J Clin Med. 2019 Apr 17;8(4). pii: E529. doi: 10.3390/jcm8040529.
EGFR and KRAS Mutations in the Non-Tumoral Lung. Prognosis in Patients with Adenocarcinoma.
Chalela R1,2,3,4, Bellosillo B5,6,7, Curull V8,9,10,11, Longarón R12, Pascual-Guardia S13,14,15,16, Badenes-Bonet D17,18,19, Arriola E20,21, Sánchez-Font A22,23,24, Pijuan L25, Gea J26,27,28,29.
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.
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.
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.
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.
These results confirm that genetic changes are present in the apparently normal lung in many ADC patients, and this finding has prognostic implications.
Adenocarcinoma; EGFR; KRAS; Mutations; Prognosis
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