Tumor Necrosis Serves As A Prognostic Predictor In Operable And Stage I Lung Adenocarcinoma

Background A relatively high proportion of stage I lung adenocarcinoma patients suffer from disease relapse after surgical resection. This highlights an unmet need in clinical risk assessment for this patient group. Several previous studies suggested adopting the feature tumor necrosis as a risk stratification parameter, but consensus has not been reached. Here we evaluated whether gene signatures that represented three biological processes, cell proliferation, tissue hypoxia and nutrient supplement, underlying their pathological sum tumor necrosis, supported the assumption that necrosis is a prognostic predictor. Methods and Results The three selected gene signatures, cell-cycle, hypoxia and mTOR, were revealed to have higher signature activities in necrosis-positive lung adenocarcinoma tissues than in necrosis-negative ones. This phenomenon was observed in a Japanese dataset and was verified in The Cancer Genome Atlas lung adenocarcinoma dataset. In these two datasets, both the feature tumor necrosis and the signatures were shown to stratify operable and/or stage I lung adenocarcinoma patients into different risk groups. We further validated this observation in a 130 surgically resected lung adenocarcinoma patient cohort. The results showed that tumor necrosis predicted shorter overall and relapse-free survival in patients with operable (P Conclusions Our study showed that tumor necrosis served as a prognostic predictor in operable and stage I lung adenocarcinomas. The findings supported the results from previous pure pathological studies. Citation Format: Pei-Ying Lin, Tzu-Hung Hsiao, Pan-Chyr Yang. Tumor necrosis serves as a prognostic predictor in operable and stage I lung adenocarcinoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5030.