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Non-BAC component but not epidermal growth factor receptor gene mutation is associated with poor outcomes in small adenocarcinoma of the lung.

AbstractOBJECTIVE:
The purpose of this study was to identify risk factors for poor clinical outcome after surgical resection of small lung adenocarcinoma.
MATERIALS AND METHODS:
Clinical records of 127 patients who had pathologic stage IA lung adenocarcinoma 20 mm or less and who had undergone a lobectomy with mediastinal lymph node dissection were reviewed. The percentage of non-bronchioloalveolar carcinoma (non-BAC) components quantified objectively, and epidermal growth factor receptor gene (EGFR) mutation determined by polymerase chain reaction-based assay were retrospectively linked with clinical data.
RESULTS:
Based on the percentage of non-BAC component, 127 patients were classified as follows: 26 in group I, BAC, 46 in group II mixed subtype with >or= 50% BAC, 18 in group III, mixed subtype with under 50% BAC, and 37 in group IV, mixed subtype with all non-BAC components or a pure pattern of one of the non-BAC components. Groups I and II were considered to be a "low non-BAC component type" and groups III and IV were considered to be a "high non-BAC component type." EGFR mutations in exon19 and exon21 were observed in 64 patients (50.4%). In terms of recurrence, the high non-BAC component type was the only independent factor for recurrence (p = 0.029). Regarding survival, the high age (p = 0.028) and high non-BAC component type (p = 0.046) were independent risk factors for poor overall survival. They were also independent risk factors for poor disease-free survival (p = 0.025 and p = 0.027, respectively).
CONCLUSION:
The high non-BAC component but not EGFR mutation status, is an independent risk factor for both recurrence and poor prognosis in patients with stage IA lung adenocarcinoma <or=20 mm.
AuthorsNaruyuki Kobayashi, Shinichi Toyooka, Kouichi Ichimura, Junichi Soh, Hiromasa Yamamoto, Keitaro Matsuo, Hiroki Otani, Masaru Jida, Takafumi Kubo, Kazunori Tsukuda, Katsuyuki Kiura, Yoshifumi Sano, Hiroshi Date
JournalJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (J Thorac Oncol) Vol. 3 Issue 7 Pg. 704-10 (Jul 2008) ISSN: 1556-1380 [Electronic] United States
PMID18594314 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adenocarcinoma (genetics, mortality, pathology, secondary)
  • Adenocarcinoma, Bronchiolo-Alveolar (pathology)
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung (genetics, mortality, pathology, secondary)
  • Female
  • Genes, erbB-1 (genetics)
  • Humans
  • Lung Neoplasms (genetics, pathology)
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Recurrence, Local
  • Prognosis
  • Risk Factors

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