Mong-Wei Lin1, Chen-Tu Wu, Jin-Yuan Shih, Yih-Leong Chang, Pan-Chyr Yang. 1. Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan; Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Abstract
BACKGROUND AND OBJECTIVES: Small lung adenocarcinomas are detected more frequently than in the past. However, the clinicopathologic characteristics and prognostic significance of EGFR/p53 mutations in these tumors remains unclear. METHODS: We evaluated the correlation of EGFR/p53 mutations with clinicopathologic characteristics and tumor relapse in 172 surgically resected lung adenocarcinomas ≤2 cm in maximal dimension. EGFR/p53 mutational analysis was performed on DNA extracted from paraffin-embedded tumors. RESULTS: EGFR and p53 mutations were identified in 104 (60.5%) and 36 (20.9%) small adenocarcinomas, respectively. EGFR/p53 mutations were associated with tumor size >1 cm, whereas p53 mutations were frequently observed in moderately differentiated tumors. Disease-free survival analysis showed that p53 mutation, presence of visceral pleural surface invasion, elevated preoperative serum carcinoembryonic antigen, and moderate histologic differentiation were significantly correlated with tumor relapse in patients with stage I disease. The 5-year survival rate was higher in relapsed patients with EGFR-mutated tumors who were treated with tyrosine kinase inhibitor (TKI) than in those who were not treated with TKI. CONCLUSIONS: p53 mutation was significantly correlated with tumor progression, and our findings may provide a rationale for the selective use of adjuvant chemotherapy in stage IB patients with p53 mutations. EGFR mutation was a predictor of EGFR TKI response in relapsed patients.
BACKGROUND AND OBJECTIVES: Small lung adenocarcinomas are detected more frequently than in the past. However, the clinicopathologic characteristics and prognostic significance of EGFR/p53 mutations in these tumors remains unclear. METHODS: We evaluated the correlation of EGFR/p53 mutations with clinicopathologic characteristics and tumor relapse in 172 surgically resected lung adenocarcinomas ≤2 cm in maximal dimension. EGFR/p53 mutational analysis was performed on DNA extracted from paraffin-embedded tumors. RESULTS:EGFR and p53 mutations were identified in 104 (60.5%) and 36 (20.9%) small adenocarcinomas, respectively. EGFR/p53 mutations were associated with tumor size >1 cm, whereas p53 mutations were frequently observed in moderately differentiated tumors. Disease-free survival analysis showed that p53 mutation, presence of visceral pleural surface invasion, elevated preoperative serum carcinoembryonic antigen, and moderate histologic differentiation were significantly correlated with tumor relapse in patients with stage I disease. The 5-year survival rate was higher in relapsed patients with EGFR-mutated tumors who were treated with tyrosine kinase inhibitor (TKI) than in those who were not treated with TKI. CONCLUSIONS:p53 mutation was significantly correlated with tumor progression, and our findings may provide a rationale for the selective use of adjuvant chemotherapy in stage IB patients with p53 mutations. EGFR mutation was a predictor of EGFR TKI response in relapsed patients.
Authors: Richard J Cassidy; Xinyan Zhang; Jeffrey M Switchenko; Pretesh R Patel; Joseph W Shelton; Sibo Tian; Ronica H Nanda; Conor E Steuer; Rathi N Pillai; Taofeek K Owonikoko; Suresh S Ramalingam; Felix G Fernandez; Seth D Force; Theresa W Gillespie; Walter J Curran; Kristin A Higgins Journal: Cancer Date: 2018-01-08 Impact factor: 6.860