Impact of genetic status on the survival outcomes of patients with clinical stage I non-small cell lung cancer with a radiological pure-solid appearance
•The frequency of genetic mutations is high in pure-solid stage I lung cancer.•Genetic mutations are related to adverse survival in radiological pure-solid tumors.•Lymph node invasion is a valuable factor related to prognosis. To investigate whether genetic status is associated with the prognosis of...
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| Veröffentlicht in: | Lung cancer (Amsterdam, Netherlands) Netherlands), 2022-04, Vol.166, p.63-69 |
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| creator | Sun, Ke Li, Meiling Shang, Mingdong Su, Xiaolian Zhao, Jiabi Wang, Bin Wu, Chunyan Zhang, Lei Yang, Shan Sun, Xiwen |
| description | •The frequency of genetic mutations is high in pure-solid stage I lung cancer.•Genetic mutations are related to adverse survival in radiological pure-solid tumors.•Lymph node invasion is a valuable factor related to prognosis.
To investigate whether genetic status is associated with the prognosis of patients with clinical stage (c-stage) I non-small cell lung cancer (NSCLC) with radiological pure-solid manifestations.
We included 340 patients with pure-solid c-stage I NSCLC and evaluated their clinicopathological and genetic information. Disease recurrence and death were also observed at the end of the 5-year follow-up period. A Cox proportional hazards model was performed to identify the effect of clinicopathological variables, including genetic status, on oncological outcomes. Recurrence-free survival (RFS) and overall survival (OS) were calculated by Kaplan-Meier curves and were compared using log-rank tests.
The gene-mutation rate of c-stage I NSCLC with a radiological pure-solid appearance was 55.9% (190/340), and the frequencies of EGFR, KRAS, ALK, ROS1 and fused genes were 69.5% (132/190), 16.8% (32/190), 8.9% (17/190), 1.6% (3/190) and 3.2% (6/190), respectively. The 5-year RFS and OS rates of eligible patients were 57.1% and 76.5%, respectively. A multivariable analysis revealed that genetic status was an independent significant prognostic factor associated with RFS (hazard ratio [HR] = 1.416, 95% confidence interval [CI]: 1.020–1.964, p = 0.038) but not with OS. RFS was lower in the genetic mutation group compared with the wild-type group (p = 0.027), with 5-year RFS rate (65.7 vs. 51.6%), but the difference in OS (mutated group vs. wild-type group: 78.0% vs. 75.3%) was not statistically significant (p = 0.602). Additionally, we found that pathological nodal involvement (HR = 2.455, 95% CI: 1.745–3.454, p |
| doi_str_mv | 10.1016/j.lungcan.2022.02.005 |
| format | Article |
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To investigate whether genetic status is associated with the prognosis of patients with clinical stage (c-stage) I non-small cell lung cancer (NSCLC) with radiological pure-solid manifestations.
We included 340 patients with pure-solid c-stage I NSCLC and evaluated their clinicopathological and genetic information. Disease recurrence and death were also observed at the end of the 5-year follow-up period. A Cox proportional hazards model was performed to identify the effect of clinicopathological variables, including genetic status, on oncological outcomes. Recurrence-free survival (RFS) and overall survival (OS) were calculated by Kaplan-Meier curves and were compared using log-rank tests.
The gene-mutation rate of c-stage I NSCLC with a radiological pure-solid appearance was 55.9% (190/340), and the frequencies of EGFR, KRAS, ALK, ROS1 and fused genes were 69.5% (132/190), 16.8% (32/190), 8.9% (17/190), 1.6% (3/190) and 3.2% (6/190), respectively. The 5-year RFS and OS rates of eligible patients were 57.1% and 76.5%, respectively. A multivariable analysis revealed that genetic status was an independent significant prognostic factor associated with RFS (hazard ratio [HR] = 1.416, 95% confidence interval [CI]: 1.020–1.964, p = 0.038) but not with OS. RFS was lower in the genetic mutation group compared with the wild-type group (p = 0.027), with 5-year RFS rate (65.7 vs. 51.6%), but the difference in OS (mutated group vs. wild-type group: 78.0% vs. 75.3%) was not statistically significant (p = 0.602). Additionally, we found that pathological nodal involvement (HR = 2.455, 95% CI: 1.745–3.454, p < 0.001 for RFS; HR = 2.204, 95% CI: 1.409–3.447, p = 0.001 for OS) was also a valuable prognostic factor in patients with pure-solid c-stage I NSCLC.
Our study provides a comprehensive description of the mutational landscape of c-stage I NSCLC, and indicates that genetic status has an impact on disease recurrence in patients with c-stage I NSCLC with pure-solid appearance.</description><identifier>ISSN: 0169-5002</identifier><identifier>EISSN: 1872-8332</identifier><identifier>DOI: 10.1016/j.lungcan.2022.02.005</identifier><identifier>PMID: 35196635</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Carcinoma, Non-Small-Cell Lung - genetics ; Carcinoma, Non-Small-Cell Lung - pathology ; Computed tomography ; Gene ; Humans ; Lung Neoplasms - pathology ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Non-small cell lung cancer ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins ; Pure-solid manifestation ; Retrospective Studies</subject><ispartof>Lung cancer (Amsterdam, Netherlands), 2022-04, Vol.166, p.63-69</ispartof><rights>2022 Elsevier B.V.</rights><rights>Copyright © 2022 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-c15ce8bbd279eea56e9fc23bdb444cfd546f6ed2a0e6b35a35ae906ca214ece63</citedby><cites>FETCH-LOGICAL-c365t-c15ce8bbd279eea56e9fc23bdb444cfd546f6ed2a0e6b35a35ae906ca214ece63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.lungcan.2022.02.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35196635$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Ke</creatorcontrib><creatorcontrib>Li, Meiling</creatorcontrib><creatorcontrib>Shang, Mingdong</creatorcontrib><creatorcontrib>Su, Xiaolian</creatorcontrib><creatorcontrib>Zhao, Jiabi</creatorcontrib><creatorcontrib>Wang, Bin</creatorcontrib><creatorcontrib>Wu, Chunyan</creatorcontrib><creatorcontrib>Zhang, Lei</creatorcontrib><creatorcontrib>Yang, Shan</creatorcontrib><creatorcontrib>Sun, Xiwen</creatorcontrib><title>Impact of genetic status on the survival outcomes of patients with clinical stage I non-small cell lung cancer with a radiological pure-solid appearance</title><title>Lung cancer (Amsterdam, Netherlands)</title><addtitle>Lung Cancer</addtitle><description>•The frequency of genetic mutations is high in pure-solid stage I lung cancer.•Genetic mutations are related to adverse survival in radiological pure-solid tumors.•Lymph node invasion is a valuable factor related to prognosis.
To investigate whether genetic status is associated with the prognosis of patients with clinical stage (c-stage) I non-small cell lung cancer (NSCLC) with radiological pure-solid manifestations.
We included 340 patients with pure-solid c-stage I NSCLC and evaluated their clinicopathological and genetic information. Disease recurrence and death were also observed at the end of the 5-year follow-up period. A Cox proportional hazards model was performed to identify the effect of clinicopathological variables, including genetic status, on oncological outcomes. Recurrence-free survival (RFS) and overall survival (OS) were calculated by Kaplan-Meier curves and were compared using log-rank tests.
The gene-mutation rate of c-stage I NSCLC with a radiological pure-solid appearance was 55.9% (190/340), and the frequencies of EGFR, KRAS, ALK, ROS1 and fused genes were 69.5% (132/190), 16.8% (32/190), 8.9% (17/190), 1.6% (3/190) and 3.2% (6/190), respectively. The 5-year RFS and OS rates of eligible patients were 57.1% and 76.5%, respectively. A multivariable analysis revealed that genetic status was an independent significant prognostic factor associated with RFS (hazard ratio [HR] = 1.416, 95% confidence interval [CI]: 1.020–1.964, p = 0.038) but not with OS. RFS was lower in the genetic mutation group compared with the wild-type group (p = 0.027), with 5-year RFS rate (65.7 vs. 51.6%), but the difference in OS (mutated group vs. wild-type group: 78.0% vs. 75.3%) was not statistically significant (p = 0.602). Additionally, we found that pathological nodal involvement (HR = 2.455, 95% CI: 1.745–3.454, p < 0.001 for RFS; HR = 2.204, 95% CI: 1.409–3.447, p = 0.001 for OS) was also a valuable prognostic factor in patients with pure-solid c-stage I NSCLC.
Our study provides a comprehensive description of the mutational landscape of c-stage I NSCLC, and indicates that genetic status has an impact on disease recurrence in patients with c-stage I NSCLC with pure-solid appearance.</description><subject>Carcinoma, Non-Small-Cell Lung - genetics</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Computed tomography</subject><subject>Gene</subject><subject>Humans</subject><subject>Lung Neoplasms - pathology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Non-small cell lung cancer</subject><subject>Prognosis</subject><subject>Protein-Tyrosine Kinases</subject><subject>Proto-Oncogene Proteins</subject><subject>Pure-solid manifestation</subject><subject>Retrospective Studies</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0EokPhEUBessngn9iTrBCqSjtSJTawtpybm6lHiR1sZ1DfhMfFYQa2lY7szXd8j-8h5D1nW864_nTcjos_gPVbwYTYsiKmXpANb3aiaqQUL8mmcG2lGBNX5E1KR8b4jrP2NbmSirdaS7Uhv_fTbCHTMNADeswOaMo2L4kGT_Mj0rTEkzvZkYYlQ5gwrehss0OfE_3l8iOF0XkHBSnOA9I99cFXabLjSAHLsQalJSlgPBssjbZ3YQyHv7Z5iVilMLqe2nlGG1f0LXk12DHhu8t9TX58vf1-c189fLvb33x5qEBqlSvgCrDpul7sWkSrNLYDCNn1XV3XMPSq1oPGXliGupPKFmHLNFjBawTU8pp8PL87x_BzwZTN5NIa23oMSzJCS9GwpqyuoOqMQgwpRRzMHN1k45PhzKylmKO5lGLWUgwrYqr4PlxGLN2E_X_XvxYK8PkMYPnoyWE0Ccp-AXsXEbLpg3tmxB_KxaSk</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Sun, Ke</creator><creator>Li, Meiling</creator><creator>Shang, Mingdong</creator><creator>Su, Xiaolian</creator><creator>Zhao, Jiabi</creator><creator>Wang, Bin</creator><creator>Wu, Chunyan</creator><creator>Zhang, Lei</creator><creator>Yang, Shan</creator><creator>Sun, Xiwen</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202204</creationdate><title>Impact of genetic status on the survival outcomes of patients with clinical stage I non-small cell lung cancer with a radiological pure-solid appearance</title><author>Sun, Ke ; Li, Meiling ; Shang, Mingdong ; Su, Xiaolian ; Zhao, Jiabi ; Wang, Bin ; Wu, Chunyan ; Zhang, Lei ; Yang, Shan ; Sun, Xiwen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-c15ce8bbd279eea56e9fc23bdb444cfd546f6ed2a0e6b35a35ae906ca214ece63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Carcinoma, Non-Small-Cell Lung - genetics</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Computed tomography</topic><topic>Gene</topic><topic>Humans</topic><topic>Lung Neoplasms - pathology</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Non-small cell lung cancer</topic><topic>Prognosis</topic><topic>Protein-Tyrosine Kinases</topic><topic>Proto-Oncogene Proteins</topic><topic>Pure-solid manifestation</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Ke</creatorcontrib><creatorcontrib>Li, Meiling</creatorcontrib><creatorcontrib>Shang, Mingdong</creatorcontrib><creatorcontrib>Su, Xiaolian</creatorcontrib><creatorcontrib>Zhao, Jiabi</creatorcontrib><creatorcontrib>Wang, Bin</creatorcontrib><creatorcontrib>Wu, Chunyan</creatorcontrib><creatorcontrib>Zhang, Lei</creatorcontrib><creatorcontrib>Yang, Shan</creatorcontrib><creatorcontrib>Sun, Xiwen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Ke</au><au>Li, Meiling</au><au>Shang, Mingdong</au><au>Su, Xiaolian</au><au>Zhao, Jiabi</au><au>Wang, Bin</au><au>Wu, Chunyan</au><au>Zhang, Lei</au><au>Yang, Shan</au><au>Sun, Xiwen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of genetic status on the survival outcomes of patients with clinical stage I non-small cell lung cancer with a radiological pure-solid appearance</atitle><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle><addtitle>Lung Cancer</addtitle><date>2022-04</date><risdate>2022</risdate><volume>166</volume><spage>63</spage><epage>69</epage><pages>63-69</pages><issn>0169-5002</issn><eissn>1872-8332</eissn><abstract>•The frequency of genetic mutations is high in pure-solid stage I lung cancer.•Genetic mutations are related to adverse survival in radiological pure-solid tumors.•Lymph node invasion is a valuable factor related to prognosis.
To investigate whether genetic status is associated with the prognosis of patients with clinical stage (c-stage) I non-small cell lung cancer (NSCLC) with radiological pure-solid manifestations.
We included 340 patients with pure-solid c-stage I NSCLC and evaluated their clinicopathological and genetic information. Disease recurrence and death were also observed at the end of the 5-year follow-up period. A Cox proportional hazards model was performed to identify the effect of clinicopathological variables, including genetic status, on oncological outcomes. Recurrence-free survival (RFS) and overall survival (OS) were calculated by Kaplan-Meier curves and were compared using log-rank tests.
The gene-mutation rate of c-stage I NSCLC with a radiological pure-solid appearance was 55.9% (190/340), and the frequencies of EGFR, KRAS, ALK, ROS1 and fused genes were 69.5% (132/190), 16.8% (32/190), 8.9% (17/190), 1.6% (3/190) and 3.2% (6/190), respectively. The 5-year RFS and OS rates of eligible patients were 57.1% and 76.5%, respectively. A multivariable analysis revealed that genetic status was an independent significant prognostic factor associated with RFS (hazard ratio [HR] = 1.416, 95% confidence interval [CI]: 1.020–1.964, p = 0.038) but not with OS. RFS was lower in the genetic mutation group compared with the wild-type group (p = 0.027), with 5-year RFS rate (65.7 vs. 51.6%), but the difference in OS (mutated group vs. wild-type group: 78.0% vs. 75.3%) was not statistically significant (p = 0.602). Additionally, we found that pathological nodal involvement (HR = 2.455, 95% CI: 1.745–3.454, p < 0.001 for RFS; HR = 2.204, 95% CI: 1.409–3.447, p = 0.001 for OS) was also a valuable prognostic factor in patients with pure-solid c-stage I NSCLC.
Our study provides a comprehensive description of the mutational landscape of c-stage I NSCLC, and indicates that genetic status has an impact on disease recurrence in patients with c-stage I NSCLC with pure-solid appearance.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>35196635</pmid><doi>10.1016/j.lungcan.2022.02.005</doi><tpages>7</tpages></addata></record> |
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| subjects | Carcinoma, Non-Small-Cell Lung - genetics Carcinoma, Non-Small-Cell Lung - pathology Computed tomography Gene Humans Lung Neoplasms - pathology Neoplasm Recurrence, Local - pathology Neoplasm Staging Non-small cell lung cancer Prognosis Protein-Tyrosine Kinases Proto-Oncogene Proteins Pure-solid manifestation Retrospective Studies |
| title | Impact of genetic status on the survival outcomes of patients with clinical stage I non-small cell lung cancer with a radiological pure-solid appearance |
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