Bronchial pulmonary carcinoma: molecular and clinical characterization: histology, mutations, staging, therapeutics and survival

Abstract

OBJECTIVE: Clinical characterization and therapeutic follow-up after histological typing and molecular pathology of Bronchial-Pulmonary Carcinoma MATERIAL AND METHODS: This retrospective study is supported by information collected from a 2011-2013 data basis provided by Instituto de Anatomia Patológica e Patologia Molecular of Faculty of Medicine of Coimbra, concerning histological typing and EGFR, KRAS and ALK mutation status in biopsies, and subsequent follow up of patients, treated at University Hospital of Coimbra, Instituto Português de Oncologia of Coimbra and Hospital of Guarda. RESULTS: Data corresponds to 56 patients with bronchial-pulmonary carcinoma, most (64.3%) of whom were male. Adenocarcinoma was the most common histological type (66.1%), followed by pleomorphic (8.9%), epidermoid (7.1%), adenosquamous (7.1%), large cell (5.4%), sarcomatoid (3.6%) and mucoepidermoid (1.8%) carcinomas. In men, the most common histological type was adenocarcinoma (66.7%), as well as in women (65%). The mean age at diagnosis was 66 years old. About 62.5% had prior history of smoking. 64.3% presented stage IV at diagnosis, 14.3 % IIIB, 7.1 % IIIA and the remaining 14.3% was classified as stage I or II. In 29 cases patients showed mutated epidermal growth factor receptor, comparing with 27 biopsies wild type. About 39.3% received tyrosine kinase inhibitors and 32.1% were treated with chemotherapy combined with radiotherapy. CONCLUSIONS: The study showed higher incidence of bronchial pulmonary carcinoma in men. Adenocarcinoma was the most frequent histological type either in men and women. Smoking habit was prevalent. The majority of patients with mutated status for epidermal growth factor receptor received tyrosine kinase inhibitors (19). For patients wild type, conventional chemotherapy was applied in most cases (19) .The overall survival for patients carrying mutated epidermal growth factor receptor is higher, comparing with the ones wild type, and this result has statistical significance. Radiotherapy was used in association with chemotherapy or alone in palliative therapeutic measures. Most patients presented advanced stages at diagnosis and so curative options were applied only in few cases (11).