Prognostic impact and distinctive characteristics of surgically resected anaplastic lymphoma kinase-rearranged lung adenocarcinoma
Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: Anaplastic lymphoma kinase (ALK) rearrangement is a representative lung cancer with driver mutation because of the efficacy of ALK-tyrosine kinase inhibitors. ALK-tyrosine kinase inhibitors are extensively used for ALK-rearranged lung cancer, whereas the therapeutic benefit of surgery remains unclear. Thus, we aimed to assess the clinical benefit of surgery in ALK-rearranged lung cancer and to elucidate the oncologic characteristics of ALK-rearranged lung cancer through surgically resected cases.
METHODS: We retrospectively evaluated 1925 lung adenocarcinoma cases surgically resected between 1996 and 2017 at our institute. Moreover, 75 ALK-rearranged and 75 non-ALK-rearranged cases were extracted using propensity score matching. The survival rates, prognostic factors, and post-recurrence state were assessed.
RESULTS: Multivariable analysis revealed that ALK rearrangement was an independent prognostic factor for improved cancer-specific survival (hazard ratio, 0.2; 95% confidence interval, 0.05-0.88; P = .033). In the matched cohort, the 5-year cancer-specific survival rates after surgery in the ALK-rearranged and non-ALK-rearranged groups were 97% and 77%, respectively. The ALK-rearranged group had a significantly better cancer-specific survival than did the non-ALK-rearranged group (log-rank test; P = .003). With respect to post-recurrence state, oligo-recurrence was highly frequent in the ALK-rearranged group, and post-recurrence survival was significantly improved by administration of either ALK-tyrosine kinase inhibitors (log-rank test; P = .011) or local ablative therapies (log-rank test; P = .035).
CONCLUSIONS: Surgically resected ALK-rearranged lung adenocarcinoma has excellent long-term outcome. Not only ALK-tyrosine kinase inhibitors but also a combination of local and systemic therapies may be important treatment strategies for ALK-rearranged lung adenocarcinoma even in the post-recurrence state.
| Errataetall: |
CommentIn: J Thorac Cardiovasc Surg. 2022 Feb;163(2):452-453. - PMID 33162170 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:163 |
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| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 163(2022), 2 vom: 15. Feb., Seite 441-451.e1 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Matsuura, Yosuke [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 31.01.2022 Date Revised 31.01.2022 published: Print-Electronic CommentIn: J Thorac Cardiovasc Surg. 2022 Feb;163(2):452-453. - PMID 33162170 Citation Status MEDLINE |
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| doi: |
10.1016/j.jtcvs.2020.09.120 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31700302X |
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| 100 | 1 | |a Matsuura, Yosuke |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic impact and distinctive characteristics of surgically resected anaplastic lymphoma kinase-rearranged lung adenocarcinoma |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 31.01.2022 | ||
| 500 | |a Date Revised 31.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Thorac Cardiovasc Surg. 2022 Feb;163(2):452-453. - PMID 33162170 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Anaplastic lymphoma kinase (ALK) rearrangement is a representative lung cancer with driver mutation because of the efficacy of ALK-tyrosine kinase inhibitors. ALK-tyrosine kinase inhibitors are extensively used for ALK-rearranged lung cancer, whereas the therapeutic benefit of surgery remains unclear. Thus, we aimed to assess the clinical benefit of surgery in ALK-rearranged lung cancer and to elucidate the oncologic characteristics of ALK-rearranged lung cancer through surgically resected cases | ||
| 520 | |a METHODS: We retrospectively evaluated 1925 lung adenocarcinoma cases surgically resected between 1996 and 2017 at our institute. Moreover, 75 ALK-rearranged and 75 non-ALK-rearranged cases were extracted using propensity score matching. The survival rates, prognostic factors, and post-recurrence state were assessed | ||
| 520 | |a RESULTS: Multivariable analysis revealed that ALK rearrangement was an independent prognostic factor for improved cancer-specific survival (hazard ratio, 0.2; 95% confidence interval, 0.05-0.88; P = .033). In the matched cohort, the 5-year cancer-specific survival rates after surgery in the ALK-rearranged and non-ALK-rearranged groups were 97% and 77%, respectively. The ALK-rearranged group had a significantly better cancer-specific survival than did the non-ALK-rearranged group (log-rank test; P = .003). With respect to post-recurrence state, oligo-recurrence was highly frequent in the ALK-rearranged group, and post-recurrence survival was significantly improved by administration of either ALK-tyrosine kinase inhibitors (log-rank test; P = .011) or local ablative therapies (log-rank test; P = .035) | ||
| 520 | |a CONCLUSIONS: Surgically resected ALK-rearranged lung adenocarcinoma has excellent long-term outcome. Not only ALK-tyrosine kinase inhibitors but also a combination of local and systemic therapies may be important treatment strategies for ALK-rearranged lung adenocarcinoma even in the post-recurrence state | ||
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| 650 | 7 | |a Anaplastic Lymphoma Kinase |2 NLM | |
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| 700 | 1 | |a Ichinose, Junji |e verfasserin |4 aut | |
| 700 | 1 | |a Nakao, Masayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Okumura, Sakae |e verfasserin |4 aut | |
| 700 | 1 | |a Nishio, Makoto |e verfasserin |4 aut | |
| 700 | 1 | |a Mun, Mingyon |e verfasserin |4 aut | |
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