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Comment
. 2016 Dec;8(12):E1734-E1738.
doi: 10.21037/jtd.2016.12.06.

Clinical implications of genetic heterogeneity in multifocal pulmonary adenocarcinomas

Tawee Tanvetyanon  1 , Theresa A Boyle  1
Affiliations
Comment

Clinical implications of genetic heterogeneity in multifocal pulmonary adenocarcinomas

Tawee Tanvetyanon et al. J Thorac Dis. 2016 Dec.

Abstract

Multifocal pulmonary adenocarcinomas are increasingly encountered in clinical practice, in part due to the increased availability and improvement in the thoracic imaging. Recognized as a distinct entity in the upcoming 8th edition of American Joint Commission on Cancer (AJCC) staging system, multifocal adenocarcinomas exhibit several unique features such as the characteristic appearance of multiple ground glass opacities or nodules in computerized tomography (CT). Recent studies have suggested that the vast majority of these malignant lesions are genetically independent even when occurring synchronously in a single patient. For instance, the pattern of epidermal growth factor receptor (EGFR) mutations in multifocal pulmonary adenocarcinomas can vary from one lesion to another. This observation has several important clinical implications. These include the potential need to perform multiple molecular tests on multiple lesions, the possible role of molecular marker such as EGFR mutation in the staging of questionable multiple lung cancers, and the justification for empirical use EGFR inhibitors for multifocal adenocarcinomas among high-prevalence population when no known mutation has been detected.

Keywords: Non-small cell lung carcinoma; epidermal growth factor receptor (EGFR); multiple primary neoplasm.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Comment on

References

    1. Vazquez M, Carter D, Brambilla E, et al. Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: histopathologic features and their prognostic implications. Lung Cancer 2009;64:148-54. 10.1016/j.lungcan.2008.08.009 - DOI - PMC - PubMed
    1. Garfield DH, Cadranel JL, Wislez M, et al. The bronchioloalveolar carcinoma and peripheral adenocarcinoma spectrum of diseases. J Thorac Oncol 2006;1:344-59. 10.1016/S1556-0864(15)31593-8 - DOI - PubMed
    1. Dumont P, Gasser B, Rougé C, et al. Bronchoalveolar carcinoma: histopathologic study of evolution in a series of 105 surgically treated patients. Chest 1998;113:391-5. 10.1378/chest.113.2.391 - DOI - PubMed
    1. Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 2011;6:244-85. 10.1097/JTO.0b013e318206a221 - DOI - PMC - PubMed
    1. Detterbeck FC, Marom EM, Arenberg DA, et al. The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Application of TNM Staging Rules to Lung Cancer Presenting as Multiple Nodules with Ground Glass or Lepidic Features or a Pneumonic Type of Involvement in the Forthcoming Eighth Edition of the TNM Classification. J Thorac Oncol 2016;11:666-80. - PubMed