Preoperative clinical and tumor genomic features associated with pathologic lymph node metastasis in clinical stage I and II lung adenocarcinoma

Bibliographic Details
Title: Preoperative clinical and tumor genomic features associated with pathologic lymph node metastasis in clinical stage I and II lung adenocarcinoma
Authors: Raul Caso, James G. Connolly, Jian Zhou, Kay See Tan, James J. Choi, Gregory D. Jones, Brooke Mastrogiacomo, Francisco Sanchez-Vega, Bastien Nguyen, Gaetano Rocco, Daniela Molena, Smita Sihag, Prasad S. Adusumilli, Matthew J. Bott, David R. Jones
Source: npj Precision Oncology, Vol 5, Iss 1, Pp 1-8 (2021)
Publisher Information: Nature Portfolio, 2021.
Publication Year: 2021
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract While next-generation sequencing (NGS) is used to guide therapy in patients with metastatic lung adenocarcinoma (LUAD), use of NGS to determine pathologic LN metastasis prior to surgery has not been assessed. To bridge this knowledge gap, we performed NGS using MSK-IMPACT in 426 treatment-naive patients with clinical N2-negative LUAD. A multivariable logistic regression model that considered preoperative clinical and genomic variables was constructed. Most patients had cN0 disease (85%) with pN0, pN1, and pN2 rates of 80%, 11%, and 9%, respectively. Genes altered at higher rates in pN-positive than in pN-negative tumors were STK11 (p = 0.024), SMARCA4 (p = 0.006), and SMAD4 (p = 0.011). Fraction of genome altered (p = 0.037), copy number amplifications (p = 0.001), and whole-genome doubling (p = 0.028) were higher in pN-positive tumors. Multivariable analysis revealed solid tumor morphology, tumor SUVmax, clinical stage, SMARCA4 and SMAD4 alterations were independently associated with pathologic LN metastasis. Incorporation of clinical and tumor genomic features can identify patients at risk of pathologic LN metastasis; this may guide therapy decisions before surgical resection.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2397-768X
Relation: https://doaj.org/toc/2397-768X
DOI: 10.1038/s41698-021-00210-2
Access URL: https://doaj.org/article/20e2c3f365ef4a4b89f96ace034d68c1
Accession Number: edsdoj.20e2c3f365ef4a4b89f96ace034d68c1
Database: Directory of Open Access Journals
More Details
ISSN:2397768X
DOI:10.1038/s41698-021-00210-2
Published in:npj Precision Oncology
Language:English