Proposal for a Combined Histomolecular Algorithm to Distinguish Multiple Primary Adenocarcinomas from Intrapulmonary Metastasis in Patients with Multiple Lung Tumors.
Introduction: Multiple nodules in the lung are being diagnosed with an increasing frequency thanks to high-quality computed tomography imaging. In patients with lung cancer, this situation represents up to 10% of patients who have an operation. For clinical management, it is important to classify th...
| Publicado en: | Journal of Thoracic Oncology Vol. 14; no. 5; pp. 844 - 857 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
May2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136013299&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136013299 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15560864 4Z2B jtl: Journal of Thoracic Oncology issn: 15560864 maglogo: N pubinfo: dt: May2019 vid: 14 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 136013299 136013299 NLM30721797 136013299 10.1016/j.jtho.2019.01.017 NLM30721797 136013299 ppf: 844 ppct: 13 formats: tig: atl: Proposal for a Combined Histomolecular Algorithm to Distinguish Multiple Primary Adenocarcinomas from Intrapulmonary Metastasis in Patients with Multiple Lung Tumors. aug: au: Mansuet-Lupo, Audrey Barritault, Marc Alifano, Marco Janet-Vendroux, Aurélie Zarmaev, Makmoud Biton, Jérôme Velut, Yoan Le Hay, Christine Cremer, Isabelle Régnard, Jean-François Fournel, Ludovic Rance, Bastien Wislez, Marie Laurent-Puig, Pierre Herbst, Ronald Damotte, Diane Blons, Hélène affil: Department of Pathology, Hôpitaux Universitaire Paris Centre, Cochin Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France sug: subj: Sequence Analysis Methods Adenocarcinoma Complications Neoplasms, Multiple Primary Complications Lung Neoplasms Neoplasm Metastasis Algorithms Aged, 80 and Over Adult Male Adenocarcinoma Pathology Human Female Middle Age Lung Neoplasms Pathology Aged Validation Studies Comparative Studies Evaluation Research Multicenter Studies Aged, 80 & over Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: Multiple nodules in the lung are being diagnosed with an increasing frequency thanks to high-quality computed tomography imaging. In patients with lung cancer, this situation represents up to 10% of patients who have an operation. For clinical management, it is important to classify the disease as intrapulmonary metastasis or multiple primary lung carcinoma to define TNM classification and optimize therapeutic options. In the present study, we evaluated the respective and combined input of histological and molecular classification to propose a classification algorithm for multiple nodules.Methods: We studied consecutive patients undergoing an operation with curative intent for lung adenocarcinoma (N = 120) and harboring two tumors (N = 240). Histological diagnosis according to the WHO 2015 classification and molecular profiling using next-generation sequencing targeting 22 hotspot genes allowed classification of samples as multiple primary lung adenocarcinomas or as intrapulmonary metastasis.Results: Next-generation sequencing identified molecular mutations in 91% of tumor pairs (109 of 120). Genomic and histological classification showed a fair agreement when the κ test was used (κ = 0.43). Discordant cases (30 of 109 [27%]) were reclassified by using a combined histomolecular algorithm. EGFR mutations (p = 0.03) and node involvement (p = 0.03) were significantly associated with intrapulmonary metastasis, whereas KRAS mutations (p = 0.00005) were significantly associated with multiple primary lung adenocarcinomas. EGFR mutations (p = 0.02) and node involvement (p = 0.004) were the only independent prognostic factors.Conclusion: We showed that combined histomolecular algorithm represents a relevant tool to classify multifocal lung cancers, which could guide adjuvant treatment decisions. Survival analysis underlined the good prognosis of EGFR-mutated adenocarcinoma in patients with intrapulmonary metastasis. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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