Article

Prognostic significance of K-ras codon 12 mutations in patients with resected stage I and II non-small-cell lung cancer.

Department of Medicine, State University of New York Health Science Center and Veterans Affairs Medical Center, Syracuse 13210, USA.
Journal of Clinical Oncology (impact factor: 18.37). 03/1999; 17(2):668-75. pp.668-75
Source: PubMed

ABSTRACT The aim of this study was to investigate the prognostic importance of codon 12 K-ras mutations in patients with early-stage non-small-cell lung cancer (NSCLC).
We identified 260 patients with surgically resected stage I (n = 193) and stage II (n = 67) NSCLC with at least a 5-year follow-up. We performed polymerase chain reaction analysis of DNA obtained from paraffin-embedded NSCLC tissue, using mutation-specific probes for codon 12 K-ras.
K-ras mutations were detected in 35 of 213 assessable specimens (16.4%). K-ras mutations were detected in 27 of 93 adenocarcinomas (29.0%), one of 61 squamous cell carcinomas (1.6%), five of 39 large-cell carcinomas (12.8%), and two of 20 adenosquamous carcinomas (10%) (P = .001). G to T transversions accounted for 71% of the mutations. There was no statistically significant difference in overall survival for all patients with K-ras mutations (median survival, 39 months) compared with patients without K-ras mutations (median survival, 53 months; P = .33). There was no statistically significant difference in overall or disease-free survival for subgroups with stage I disease, adenocarcinoma, or non-squamous cell carcinoma or for specific amino acid substitutions. The median survival time for stage II patients with K-ras mutations was 13 months, compared with 38 months for patients without K-ras mutations (P = .03).
Codon 12 K-ras mutations were more common in adenocarcinomas than in squamous cell carcinomas. For the subgroup with stage II NSCLC, there was a statistically significant adverse effect on survival for the presence of K-ras mutations. However, when the entire group was considered, the presence of K-ras mutations was not of prognostic significance in this cohort of patients with resected early-stage NSCLC.

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Keywords

38 months
 
39 large-cell carcinomas
 
39 months
 
5-year follow-up
 
53 months
 
codon 12 K-ras
 
Codon 12 K-ras mutations
 
disease-free survival
 
early-stage non-small-cell lung cancer
 
entire group
 
median survival
 
median survival time
 
non-squamous cell carcinoma
 
paraffin-embedded NSCLC tissue
 
polymerase chain reaction analysis
 
resected early-stage NSCLC
 
statistically significant adverse effect
 
statistically significant difference
 
surgically resected stage
 
T transversions
 

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