95% CI: 1.10–3.51). However, presence of sensitizing EGFR mutation was not found to be a significant prognostic factor (HR: 1.20; 95% CI: 0.66–2.18; P=0.56). CONCLUSIONS: In N0 surgically resected lung adenocarcinoma, there were significant pathological prognostic factors including tumor 4 cm or more, visceral pleural invasion, tumor necrosis and bronchial resection margin less than 2 cm. Mutation of EGFR is not a significant prognostic factor to determine the risk of recurrence in this population and their risks shall be determined by the other poor prognostic factors. AME Publishing Company 2022-07 /pmc/articles/PMC9372192/ /pubmed/35966323 http://dx.doi.org/10.21037/tcr-21-2633 Text en 2022 Translational Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Pakvisal, Nussara Chantranuwat, Poonchavist Vinayanuwattikun, Chanida Sitthideatphaiboon, Piyada Teerapakpinyo, Chinachote Shuangshoti, Shanop Benjacholamas, Vichai Pornpattanarak, Nopporn Sriuranpong, Virote Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title | Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title_full | Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title_fullStr | Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title_full_unstemmed | Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title_short | Prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
title_sort | prognostic factors in completely resected lymph-node-negative pulmonary adenocarcinoma |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372192/ https://www.ncbi.nlm.nih.gov/pubmed/35966323 http://dx.doi.org/10.21037/tcr-21-2633 |
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