scholarly journals Clinical Features and Surgical Treatment of Synchronous Multiple Primary Lung Adenocarcinomas With Different EGFR Mutations

2022 ◽  
Vol 11 ◽  
Author(s):  
Rirong Qu ◽  
Fan Ye ◽  
Dehao Tu ◽  
Yixin Cai ◽  
Xiangning Fu
Keyword(s):  
Clinical Features ◽  
Mutation Rate ◽  
Surgical Outcomes ◽  
Clinical Characteristics ◽  
Egfr Mutations ◽  
Driver Gene ◽  
Invasive Adenocarcinoma ◽  
Significant Difference ◽  
Multiple Primary ◽  
Lung Adenocarcinomas

BackgroundWith the popularity of lung cancer screening and advances in imaging technology, more and more synchronous multiple primary lung adenocarcinomas (SMPLA) are being diagnosed clinically, however, the clinical characteristics and prognosis of SMPLA with different EGFR mutations remains unclear. We aimed to explore clinical features and surgical outcomes of these patients to aid in the diagnosis and treatment of SMPLA.MethodsMedical records of patients with different EGFR mutations who have been diagnosed as SMPLA and underwent surgical resection from March 2015 to December 2019 were retrospectively analyzed. Clinical characteristics, surgical outcomes, recurrence-free survival (RFS) and overall survival (OS) were investigated.ResultsA total of 70 patients (68.6% female and 77.1% non-somkers) were included. Total of 161 lesions in all patients, 84.4% were ground-glass opacity (GGO) lesions. EGFR mutations were detected in 108 lesions, most of which were L858R (35.4%) and 19Del (20.5%). The mutation rate of mixed GGO is significantly higher than that of pure GGO and solid nodules (SN); the mutation rate of invasive adenocarcinoma is significantly higher than that of other histology subtypes; the mutation rate of lesions >20 mm was significantly higher than that of ≤20 mm. However, there is no significant difference in the mutation rate of specific driver gene between different radiological features, pathological characteristics and sizes. After a median follow-up time of 29 months, the 3-year OS and RFS were 94.4% and 86.0%, respectively.ConclusionsA high discordance of EGFR mutations were identified between tumors in patients with SMPLA. Synchronous multiple lung adenocarcinomas with predominantly multiple GGO should be considered as SMPLA, and surgery may be aggressively performed for these patients due to a good prognosis.

scholarly journals Clinical Features and Surgical Treatment of Synchronous Multiple Primary Lung Adenocarcinomas With Different EGFR Mutations

2021 ◽  
Author(s):  
Rirong Qu ◽  
Fan Ye ◽  
Shaojie Hu ◽  
Wei Ping ◽  
Yixin Cai ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mutation Rate ◽  
Surgical Outcomes ◽  
Ground Glass Opacity ◽  
Egfr Mutations ◽  
Driver Gene ◽  
Invasive Adenocarcinoma ◽  
Significant Difference ◽  
Multiple Primary ◽  
Lung Adenocarcinomas

Abstract Purpose: We aimed to explore clinical features and surgical outcomes of synchronous multiple primary lung adenocarcinomas (SMPLA) with different EGFR mutations to aid in the diagnosis and treatment of SMPLA.Methods: Medical records of patients with different EGFR mutations who have been diagnosed as SMPLA and underwent surgical resection from March 2015 to December 2019 were retrospectively analyzed. Clinical characteristics, surgical outcomes, recurrence-free survival (RFS) and overall survival (OS) were investigated.Results: A total of 70 patients ( 68.6% female and 77.1% non-somkers) were included. Total of 161 lesions in all patients, 84.4% were ground-glass opacity (GGO) lesions. EGFR mutations were detected in 108 lesions, most of which were L858R (35.4%) and 19Del (20.5%). The mutation rate of mixed GGO is significantly higher than that of pure GGO and solid nodules (SN); the mutation rate of invasive adenocarcinoma is significantly higher than that of other histology subtypes; the mutation rate of lesions >20 mm was significantly higher than that of ≤20 mm. However, there is no significant difference in the mutation rate of specific driver gene between different radiological features, pathological characteristics and sizes. After a median follow-up time of 29 months, the 3-year OS and RFS were 94.4% and 86.0%, respectively.Conclusions: A high discordance of EGFR mutations were identified between tumors in patients with SMPLA. Synchronous multiple lung adenocarcinomas with predominantly multiple GGO should be considered as SMPLA, and surgery may be aggressively performed for these patients due to a good prognosis.

scholarly journals Surgical outcomes of one-stage resection for synchronous multiple primary lung adenocarcinomas with no less than three lesions

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rirong Qu ◽  
Dehao Tu ◽  
Wei Ping ◽  
Yixin Cai ◽  
Ni Zhang ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Mutation Rate ◽  
Surgical Outcomes ◽  
Surgical Procedure ◽  
Clinical Characteristics ◽  
Sublobar Resection ◽  
Invasive Adenocarcinoma ◽  
One Stage ◽  
Multiple Primary ◽  
Lung Adenocarcinomas

Abstract Background More and more synchronous multiple primary lung adenocarcinomas (SMPLA) have been diagnosed and surgical treatment has become the mainstay of treatment for them, but there are few reports on the surgical outcome of patients with ≥ 3 lesions who underwent surgical resection. Therefore, we summarized and analyzed the clinical characteristics and surgical outcomes of these patients, hoping to provide some experience in the diagnosis and treatment. Methods Clinical characteristics and treatment outcomes of patients with ≥ 3 lesions who have been diagnosed as SMPLA and underwent surgical resection in our hospital from March 2015 to July 2019 were retrospectively reviewed. Results Twenty-eight patients, 20 females and 8 males, with a mean age of 57.7 ± 5.69 (45–76) years, were finally included. A total of 95 lesions, 86.4% were ground-glass opacity (GGO) lesions (pure-GGO,45.3%; mixed-GGO,41.1%); 51 lesions had EGFR mutations and the mutation rate of invasive adenocarcinoma was significantly higher than that of other pathological subtypes (P < 0.001); the mutation rate of mGGO was also significantly higher than that of pGGO and solid nodule (SN) (P < 0.05). Four and 24 patients respectively underwent bilateral and unilateral surgical resection. The surgical procedure was mainly sublobar resection, and no severe postoperative complications or deaths occurred. After a median follow-up time of 32.2 months, the rates of overall survival and disease-free survival at 3 years were 94.7% and 88.9%, respectively. Conclusions For SMPLA with ≥ 3 lesions, one-stage resection may be safe and feasible, and surgical procedure was mainly sublobar resection as far as possible, which can yield satisfactory prognosis. EGFR mutation testing should be used routinely in the diagnosis and treatment of patients with SMPLA, especially in the presence of mGGO and invasive adenocarcinoma.

scholarly journals Comparative Characteristics of Napsin A, TTF 1 and EGFR Mutation Expression in Mucinous Lung Cell Carcinomas

Folia Medica ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 174-182
Author(s):  
Sylvia N. Genova ◽  
Veselin T. Belovezhdov ◽  
Stoyan N. Bichev ◽  
Vladimir H. Danev
Keyword(s):  
Salivary Gland ◽  
Mutation Frequency ◽  
Egfr Mutation ◽  
Egfr Mutations ◽  
Common Pattern ◽  
Specificity And Sensitivity ◽  
Napsin A ◽  
Significant Difference ◽  
Pcr Technology ◽  
Lung Adenocarcinomas

AbstractBackground:Invasive mucinous lung adenocarcinomas are rare and account for 2%–10% of all lung adenocarcinoma cases. It is believed that Napsin A exhibits a weaker expression in mucinous adenocarcinomas compared with TTF1, but such correlation is still poorly researched.Aim:The aim of the study was to determine the frequency of mucinous to nonmucinous adenocarcinomas and compare specificity and sensitivity of monoclonal Napsin A with TTF1 in mucinous adenocarcinomas and define the frequency of EGFR mutations.Materials and methods:Eighty-four resected lung carcinomas were prospectively evaluated. All biopsies were analysed with p63, TTF1, monoclonal Napsin A, CK7, CK20 and CDX2 and were studied with real-time PCR technology.Results:In resected material we detected 49/84 (58.3%) adenocarcinomas and selected 21 mucinous adenocarcinomas out of 46 non-mucinous adenocarcinomas (45.6%). The most common pattern of mucinous adenocarcinomas is papillary - 24% and colloidal - 24%, followed by acinar - 19.2% and lepidic - 19.2%. mNapsin A was positive in 18/21 (85.7%) mucinous adenocarcinomas v/s 17/21 TTF1 positive (80.9%). EGFR mutations were detected in 3/21 cases with mucinous adenocarcinomas (14.3%): mucinous papillary, mucinous acinar and “salivary gland-like”.Conclusion:Our study demonstrates a high proportion of primary mucinous lung adenocarcinomas to primary non-mucinous adenocarcinomas. Sensitivity and specificity of mNapsin A and TTF1 did not show significant difference in pulmonary mucinous and non-mucinous adenocarcinomas, as mNapsin A gave greater sensitivity to mucinous adenocarcinomas. Our results indicate the same mutation frequency of EGFR in mucinous adenocarcinomas as mutation frequency detected in non-mucinous adenocarcinomas in the Bulgarian region.

Clinical Characteristics and Surgical Outcomes of Sinonasal Lesions Associated With Tumor-Induced Osteomalacia

2020 ◽  
pp. 019459982097543
Author(s):  
Zhenzhen Zhu ◽  
Weibo Xia ◽  
Fang Qi ◽  
Weiqing Wang ◽  
Xiaowei Wang ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Outcomes ◽  
Recovery Rate ◽  
Open Surgery ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Case Series ◽  
Ethmoid Sinus ◽  
Tertiary Center ◽  
Significant Difference

Objective To investigate the clinical characteristics and surgical outcomes of sinonasal tumors associated with tumor-induced osteomalacia (TIO). Study Design Retrospective case series. Setting Single tertiary center. Methods We studied the clinical characteristics and surgical outcomes of 43 patients (22 male, 21 female) who had lesions in the nasal cavity and paranasal sinus associated with TIO and underwent surgery between August 2006 and November 2019. Results The mean ± SD duration between the onset of symptoms and surgery was 3.9 ± 2.6 years. The most common tumor site was the ethmoid sinus (76.7%), and the skull base was involved in 12 cases. Phosphaturic mesenchymal tumors were diagnosed in 41 patients, among whom there was 1 multifocal case. Another 2 cases involved odontogenic fibroma and hemangiofibroma, respectively. Serum phosphorus normalized in 39 cases within 4.4 ± 2.3 days, and serum fibroblastic growth factor 23 normalized within 1 day; clinical symptoms, however, gradually improved within several months after the first operation. There was no significant difference in the recovery rate between endoscopic and open surgery ( P = 0.639). Two patients with recurrent cases and 2 with nonremission cases recovered after a sinonasal reoperation. The patient with a multifocal case recovered after the resection of the tumors in the ethmoid sinus and mandible. The overall recovery rate was 97.7%. Conclusion Most sinonasal tumors associated with TIO are located in the ethmoid sinus, and the skull base is involved in some cases. Complete excision of the tumor leads to recovery, and endoscopic surgery could achieve recovery rates similar to those of open surgery.

Smoking history and frequency of somatic KRAS mutations in adenocarcinoma of the lung

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7573-7573
Author(s):  
V. A. Miller ◽  
G. J. Riely ◽  
M. G. Kris ◽  
D. Rosenbaum ◽  
J. Marks ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Mutational Analysis ◽  
Smoking History ◽  
Egfr Mutations ◽  
Molecular Testing ◽  
Kras Mutations ◽  
Exon 2 ◽  
Significant Difference ◽  
Never Smokers ◽  
Lung Adenocarcinomas

7573 Background: Somatic mutations in the epidermal growth factor receptor (EGFR) gene are more common in patients with adenocarcinoma, especially those who smoked < 15 pack years (py). KRAS mutations are found in ∼25% of lung adenocarcinomas, most commonly in codons 12 and 13 of exon 2 (∼85%) and have been associated with poor prognosis in resected disease [Winton NEJM 2005] and resistance to EGFR tyrosine kinase inhibitors [Pao PLoS Med 2005]. KRAS mutations are uncommon in non-small cell lung cancer histologies other than adenocarcinoma. We sought to determine the association between quantitative measures of cigarette smoking and presence of KRAS mutations in lung adenocarcinomas. Methods: Standard direct sequencing techniques were used to identify KRAS codon 12 and 13 mutations in lung adenocarcinoma specimens from surgical resections between 2001 and 2006 and tumor specimens sent for KRAS molecular analysis in 2006. Surgical specimens were obtained from an institutional tumor bank. Detailed smoking history (age at first cigarette, packs per day, years smoked, years since quitting smoking) was obtained from the medical record and a patient-completed smoking questionnaire. Results: KRAS mutational analysis was performed on 408 lung adenocarcinomas from 242 women and 166 men. Median age was 68 (range 33–89). KRAS mutations were present in 19% (78/408, 95% CI 15 to 23%). The frequency of KRAS mutation was not associated with age or gender. The presence of KRAS mutations was not related to smoking history with 15% (9/61) of never smokers having KRAS mutations compared with 19% (51/275) of former smokers. When compared with never smokers, there was no significant difference in frequency of KRAS mutations for tumors from patients with 1–5 py (5%, p=0.44), 6- 10 py (12%, p=0.99), 11–15 py (25%, p=0.45), 16–25 py (16%, p=0.99), 26–50 py (25%, p=0.129), 51–75 py (20%, p=0.48), >75 py (20%, p=0.47) history of cigarette smoking. Conclusions: While the incidence of EGFR mutations has a strong inverse relationship with the amount of cigarettes smoked, allowing the selective molecular testing for EGFR mutations, the frequency of KRAS mutations cannot be predicted by age, gender, or smoking history. KRAS mutational analysis of all adenocarcinomas is required to reliably identify patients with KRAS mutations. No significant financial relationships to disclose.

Clinical characteristics and outcomes of simultaneous multiple primary lung cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21088-e21088
Author(s):  
Ying Liu
Keyword(s):  
Lung Cancer ◽  
Survival Rate ◽  
Clinical Features ◽  
Respiratory Symptom ◽  
Clinical Characteristics ◽  
Primary Lung Cancer ◽  
Smoking History ◽  
Multiple Primary ◽  
Worse Prognosis

e21088 Background: Simultaneous multiple primary lung cancer (sMPLC) is detected increasingly nowadays with the development of image technology. But it has not been well characterized. Methods: All consecutive patients diagnosed as sMPLC according to Martini-Melamed and American College of Chest Physicians criteria from June 2010 to June 2019 were enrolled in our center. The clinical characteristics and outcomes were compared between patients with same histology and different histology. Results: A total of 336 patients were enrolled, consist of 297 (88.4%) patients with same histology and 39(11.6%) patients with different histology. Compared to patients with same histology, patients with different histology were more common male (87.2% vs. 34%, p < 0.001) and diagnosed at an older age (54 [62-69] vs. 59 [52-65], p < 0.001). Also, more than half of them (56.4%) had respiratory symptom or pain before diagnosis and most of them had smoking history (79.5% vs. 19.2%, p < 0.001). During follow-up, 5 patients were lost and 16 patients were died, contributing the 1-, 2-, and 3-year survival of overall patients was 97.7%, 96.1%, and 92.2%, respectively. Importantly, the survival rate was lower in patients with different histology (1-, 2-, and 3-year 88.5%, 75.4, and 64.3%) than same histology (1-, 2-, and 3-year 99.2%, 99.2, and 96.8%) (p < 0.001). Conclusions: Although relative less common in sMPLC, patients with different histology showed different clinical features and worse prognosis. [Table: see text]

scholarly journals Uncommon EGFR mutations in lung adenocarcinomas: Clinical features and response to tyrosine kinase inhibitors

2018 ◽  
Vol 29 ◽  
pp. viii747-viii748 ◽  
Author(s):  
A. Brindel ◽  
W. Althakfi ◽  
M. Barritault ◽  
P.-P. Bringuier ◽  
E. Watkin ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Tyrosine Kinase Inhibitors ◽  
Clinical Features ◽  
Kinase Inhibitors ◽  
Egfr Mutations ◽  
Lung Adenocarcinomas

scholarly journals CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoyu Han ◽  
Jun Fan ◽  
Jin Gu ◽  
Yumin Li ◽  
Ming Yang ◽  
...  
Keyword(s):  
Egfr Mutations ◽  
Multiple Primary ◽  
Lung Adenocarcinomas ◽  
Ct Features

scholarly journals Clinical Characteristics of Patients With Lung Adenocarcinomas Harboring BRAF Mutations

2011 ◽  
Vol 29 (15) ◽  
pp. 2046-2051 ◽  
Author(s):  
Paul K. Paik ◽  
Maria E. Arcila ◽  
Michael Fara ◽  
Camelia S. Sima ◽  
Vincent A. Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Lung Adenocarcinoma ◽  
Clinical Characteristics ◽  
Median Overall Survival ◽  
Smoking History ◽  
Egfr Mutations ◽  
Braf Mutations ◽  
Former Smokers ◽  
Lung Adenocarcinomas

Purpose BRAF mutations occur in non–small-cell lung cancer. Therapies targeting BRAF mutant tumors have recently been identified. We undertook this study to determine the clinical characteristics of patients with lung adenocarcinomas harboring BRAF mutations. Patients and Methods We reviewed data from consecutive patients with lung adenocarcinoma whose tumors underwent BRAF, EGFR, and KRAS mutation testing as well as fluorescence in situ hybridization for ALK rearrangements. Patient characteristics including age, sex, race, performance status, smoking history, stage, treatment history, and overall survival were collected. Results Among 697 patients with lung adenocarcinoma, BRAF mutations were present in 18 patients (3%; 95% CI, 2% to 4%). The BRAF mutations identified were V600E (50%), G469A (39%), and D594G (11%). Mutations in EGFR were present in 24%, KRAS in 25%, and ALK translocations in 6%. In contrast to patients with EGFR mutations and ALK rearrangements who were mostly never smokers, all patients with BRAF mutations were current or former smokers (P < .001). The median overall survival of advanced-stage patients with BRAF mutations was not reached. In comparison, the median overall survival of patients with EGFR mutations was 37 months (P = .73), with KRAS mutations was 18 months (P = .12), and with ALK rearrangements was not reached (P = .64). Conclusion BRAF mutations occur in 3% of patients with lung adenocarcinoma and occur more commonly in current and former smokers. The incidence of BRAF mutations other than V600E is significantly higher in lung cancer than in melanoma.

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