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J. Clin. Med. 2019, 8(4), 529; https://doi.org/10.3390/jcm8040529

EGFR and KRAS Mutations in the Non-Tumoral Lung. Prognosis in Patients with Adenocarcinoma

1
Respiratory Medicine Department, Hospital del Mar, 08003 Barcelona, Spain
2
IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
3
School of Health & Life Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
4
CIBER de Enfermedades Respiratorias (CibeRes), Instituto de Salud Carlos III, 28029 Madrid, Spain
5
Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain
6
Universitat Autònoma de Barcelona, 08003 Barcelona, Spain
7
Department of Oncology, Hospital del Mar, 08003 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Received: 7 March 2019 / Revised: 5 April 2019 / Accepted: 14 April 2019 / Published: 17 April 2019
(This article belongs to the Section Pulmonology)
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Abstract

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. Objective: 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. Methods: 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. Results: 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. Conclusions: These results confirm that genetic changes are present in the apparently normal lung in many ADC patients, and this finding has prognostic implications. View Full-Text
Keywords: Adenocarcinoma; Mutations; EGFR; KRAS; Prognosis Adenocarcinoma; Mutations; EGFR; KRAS; Prognosis
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Chalela, R.; Bellosillo, B.; Curull, V.; Longarón, R.; Pascual-Guardia, S.; Badenes-Bonet, D.; Arriola, E.; Sánchez-Font, A.; Pijuan, L.; Gea, J. EGFR and KRAS Mutations in the Non-Tumoral Lung. Prognosis in Patients with Adenocarcinoma. J. Clin. Med. 2019, 8, 529.

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