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Clinicopathologic characteristics and prognostic significance of EGFR and p53 mutations in surgically resected lung adenocarcinomas ≤2 cm in maximal dimension
Author(s) -
Lin MongWei,
Wu ChenTu,
Shih JinYuan,
Chang YihLeong,
Yang PanChyr
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23628
Subject(s) - medicine , carcinoembryonic antigen , adenocarcinoma , chemotherapy , lung , oncology , stage (stratigraphy) , mutation , tyrosine kinase inhibitor , pathology , cancer research , cancer , biology , gene , paleontology , biochemistry
Background and Objectives Small lung adenocarcinomas are detected more frequently than in the past. However, the clinicopathologic characteristics and prognostic significance of EGFR / p53 mutations in these tumors remains unclear. Methods We evaluated the correlation of EGFR / p53 mutations with clinicopathologic characteristics and tumor relapse in 172 surgically resected lung adenocarcinomas ≤2 cm in maximal dimension. EGFR / p53 mutational analysis was performed on DNA extracted from paraffin‐embedded tumors. Results EGFR and p53 mutations were identified in 104 (60.5%) and 36 (20.9%) small adenocarcinomas, respectively. EGFR / p53 mutations were associated with tumor size >1 cm, whereas p53 mutations were frequently observed in moderately differentiated tumors. Disease‐free survival analysis showed that p53 mutation, presence of visceral pleural surface invasion, elevated preoperative serum carcinoembryonic antigen, and moderate histologic differentiation were significantly correlated with tumor relapse in patients with stage I disease. The 5‐year survival rate was higher in relapsed patients with EGFR ‐mutated tumors who were treated with tyrosine kinase inhibitor (TKI) than in those who were not treated with TKI. Conclusions p53 mutation was significantly correlated with tumor progression, and our findings may provide a rationale for the selective use of adjuvant chemotherapy in stage IB patients with p53 mutations. EGFR mutation was a predictor of EGFR TKI response in relapsed patients. J. Surg. Oncol. 2014; 110:99–106 . © 2014 Wiley Periodicals, Inc.