Wenfang Tang1,2, Yuanyuan Lei3, Jian Su1, Chao Zhang1, Rui Fu1,2, Jin Kang1, Honghong Yan1, Xuening Yang1, Haiyan Tu1, Yilong Wu1, Wenzhao Zhong1. 1. Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China. 2. Shantou University Medical College, Shantou 515041, China. 3. Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, New Territories, Hong Kong, China.
Abstract
BACKGROUND: To clearly reveal the correlations between age at diagnosis, tumor-nodes-metastasis (TNM) stages and frequency of ALK-positive lung cancer. METHODS: We reviewed patients who presented with ALK rearrangements (n=411) or KRAS-mutations (n=122) between September 2010 and January 2018. The clinical characteristics and overall survival were analyzed for the two genotype cohorts and stratified by different age categories (<40, 40-49, 50-59, ≥60 years). RESULTS: In the ALK-positive cohort, the younger group showed more frequent disease in the T3/4 stage (P=0.014), lymph node metastasis (P=0.011) and distant metastasis (P=0.015) than the older groups. Meanwhile, the mean age at diagnosis for the ALK-positive patients showed a significant inverse correlation with the clinical stages (stage I/II vs. III vs. IV, 54.7 vs. 52.0 vs. 49.7 years; P<0.001), as well as with the T, N, and M categories. However, KRAS-mutant patients did not exhibit similar relationships to those observed in ALK-positive patients. Importantly, for ALK-positive patients, the frequency of stage IIIb-IV disease was almost twice that of stage I-IIIa disease (6.1% vs. 3.4%, P<0.001); there was a similar incidence of the different disease stages in KRAS-mutant lung cancer (P=0.924). Lastly, in ALK-positive patients, the ≥60 years group was associated with a trend toward better survival than the other younger groups. CONCLUSIONS: The TNM stages exhibited a significant inverse correlation with age at diagnosis for ALK-positive lung cancer patients. More unique therapeutic strategies should be required in these young patients.
BACKGROUND: To clearly reveal the correlations between age at diagnosis, tumor-nodes-metastasis (TNM) stages and frequency of ALK-positive lung cancer. METHODS: We reviewed patients who presented with ALK rearrangements (n=411) or KRAS-mutations (n=122) between September 2010 and January 2018. The clinical characteristics and overall survival were analyzed for the two genotype cohorts and stratified by different age categories (<40, 40-49, 50-59, ≥60 years). RESULTS: In the ALK-positive cohort, the younger group showed more frequent disease in the T3/4 stage (P=0.014), lymph node metastasis (P=0.011) and distant metastasis (P=0.015) than the older groups. Meanwhile, the mean age at diagnosis for the ALK-positive patients showed a significant inverse correlation with the clinical stages (stage I/II vs. III vs. IV, 54.7 vs. 52.0 vs. 49.7 years; P<0.001), as well as with the T, N, and M categories. However, KRAS-mutant patients did not exhibit similar relationships to those observed in ALK-positive patients. Importantly, for ALK-positive patients, the frequency of stage IIIb-IV disease was almost twice that of stage I-IIIa disease (6.1% vs. 3.4%, P<0.001); there was a similar incidence of the different disease stages in KRAS-mutant lung cancer (P=0.924). Lastly, in ALK-positive patients, the ≥60 years group was associated with a trend toward better survival than the other younger groups. CONCLUSIONS: The TNM stages exhibited a significant inverse correlation with age at diagnosis for ALK-positive lung cancer patients. More unique therapeutic strategies should be required in these young patients.
Entities:
Keywords:
ALK-positive lung cancer; TNM stages; age at diagnosis; inverse correlation
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