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Comparisons of clinicopathological findings of ALK positive and EGFR positive adenocarinoma

Date

20 Dec 2015

Session

Poster presentation 2

Presenters

Katsutoshi Seto

Citation

Annals of Oncology (2015) 26 (suppl_9): 125-147. 10.1093/annonc/mdv532

Authors

K. Seto1, H. Kuroda2, T. Yoshida3, T. Hida3, Y. Yatabe4, Y. Sakao1

Author affiliations

  • 1 Thoracic Surgery, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 2 Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya/JP
  • 3 Department Of Thoracic Oncology, Aichi Cancer Center Hospital, 464–8681 - Nagoya/JP
  • 4 Department Of Pathology And Molecular Diagnosis, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
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Aim/Background

Genetic mutations such as EGFR, ALK are key mutation in the patients of NSCLC. The ratio of lymph node metastasis of ALK positive patients is said to be higher than other mutations.Genetic mutations such as EGFR, ALK are key mutation in the patients of NSCLC. The ratio of lymph node metastasis of ALK positive patients is said to be higher than other mutations.

Methods

All of 648 patients in Aichi Cancer Center Hospital underwent lung resection with lymph node dissection between January 2012 to July 2015 for primary lung adenocarcinoma, among which 19 patients with ALK mutation and 237 patients with EGFR (L858R or Exon19 del.) mutation enrolled in this study. The clinicopathological characteristics (gender, age, smoking history, tumor size, SUV max of tumor, FDG accumulation of lymph nodes, preoperative CEA, pathological lymph node metastasis) were compared between the two groups.

Results

In pN1-2, all (8/8, 100%) patients harboring ALK were diagnosed as cN0 by preoperative PET evaluation, whereas 32.1% (18/56) patients harboring EGFR were diagnosed as cN0. In the patients with pN1-2 showing no FDG accumulation on PET for lymph node, the maximum tumor size (MTS) and mediastinal size on CT tended to be smaller in ALK (mean 29.1 and 29.0 mm) than EGFR (34.0 and 31.2 mm), and the proportion of solid component (consolidation/MTS) was also larger in ALK (8/8, 100%) than EGFR (30/38, 78.9%), but the significant differences were not obtained respectively (p = 0.27, p = 0.50 and p = 0.37). No significant differences were observed for smoking index (p = 0.40) and preoperative CEA (p = 0.66), but patients harboring ALK were younger than those of EGFR (p < 0.01).

Conclusions

Detection of preoperative lymph node metastasis for ALK harboring patients tended to be difficult. Further studies in genetic mutations for NSCLC are needed.

Clinical trial identification

Disclosure

All authors have declared no conflicts of interest.

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