Clinicopathological Features and Survival Outcomes of Primary Pulmonary Invasive Mucinous Adenocarcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Mutation Analyses
2.3. Histologic Grade
2.4. Statistical Analyses
3. Results
3.1. Clinical Characteristics of Patients with Invasive Mucinous Adenocarcinoma (IMA) and Non-IMA-Type Adenocarcinoma
3.2. Mutation Analyses of IMAs
3.3. Recurrence-Free Survival and Overall Survival in Patients with Stage I–IIIA IMA
3.4. Clinical Application of Two-Tier IMA Grading System for Survival Outcomes in Patients with Stage I-IIIA IMA
3.5. Overall Survival in Different Stages of Patients with IMA Compared to Patients with Non-IMA-Type ADC
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinical Characteristic | IMA | Non-IMA-Type ADC | p-Value # |
---|---|---|---|
Patients, n | 77 | 520 | |
Age, years | 0.087 | ||
Median (range) | 62.2 (35–90) | 64.4 (32–90) | |
≥65, n (%) | 29 (38) | 252 (49) | |
Sex, n (%) | 0.063 | ||
M | 24 (31) | 223 (43) | |
F | 53 (69) | 297 (57) | |
Smokers, n (%) | 0.010 * | ||
Current/ever | 12 (16) | 159 (31) | |
Never | 65 (84) | 361 (69) | |
ECOG PS score, n (%) | 0.263 | ||
0−1 | 71 (92) | 453 (87) | |
2−4 | 6 (8) | 67 (13) | |
Stage, n (%) | <0.001 * | ||
I | 53 (69) | 162 (31) | |
II | 7 (9) | 29 (6) | |
IIIA | 8 (10) | 59 (11) | |
IIIB | 0 (0) | 30 (6) | |
IV | 9 (12) | 240 (46) | |
Early/Advanced stage | <0.001 * | ||
I-IIIA | 68 (88) | 250 (48) | |
IIIB-IV | 9 (12) | 270 (52) | |
History of other primary malignancies, n (%) | 1.000 | ||
Only lung cancer | 68 (88) | 461 (89) | |
Other cancers | 9 (12) | 59 (11) |
Driver Mutation | No. of Sample Tested/Not Tested | Mutation Rate, % (No. of Mutation/Tested) | Aminoa Acid Mutation (n) |
---|---|---|---|
KRAS mutation | 28/49 | 43 (12/28) | G12A (2), G12C (3), G12D (6), G12V (1) |
HER2 TMD mutation | 14/63 | 7 (1/14) | V659E (1) |
CD74-NRG1 fusion | 17/60 | 6 (1/17) | |
ALK fusion | 34/43 | 6 (2/34) | |
ROS1 fusion | 22/55 | 5 (1/22) | |
EGFR KD mutation | 47/30 | 4 (2/47) | delE746-A750 (1), M825L (1) |
HER2 KD | 27/50 | 0 (0/27) | |
BRAF V600E | 25/52 | 0 (0/25) | |
RET fusion | 17/60 | 0 (0/17) | |
MET exon 14 skipping | 17/60 | 0 (0/17) | |
SLC3A2-NRG1 fusion | 18/59 | 0 (0/18) | |
VAMP2-NRG1 fusion | 18/59 | 0 (0/18) |
Recurrence-Free Survival | Overall Survival | |||||
---|---|---|---|---|---|---|
Factor | Univariate | Multivariate # | Univariate | |||
HR (95% CI) | p-Value | HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Age, years | 0.074 | |||||
<65 (n = 44) | 1 | 1 | ||||
≥65 (n = 24) | 0.63 (0.19–2.01) | 0.436 | 3.71 (0.88–15.62) | |||
Sex | 0.517 | |||||
Male (n = 22) | 1 | 1 | ||||
Female (n = 46) | 0.39 (0.19–1.91) | 0.392 | 0.62 (0.15–2.62) | |||
Smokers | 0.254 | |||||
Current/ever (n = 10) | 1 | 1 | ||||
Never (n = 58) | 0.51 (0.07–3.98) | 0.523 | 2.60 (0.50–12.43) | |||
History of other primary | 0.024 * | |||||
malignancies | ||||||
Only lung (n = 59) | 1 | 1 | ||||
Other cancers (n = 9) | 1.47 (0.32–6.81) | 0.622 | 6.34 (1.28–31.5) | |||
Driver mutation | 0.870 | |||||
Undetected (n = 15) | 1 | 1 | ||||
Yes (n = 53) | 1.69 (0.51–5.63) | 0.391 | 1.15 (0.22–5.95) | |||
Satellite nodules/ skipping | 0.642 | |||||
lesions | ||||||
No (n = 27) | 1 | 1 | 1 | |||
Yes (n = 30) | 3.08 (0.62–15.26) | 0.169 | 2.62 (0.49–13.7) | 0.255 | 1.53 (0.25–9.18) | |
Spread through air spaces | 0.422 | |||||
(STAS) | ||||||
No (n = 31) | 1 | 1 | 1 | |||
Yes (n = 26) | 5.28 (1.02–27.22) | 0.047 * | 2.12 (0.28–18.9) | 0.503 | 2.09 (0.35–12.53) | |
Tumor necrosis | 0.624 | |||||
No (n = 55) | 1 | 1 | 1 | |||
Yes (n = 6) | 2.19 (0.46–10.43) | 0.324 | 2.27(0.36–14.2) | 0.381 | 1.71 (0.20–14.66) | |
IMA-2 grade | 0.487 | |||||
Low (IMA-G1) (n = 48) | 1 | 1 | 1 | |||
High (IMA-G2) (n = 13) | 2.12 (1.14–3.94) | 0.018 * | 2.66 (1.30–5.47) | 0.008 * | 1.35 (0.58–3.16) |
Clinical Characteristic | Low Grade (IMA-G1) | High Grade (IMA-G2) | p-Value # |
---|---|---|---|
Patients, n | 48 | 13 | |
Age, years | 1.000 | ||
<65 | 31 (65) | 8 (62) | |
≥ 65, n (%) | 17 (35) | 5 (38) | |
Sex, n (%) | 0.063 | ||
M | 17 (35) | 3 (23) | |
F | 31 (65) | 10 (77) | |
Smokers, n (%) | 1.000 | ||
Current/ever | 7 (15) | 1 (8) | |
Never | 41 (85) | 12 (92) | |
ECOG PS score, n (%) | 1.000 | ||
0−1 | 46 (95) | 12 (92) | |
2−4 | 2 (5) | 1 (8) | |
Stage, n (%) | 0.020 * | ||
I | 41 (85) | 7 (54) | |
II | 4 (8) | 2 (15) | |
IIIA | 3 (6) | 4 (30) | |
History of other primary malignancies, n (%) | 0.350 | ||
Only lung cancer | 43 (90) | 10 (77) | |
Other cancers | 5 (10) | 3 (23) | |
Driver mutations, n (%) | 0.200 | ||
KRAS | 8 (17) | 2 (15) | |
Others | 1 (2) | 2 (15) | |
No | 39 (81) | 9 (70) |
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Gow, C.-H.; Hsieh, M.-S.; Liu, Y.-N.; Lee, Y.-H.; Shih, J.-Y. Clinicopathological Features and Survival Outcomes of Primary Pulmonary Invasive Mucinous Adenocarcinoma. Cancers 2021, 13, 4103. https://doi.org/10.3390/cancers13164103
Gow C-H, Hsieh M-S, Liu Y-N, Lee Y-H, Shih J-Y. Clinicopathological Features and Survival Outcomes of Primary Pulmonary Invasive Mucinous Adenocarcinoma. Cancers. 2021; 13(16):4103. https://doi.org/10.3390/cancers13164103
Chicago/Turabian StyleGow, Chien-Hung, Min-Shu Hsieh, Yi-Nan Liu, Yi-Hsuan Lee, and Jin-Yuan Shih. 2021. "Clinicopathological Features and Survival Outcomes of Primary Pulmonary Invasive Mucinous Adenocarcinoma" Cancers 13, no. 16: 4103. https://doi.org/10.3390/cancers13164103