Mutations In Margins Predict Lung Cancer Recurrence

NEW YORK (Reuters Health) - A new test reliably identifies lung cancer patients who are at risk of recurrence after sublobar resection, Johns Hopkins researchers report in the March 1st issue of the International Journal of Cancer.

Sublobar resection, they note, is associated with high local recurrence rates despite tumor-free parenchymal margins. The mechanisms are not well understood.

However, using a fluorescence-based assay to detect k-ras mutations in apparently tumor-free margins sensitively and specifically identified patients whose tumors recurred locally, Dr. Joseph Califano of Johns Hopkins Medical Institutions, Baltimore and colleagues observe.

The researchers looked at 44 patients who underwent sublobar resection for lung cancer, 13 of whom were found to have the k-ras mutation. Margins were tested for the k-ras mutation using fluorescent gap ligase chain reaction.

Nine of the patients had a 1/5,000 or greater ratio of mutant to wild type cells in one or more margins, and 67% of these patients had local recurrence. None of the patients with no detectable mutant DNA in their margins had local recurrence.

The findings demonstrate that local recurrence after sublobar resection could be reduced by extending surgical margins or adding adjuvant treatment, such as brachytherapy, say the investigators. Sublobar resection, they add, could be used more frequently among patients determined by the test to be at a lower risk of recurrence.

Source: Int J Cancer 2005;133:1022-1025. [ Google search on this article ]

MeSH Headings: Cytological Techniques : Genetic Techniques : Health Occupations : Lung Neoplasms : Investigative Techniques : Neoplasm Recurrence, Local : Neoplasms : Neoplasms by Site : Neoplastic Processes : Respiratory Tract Neoplasms : Technology : Technology, Industry, and Agriculture : Technology, Medical : Thoracic Neoplasms : Allied Health Occupations : Cytogenetic Analysis : Analytical, Diagnostic and Therapeutic Techniques and Equipment : Biological Sciences : Diseases : Technology, Food and Beverages

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