HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hiran C. Fernando Neil A. Christie Percival O. Buenaventura James D. Luketich Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fernando, H. C. Articles by Luketich, J. D. Search for Related Content PubMed PubMed Citation Articles by Fernando, H. C. Articles by Luketich, J. D. Related Collections Lung - cancer

J Thorac Cardiovasc Surg 2004;127:87-91
© 2004 The American Association for Thoracic Surgery

General thoracic surgery

Comparison of mutational changes in involved N1 lymph nodes with those in primary tumors in stage II non–small cell lung cancer: A pilot study

^a Division of Thoracic and Foregut Surgery,University of Pittsburgh Medical Center Health System, UPMC Presbyterian, Pittsburgh, Pa, USA
^b Department of Pathology,University of Pittsburgh Medical Center Health System, UPMC Presbyterian, Pittsburgh, Pa, USA
^c Department of Dental Public Health, University of Pittsburgh Medical Center Health System, UPMC Presbyterian, Pittsburgh, Pa, USA

Read at the Eighty-second Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 5-8, 2002.

Received for publication May 10, 2002; revisions received November 30, 2002; accepted for publication February 3, 2003.

^* Address for reprints: Hiran C. Fernando, FRCS, Division Thoracic Surgery, UPMC Presbyterian, 200 Lothrop St, Suite C-800, Pittsburgh, PA 15213, USA
fernandohc{at}msx.upmc.edu

OBJECTIVES: Surgical resection is the standard treatment for stage II non–small cell lung cancer, but recurrence rates approach 60%. This study compared mutational changes in involved lymph nodes and primary tumors from patients with stage II non–small cell lung cancer to determine whether risk factors for recurrence could be identified.

METHODS: Forty patients with resected stage II non–small cell lung cancer (excluding T3 N0 disease) were studied. Microdissection was performed on primary tumors and lymph nodes. Analysis was performed across 9 genomic loci by using polymerase chain reaction amplification. The ratio of fractional allelic loss between involved lymph nodes and primary tumors was used to stratify patients into high-risk (fractional allelic loss ratio of 1) and low-risk (fractional allelic loss ratio of <1) groups.

RESULTS: The median age of the patients was 68 years (range, 42-85 years). Median follow-up was 30 months. Fractional allelic loss was greater in patients with squamous carcinomas compared with that in adenocarcinomas, but survival was similar (35 vs 39 months). The median survival was 35 months in high-risk patients and was not reached in low-risk patients (P = .3). Disease-free survival was 24 months in high-risk patients and was not reached in low-risk patients (P = .35). In the subset with adenocarcinoma (n = 18), median survival was 24 months in the high-risk group; no deaths occurred in low-risk patients (P = .01). Also, disease-free survival was 14 months in high-risk patients and was not reached in the low-risk patients (P = .05).

CONCLUSIONS: Squamous cancers demonstrate greater mutational changes than adenocarcinomas; this does not affect outcome. The patients with low-risk adenocarcinomas demonstrated superior outcomes compared with those of other patients. These results should be confirmed in larger studies.