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Cancer Med. 2019 Feb 25. doi: 10.1002/cam4.2031. [Epub ahead of print]

Comprehensive clinical profiling of the Gauting locoregional lung adenocarcinoma donors.

Klotz LV1,2,3,4,5,6, Courty Y7, Lindner M1,2,3,4,5,6, Petit-Courty A7, Stowasser A1,2, Koch I1,2, Eichhorn ME1,2,8, Lilis I9,10, Morresi-Hauf A11, Arendt KAM3,4,5,6, Pepe M3,4,5,6, Giopanou I9,10, Ntaliarda G9,10, Behrend SJ3,4,5,6, Oplopoiou M9,10, Gissot V12, Guyetant S7,13, Marchand-Adam S7,13, Behr J3,4,5,6,14,2, Kaiser JC15, Hatz RA1,2,3,4,5,6, Lamort AS3,4,5,6, Stathopoulos GT3,4,5,6,8.

Author information

1
Center for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center, Gauting, Bavaria, Germany.
2
German Center for Lung Research (DZL), Gauting, Bavaria, Germany.
3
Comprehensive Pneumology Center and Institute for Lung Biology and Disease, Munich, Bavaria, Germany.
4
University Hospital, Munich, Bavaria, Germany.
5
Ludwig-Maximilians University of Munich (LMU) and Helmholtz Center Munich, Munich, Bavaria, Germany.
6
German Center for Lung Research (DZL), Munich, Bavaria, Germany.
7
French National Institute of Health and Medical Research (INSERM) Unit 1100, Research Center for Respiratory Diseases, Faculty of Medicine, University F. Rabelais, Tours cedex, Centre, France.
8
Department of Thoracic Surgery, Ruprecht-Karls-University of Heidelberg, Heidelberg, Baden-Württemberg, Germany.
9
Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Rio, Achaia, Greece.
10
Biomedical Sciences Research Center, Rio, Achaia, Greece.
11
Department of Pathology, Asklepios Medical Center, Gauting, Bavaria, Germany.
12
INSERM, Center for Clinical Investigation (CIC) Unit 1415, Regional University Hospital Center (CHRU) Tours, Bretonneau Hospital, Tours cedex, Centre, France.
13
Regional University Hospital Center (CHRU) Tours, Department of Pathology and Tumor Biobank, Bretonneau Hospital, Tours cedex, Centre, France.
14
Department of Pneumology, Asklepios Lung Clinic Gauting, Gauting, Bavaria, Germany.
15
Institute of Radiation Protection (ISS), Helmholtz Center Munich, Neuherberg, Bavaria, Germany.

Abstract

A comprehensive characterization of lung adenocarcinoma (LADC) clinical features is currently missing. We prospectively evaluated Caucasian patients with early-stage LADC. Patients with LADC diagnosed between 2011 and 2015 were prospectively assessed for lung resection with curative intent. Fifty clinical, pathologic, radiologic, and molecular variables were recorded. Patients were followed till death/study conclusion. The main findings were compared to a separate cohort from France. Of 1943 patients evaluated, 366 were enrolled (18.8%; 181 female; 75 never-smokers; 28% of registered Bavarian cases over the study period). Smoking and obstruction were significantly more prevalent in GLAD compared with adult Bavarians (P < 0.0001). Ever-smoker tumors were preferentially localized to the upper lobes. We observed 120 relapses and 74 deaths over 704 cumulative follow-up years. Median overall and disease-free survival were >7.5 and 3.6 years, respectively. Patients aged <45 or >65 years, resected >60 days postdiagnosis, with abnormal FVC/DLCO VA , N2/N3 stage, or solid histology had significantly decreased survival estimates. These were fit into a weighted locoregional LADC death risk score that outperformed pTNM7 in predicting survival in the GLAD and in our second cohort. We define the clinical gestalt of locoregional LADC and provide a new clinical tool to predict survival, findings that may aid future management and research design.

KEYWORDS:

LADC ; lung adenocarcinoma; obstruction; smoking; survival

PMID:
30806043
DOI:
10.1002/cam4.2031
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