ALK rearrangement is an independent predictive factor of unexpected nodal metastasis after surgery in early stage, clinical node negative lung adenocarcinoma
Despite notable advances made in preoperative staging, unexpected nodal metastases after surgery are still significantly detected. Given the promising role of neoadjuvant targeted treatments, the definition of novel predictive factors of nodal metastases is an extremely important issue. In this stud...
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| Veröffentlicht in: | Lung cancer (Amsterdam, Netherlands) Netherlands), 2023-06, Vol.180, p.107215-107215, Article 107215 |
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| creator | Gallina, Filippo Tommaso Tajè, Riccardo Letizia Cecere, Fabiana Forcella, Daniele Landi, Lorenza Minuti, Gabriele Fusco, Francesca Buglioni, Simonetta Visca, Paolo Melis, Enrico Sperduti, Isabella Ciliberto, Gennaro Cappuzzo, Federico Facciolo, Francesco |
| description | Despite notable advances made in preoperative staging, unexpected nodal metastases after surgery are still significantly detected. Given the promising role of neoadjuvant targeted treatments, the definition of novel predictive factors of nodal metastases is an extremely important issue. In this study we aim to analyze the upstaging rate in patients with early stage NSCLC without evidence of nodal disease in the preoperative staging who underwent lobectomy and radical lymphadenectomy.
Patients who underwent lobectomy and systematic lymphadenectomy for early stage LUAD without evidence of nodal disease at the preoperative staging using NGS analysis for actionable molecular targets evaluation after surgery were evaluated. Exclusion criteria included the neoadjuvant treatment, incomplete resection and no adherence to preoperative guidelines.
A total of 359 patients were included in the study. 172 patients were female, and the median age was 68 (61–72). The variables that showed a significant correlation with the upstaging rate at the univariate analysis were the ALK rearrangement, the number of resected lymph nodes and the diameter of the tumor. This result was confirmed in the multivariate analysis, with an OR of 8.052 (CI95% 3.123–20.763, p = 0.00001) for ALK rearrangement, 1.087 (CI95% 1.048–1.127, p = 0.00001) for the number of resected nodes and 1.817 (CI95% 1.214–2.719, p = 0.004) for cT status.
Our results showed that in a homogeneous cohort of patients with clinical node early stage LUAD the ALK rearrangement, the number of resected lymph nodes and the tumor diameter can significantly predict nodal metastasis. |
| doi_str_mv | 10.1016/j.lungcan.2023.107215 |
| format | Article |
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Patients who underwent lobectomy and systematic lymphadenectomy for early stage LUAD without evidence of nodal disease at the preoperative staging using NGS analysis for actionable molecular targets evaluation after surgery were evaluated. Exclusion criteria included the neoadjuvant treatment, incomplete resection and no adherence to preoperative guidelines.
A total of 359 patients were included in the study. 172 patients were female, and the median age was 68 (61–72). The variables that showed a significant correlation with the upstaging rate at the univariate analysis were the ALK rearrangement, the number of resected lymph nodes and the diameter of the tumor. This result was confirmed in the multivariate analysis, with an OR of 8.052 (CI95% 3.123–20.763, p = 0.00001) for ALK rearrangement, 1.087 (CI95% 1.048–1.127, p = 0.00001) for the number of resected nodes and 1.817 (CI95% 1.214–2.719, p = 0.004) for cT status.
Our results showed that in a homogeneous cohort of patients with clinical node early stage LUAD the ALK rearrangement, the number of resected lymph nodes and the tumor diameter can significantly predict nodal metastasis.</description><identifier>ISSN: 0169-5002</identifier><identifier>EISSN: 1872-8332</identifier><identifier>DOI: 10.1016/j.lungcan.2023.107215</identifier><identifier>PMID: 37126920</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adenocarcinoma of Lung - genetics ; Adenocarcinoma of Lung - pathology ; Adenocarcinoma of Lung - surgery ; Aged ; ALK ; Early stage NSCLC ; Female ; Humans ; Lung Neoplasms - genetics ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Lymph Node Excision - methods ; Lymph Nodes - pathology ; Lymphadenectomy ; Male ; Neoplasm Staging ; Nodal disease ; Pneumonectomy - methods ; Receptor Protein-Tyrosine Kinases ; Retrospective Studies ; Upstaging</subject><ispartof>Lung cancer (Amsterdam, Netherlands), 2023-06, Vol.180, p.107215-107215, Article 107215</ispartof><rights>2023 Elsevier B.V.</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-6841747823f5fc8bd68b98dde0b9bbe9efbb75c23aac30581838027a129d6a003</citedby><cites>FETCH-LOGICAL-c365t-6841747823f5fc8bd68b98dde0b9bbe9efbb75c23aac30581838027a129d6a003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0169500223007535$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37126920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gallina, Filippo Tommaso</creatorcontrib><creatorcontrib>Tajè, Riccardo</creatorcontrib><creatorcontrib>Letizia Cecere, Fabiana</creatorcontrib><creatorcontrib>Forcella, Daniele</creatorcontrib><creatorcontrib>Landi, Lorenza</creatorcontrib><creatorcontrib>Minuti, Gabriele</creatorcontrib><creatorcontrib>Fusco, Francesca</creatorcontrib><creatorcontrib>Buglioni, Simonetta</creatorcontrib><creatorcontrib>Visca, Paolo</creatorcontrib><creatorcontrib>Melis, Enrico</creatorcontrib><creatorcontrib>Sperduti, Isabella</creatorcontrib><creatorcontrib>Ciliberto, Gennaro</creatorcontrib><creatorcontrib>Cappuzzo, Federico</creatorcontrib><creatorcontrib>Facciolo, Francesco</creatorcontrib><title>ALK rearrangement is an independent predictive factor of unexpected nodal metastasis after surgery in early stage, clinical node negative lung adenocarcinoma</title><title>Lung cancer (Amsterdam, Netherlands)</title><addtitle>Lung Cancer</addtitle><description>Despite notable advances made in preoperative staging, unexpected nodal metastases after surgery are still significantly detected. Given the promising role of neoadjuvant targeted treatments, the definition of novel predictive factors of nodal metastases is an extremely important issue. In this study we aim to analyze the upstaging rate in patients with early stage NSCLC without evidence of nodal disease in the preoperative staging who underwent lobectomy and radical lymphadenectomy.
Patients who underwent lobectomy and systematic lymphadenectomy for early stage LUAD without evidence of nodal disease at the preoperative staging using NGS analysis for actionable molecular targets evaluation after surgery were evaluated. Exclusion criteria included the neoadjuvant treatment, incomplete resection and no adherence to preoperative guidelines.
A total of 359 patients were included in the study. 172 patients were female, and the median age was 68 (61–72). The variables that showed a significant correlation with the upstaging rate at the univariate analysis were the ALK rearrangement, the number of resected lymph nodes and the diameter of the tumor. This result was confirmed in the multivariate analysis, with an OR of 8.052 (CI95% 3.123–20.763, p = 0.00001) for ALK rearrangement, 1.087 (CI95% 1.048–1.127, p = 0.00001) for the number of resected nodes and 1.817 (CI95% 1.214–2.719, p = 0.004) for cT status.
Our results showed that in a homogeneous cohort of patients with clinical node early stage LUAD the ALK rearrangement, the number of resected lymph nodes and the tumor diameter can significantly predict nodal metastasis.</description><subject>Adenocarcinoma of Lung - genetics</subject><subject>Adenocarcinoma of Lung - pathology</subject><subject>Adenocarcinoma of Lung - surgery</subject><subject>Aged</subject><subject>ALK</subject><subject>Early stage NSCLC</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - genetics</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymph Node Excision - methods</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphadenectomy</subject><subject>Male</subject><subject>Neoplasm Staging</subject><subject>Nodal disease</subject><subject>Pneumonectomy - methods</subject><subject>Receptor Protein-Tyrosine Kinases</subject><subject>Retrospective Studies</subject><subject>Upstaging</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUc1u1DAQthCIbguPAPKRA1n8UyfOCVUVUNSVuLRna2JPIq8SO9hJxT5M3xUvu3BFGnmk8fejmY-Qd5xtOeP1p_12XMNgIWwFE7LMGsHVC7LhuhGVllK8JJuCayvFmLgglznvGeMNZ-1rciEbLupWsA15vtnd04SQEoQBJwwL9ZlCoD44nLE8ZTIndN4u_glpD3aJicaergF_zWgXdDREByOdcIFc6sjvF0w0r2nAdChStBiMB1p-B_xI7eiDt4VReEgDDvBH-rgPhWIYLSTrQ5zgDXnVw5jx7blfkcevXx5u76rdj2_fb292lZW1WqpaX_PmutFC9qq3unO17lrtHLKu7Tpsse-6RlkhAaxkSnMtNRMNcNG6GhiTV-TDSXdO8eeKeTGTzxbHEQLGNRuhmVZaMSkKVJ2gNsWcE_ZmTn6CdDCcmWMyZm_OyZhjMuaUTOG9P1us3YTuH-tvFAXw-QTAsuiTx2Sy9RhsOX0qZzYu-v9Y_Abv3KVk</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Gallina, Filippo Tommaso</creator><creator>Tajè, Riccardo</creator><creator>Letizia Cecere, Fabiana</creator><creator>Forcella, Daniele</creator><creator>Landi, Lorenza</creator><creator>Minuti, Gabriele</creator><creator>Fusco, Francesca</creator><creator>Buglioni, Simonetta</creator><creator>Visca, Paolo</creator><creator>Melis, Enrico</creator><creator>Sperduti, Isabella</creator><creator>Ciliberto, Gennaro</creator><creator>Cappuzzo, Federico</creator><creator>Facciolo, Francesco</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>202306</creationdate><title>ALK rearrangement is an independent predictive factor of unexpected nodal metastasis after surgery in early stage, clinical node negative lung adenocarcinoma</title><author>Gallina, Filippo Tommaso ; Tajè, Riccardo ; Letizia Cecere, Fabiana ; Forcella, Daniele ; Landi, Lorenza ; Minuti, Gabriele ; Fusco, Francesca ; Buglioni, Simonetta ; Visca, Paolo ; Melis, Enrico ; Sperduti, Isabella ; Ciliberto, Gennaro ; Cappuzzo, Federico ; Facciolo, Francesco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-6841747823f5fc8bd68b98dde0b9bbe9efbb75c23aac30581838027a129d6a003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenocarcinoma of Lung - genetics</topic><topic>Adenocarcinoma of Lung - pathology</topic><topic>Adenocarcinoma of Lung - surgery</topic><topic>Aged</topic><topic>ALK</topic><topic>Early stage NSCLC</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - genetics</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymph Node Excision - methods</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphadenectomy</topic><topic>Male</topic><topic>Neoplasm Staging</topic><topic>Nodal disease</topic><topic>Pneumonectomy - methods</topic><topic>Receptor Protein-Tyrosine Kinases</topic><topic>Retrospective Studies</topic><topic>Upstaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gallina, Filippo Tommaso</creatorcontrib><creatorcontrib>Tajè, Riccardo</creatorcontrib><creatorcontrib>Letizia Cecere, Fabiana</creatorcontrib><creatorcontrib>Forcella, Daniele</creatorcontrib><creatorcontrib>Landi, Lorenza</creatorcontrib><creatorcontrib>Minuti, Gabriele</creatorcontrib><creatorcontrib>Fusco, Francesca</creatorcontrib><creatorcontrib>Buglioni, Simonetta</creatorcontrib><creatorcontrib>Visca, Paolo</creatorcontrib><creatorcontrib>Melis, Enrico</creatorcontrib><creatorcontrib>Sperduti, Isabella</creatorcontrib><creatorcontrib>Ciliberto, Gennaro</creatorcontrib><creatorcontrib>Cappuzzo, Federico</creatorcontrib><creatorcontrib>Facciolo, Francesco</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>Gallina, Filippo Tommaso</au><au>Tajè, Riccardo</au><au>Letizia Cecere, Fabiana</au><au>Forcella, Daniele</au><au>Landi, Lorenza</au><au>Minuti, Gabriele</au><au>Fusco, Francesca</au><au>Buglioni, Simonetta</au><au>Visca, Paolo</au><au>Melis, Enrico</au><au>Sperduti, Isabella</au><au>Ciliberto, Gennaro</au><au>Cappuzzo, Federico</au><au>Facciolo, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ALK rearrangement is an independent predictive factor of unexpected nodal metastasis after surgery in early stage, clinical node negative lung adenocarcinoma</atitle><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle><addtitle>Lung Cancer</addtitle><date>2023-06</date><risdate>2023</risdate><volume>180</volume><spage>107215</spage><epage>107215</epage><pages>107215-107215</pages><artnum>107215</artnum><issn>0169-5002</issn><eissn>1872-8332</eissn><abstract>Despite notable advances made in preoperative staging, unexpected nodal metastases after surgery are still significantly detected. Given the promising role of neoadjuvant targeted treatments, the definition of novel predictive factors of nodal metastases is an extremely important issue. In this study we aim to analyze the upstaging rate in patients with early stage NSCLC without evidence of nodal disease in the preoperative staging who underwent lobectomy and radical lymphadenectomy.
Patients who underwent lobectomy and systematic lymphadenectomy for early stage LUAD without evidence of nodal disease at the preoperative staging using NGS analysis for actionable molecular targets evaluation after surgery were evaluated. Exclusion criteria included the neoadjuvant treatment, incomplete resection and no adherence to preoperative guidelines.
A total of 359 patients were included in the study. 172 patients were female, and the median age was 68 (61–72). The variables that showed a significant correlation with the upstaging rate at the univariate analysis were the ALK rearrangement, the number of resected lymph nodes and the diameter of the tumor. This result was confirmed in the multivariate analysis, with an OR of 8.052 (CI95% 3.123–20.763, p = 0.00001) for ALK rearrangement, 1.087 (CI95% 1.048–1.127, p = 0.00001) for the number of resected nodes and 1.817 (CI95% 1.214–2.719, p = 0.004) for cT status.
Our results showed that in a homogeneous cohort of patients with clinical node early stage LUAD the ALK rearrangement, the number of resected lymph nodes and the tumor diameter can significantly predict nodal metastasis.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>37126920</pmid><doi>10.1016/j.lungcan.2023.107215</doi><tpages>1</tpages></addata></record> |
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| ispartof | Lung cancer (Amsterdam, Netherlands), 2023-06, Vol.180, p.107215-107215, Article 107215 |
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| subjects | Adenocarcinoma of Lung - genetics Adenocarcinoma of Lung - pathology Adenocarcinoma of Lung - surgery Aged ALK Early stage NSCLC Female Humans Lung Neoplasms - genetics Lung Neoplasms - pathology Lung Neoplasms - surgery Lymph Node Excision - methods Lymph Nodes - pathology Lymphadenectomy Male Neoplasm Staging Nodal disease Pneumonectomy - methods Receptor Protein-Tyrosine Kinases Retrospective Studies Upstaging |
| title | ALK rearrangement is an independent predictive factor of unexpected nodal metastasis after surgery in early stage, clinical node negative lung adenocarcinoma |
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