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Anaplastic lymphoma kinase rearrangement in surgically resected stage IA lung adenocarcinoma

Title
Anaplastic lymphoma kinase rearrangement in surgically resected stage IA lung adenocarcinoma
Author
이현
Keywords
Anaplastic lymphoma kinase (ALK); non-small cell lung cancer (NSCLC); stage IA lung adenocarcinoma; surgery; prognosis
Issue Date
2018-05
Publisher
AME PUBL CO
Citation
JOURNAL OF THORACIC DISEASE, v. 10, no. 6, page. 3460-3467
Abstract
Background: It has not been determined if adjuvant chemotherapy would be helpful for completely resected early-stage lung adenocarcinoma even with unfavorable genetic markers. As the positive anaplastic lymphoma kinase (ALK) rearrangement is associated with aggressive clinical feature in lung adenocarcinoma, we evaluated the treatment outcomes of completely resected stage IA lung adenocarcinoma according to initial ALK status.Methods: This is a retrospective cohort study including 309 patients with surgically resected stage IA lung adenocarcinoma from February 2010 to December 2013. Patients were screened for ALK rearrangement using immunohistochemistry. A positive ALK status was defined as an immunohistochemistry score of 2+ or more. Both disease-free survival (DFS) and the initial recurrence pattern were analyzed according to ALK status.Results: Twenty-three (7.4%) patients had ALK-positive adenocarcinoma. During the median follow-up of 35.8 months, recurrence developed in 34 (11.0%) patients. The patients with ALK-positive tumor had significantly lower 5-year DFS rate (62.4%) compared to those with ALK-negative tumor (86.5%; P=0.038). The multivariable analysis showed that ALK rearrangement was associated with a higher risk of disease recurrence (adjusted hazard ratio =2.64; 95% confidence interval, 1.08-6.44). In addition, patient with ALK-positive tumor showed more frequent recurrence in regional lymph nodes compared with those with ALK-negative tumor (83.3% vs. 28.6%; P=0.031).Conclusions: In patients with completely resected stage IA lung adenocarcinoma, ALK rearrangement was associated with unfavorable DFS and more frequent regional lymph node metastasis. Therefore, careful surveillance for recurrence should be performed in this subset of patients.
URI
http://jtd.amegroups.com/article/view/21665/17023http://repository.hanyang.ac.kr/handle/20.500.11754/118669
ISSN
2072-1439; 2077-6624
DOI
10.21037/jtd.2018.05.131
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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