EGFR and KRAS mutations in the non-tumoral lung. Prognosis in patients with adenocarcinoma

Tumor recurrence is frequent and survival rates remain extremely low in lung adenocarcinoma (ADC). We hypothesize that carcinogenic factors will promote loco-regional modifications not only in the future tumor, but throughout the exposed lung. Objective: To analyze whether the most prevalent mutatio...

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Detalles Bibliográficos
Autores: Chalela Rengifo, Roberto José, 1985-, Bellosillo Paricio, Beatriz, Curull Serrano, Víctor, Longarón Rozalen, Raquel, Pascual Guàrdia, Sergi, 1979-, Badenes Bonet, Diana, 1987-, Arriola Aperribay, Edurne, Sánchez-Font, Albert, Pijuan Andujar, Lara, Gea Guiral, Joaquim
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/43531
Acceso en línea:http://hdl.handle.net/10230/43531
http://dx.doi.org/10.3390/jcm8040529
Access Level:acceso abierto
Palabra clave:Adenocarcinoma
EGFR
KRAS
Mutations
Prognosis
Descripción
Sumario:Tumor recurrence is frequent and survival rates remain extremely low in lung adenocarcinoma (ADC). We hypothesize that carcinogenic factors will promote loco-regional modifications not only in the future tumor, but throughout the exposed lung. Objective: To analyze whether the most prevalent mutations observed in ADC can also be observed in the non-neoplastic lung tissue, as well as the short-term prognosis implications of this finding. Methods: Non-tumoral lung parenchyma specimens obtained during surgery from 47 patients with EGFR and/or KRAS abnormalities in their ADC tumors underwent similar genomic testing. Short-term outcomes were also recorded. Results: The same mutations were present in the tumor and the histologically normal tissue in 21.3% of patients (SM group). Although local recurrences were similar in both groups, distant metastases were more frequent in the former (60 vs. 5.4%, p < 0.001). Moreover, SM patients showed lower time-to-progression (8.5 vs. 11.7 months, p < 0.001) and disease-free survival (8.5 vs. 11.2 months, p < 0.001). COX regression showed a higher risk of progression or death (DFS) in the SM group (HR 5.94, p < 0.01]. Similar results were observed when adjusting for potential confounding variables. Conclusions: These results confirm that genetic changes are present in the apparently normal lung in many ADC patients, and this finding has prognostic implications.