EGFR mutations and tumor metastases in patients with nonsmall cell lung cancer in the South of Russia.

PURPOSE: To assess the frequencies of somatic EGFR mutations in the tumor tissues of patients with non-small cell lung cancer (NSCLC) residing in the South of Russia (SR), and to define the relationship between genetic subtypes of NSCLC and the emergence of different types of metastases. METHODS: DNA was extracted from formalin-fixed parrafin embedded (FFPE) samples of 721 patients. A total of 29 somatic EGFR mutations were detected using commercial Therascreen EGFR RGQ PCR Kit. RESULTS: EGFR mutations were significantly more frequent in females and non-smokers even when considering the combination of both factors. The frequency of activating EGFR mutations across three age groups (<51, 51-61, >61 years) of women with NSCLC was significantly different (x2=10.94, p=0.004) and became higher with increasing age. Both activating and resistance mutations of EGFR were not associated with the frequency of regional or distant metastases. The frequencies of both regional and distant metastases were associated with higher disease stage (odds ratio/OR)=16.71; 95% confidence interval (CI): 9.5-29.38; p<0.0001, and OR=2.94; 95% CI: 2.22-3.88; p<0.0001, respectively) and adenocarcinona histology (OR=6.52; 95% CI: 2.03-20.92; p=0.002, and OR=1.99; 95% CI: 0.91-4.34; p=0.083, respectively) even when adjusted for age, gender, and smoking status. The risk for regional metastases development was associated with poor tumor differentiation (OR=2.91; 95% CI: 1.21-7.02; p=0.017). CONCLUSION: EGFR mutations were not associated with the frequency of regional or distant metastases in SR patients with NSCLC.

Surgical treatments for esophageal cancers.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy.