Work

Pathologic nodal metastasis assessment using tumour‐derived molecular features in patients with lung adenocarcinoma

Year: 2024

Type: article

Abstract: Pathologic nodal metastasis assessment using tumour-derived molecular features in patients with lung adenocarcinomaDear Editor, Through whole-exome sequencing (WES), we identified genomic features that correlated with pathologic lymph node metastasis (pN) and poor patient prognosis in baseline tumour tissues from lung adenocarcinoma (LUAD) patients.Our study offers valuable insights into genomic traits with increased risk of lymph node metastasis that might be utilized for a more accurate pN assessment thereby optimizing treatment decision-making.Tumour size and nodal staging status constitute the two fundamental elements of the tumour-node-metastasis (TNM) staging system.Clinical assessment of mediastinal and hilar lymph node involvement primarily leans on standard imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT).1 Meanwhile, invasive staging approaches, such as endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), have demonstrated superior diagnostic effectiveness than PET-CT. 2 However, considerable differences in the assessment of metastatic lymph nodes between preoperative and postoperative samples were found.3,4 Besides, while larger tumours are generally considered more closely associated with nodal metastasis in solid tumours, recent studies have shown that small adenocarcinoma tumours tend to present with lymph node metastasis.5,6 Given the unknown risk of lymph node metastasis even with small tumours, accurate pathologic determination of nodal metastasis is of great clinical importance for optimal treatment decision-making, for example, deciding the appropriate extent of lymphadenectomy for early-stage non-small cell lung cancer (NSCLC) and whether adjuvant therapy should be applied.In this study, tumour specimens were obtained from 72 untreated LUAD patients in the curative-intent surgery and subjected to a thorough pathologic determination of nodal status.Patients were categorized based on their pN

Source: Clinical and Translational Medicine

DOI: 10.1002/ctm2.1638