https://scholars.lib.ntu.edu.tw/handle/123456789/470803
Title: | New aspects of the clinicopathology and genetic profile of metachronous multiple lung cancers | Authors: | CHEN-TU WU MONG-WEI LIN MIN-SHU HSIEH SHUENN-WEN KUO YIH-LEONG CHANG |
Issue Date: | 2014 | Publisher: | Lippincott Williams and Wilkins | Journal Volume: | 259 | Journal Issue: | 5 | Start page/Pages: | 1018-1024 | Source: | Annals of Surgery | Abstract: | OBJECTIVE: For treatment decisions and prognostic applications, we evaluated p53/epidermal growth factor receptor (EGFR) somatic aberrations in metachronous multiple lung cancers to differentiate multiple primary lung cancers (MPLCs) from pulmonary metastases. BACKGROUND: The current criteria to differentiate MPLCs from metastases are based on the histologic type and onset interval and do not incorporate genetic analysis. The genetic background of MPLCs remains unclear. METHODS: Ninety-seven metachronous multiple lung cancers were identified to investigate somatic mutations in p53 and EGFR. Mutational analysis of p53 and EGFR was performed on DNA extracted from paraffin-embedded tumors. RESULTS: A high frequency of somatic mutations in p53 (44.3%; 43/97) and/or EGFR (51.5%; 50/97) resulted in a high discrimination rate of tumor clonality (77.3%; 75/97) in metachronous multiple lung cancers. Of the 97 cases, 25 cases (33.3%) and 50 cases (66.7%) were assessed as having the same clonality (SC) and different clonality (DC), respectively. Notably, DC was commonly observed among tumors of the same histologic type (60.7%; 37/61), which further supported the carcinogenic theory of field cancerization. Multivariate analysis revealed that a first primary tumor of 3 cm or smaller (5-year survival: 92.7%; P = 0.001) and a limited resection of the latest tumor (5-year survival: 96.0%; P = 0.016) were 2 independent predictors of favorable prognosis. CONCLUSIONS: Because most metachronous tumors of the same histologic type have different clonal origins, clonality assessment is essential to differentiate MPLCs from metastases. We recommend limited resection as the treatment of choice to achieve long-term survival in MPLCs patients with tumors of 3 cm or smaller. Copyright ? 2014 by Lippincott Williams & Wilkins. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84899491217&doi=10.1097%2fSLA.0000000000000385&partnerID=40&md5=4fed12b998925a6f152a8fb5ca2901b6 https://scholars.lib.ntu.edu.tw/handle/123456789/470803 |
ISSN: | 0003-4932 | DOI: | 10.1097/SLA.0000000000000385 | SDG/Keyword: | epidermal growth factor receptor; protein p53; adult; aged; article; cancer prognosis; cancer size; cancer survival; clonal variation; exon; female; gene mutation; genetic analysis; human; lung cancer; lung metastasis; lung resection; major clinical study; male; multiple primary lung cancer; priority journal; single nucleotide polymorphism; somatic mutation; Aged; Aged, 80 and over; DNA Mutational Analysis; DNA, Neoplasm; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Neoplasms, Second Primary; Polymerase Chain Reaction; Receptor, Epidermal Growth Factor; Retrospective Studies; Survival Rate; Taiwan; Tumor Suppressor Protein p53 |
Appears in Collections: | 病理學科所 |
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