한빛사논문
- 조회317
Jae Kwang Yun1, Sugyeong Kim2, Hongyul An2, Geun Dong Lee1, Hyeong Ryul Kim1, Yong‑Hee Kim1, Dong Kwan Kim1, Seung‑Il Park1, Sehoon Choi1*† and Youngil Koh2,3*†
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, 88, Olympic‑Ro 43‑Gil, Songpa‑Gu, Seoul, Republic of Korea
2Genome Opinion Inc., Sungsu SKV1 Center, 1‑721, 48, Achasan‑Ro 17‑Gil, Seongdong‑Gu, Seoul, Republic of Korea
3Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak‑Ro, Jongno‑Gu, Seoul, Republic of Korea
†Sehoon Choi and Youngil Koh contributed equally to this work.
*Correspondence: Sehoon Choi, Youngil Koh
Abstract
Background: Clonal hematopoiesis (CH) frequently progresses after chemotherapy or radiotherapy. We evaluated the clinical impact of preoperative CH on the survival outcomes of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection followed by adjuvant therapy.
Methods: A total of 415 consecutive patients with NSCLC who underwent surgery followed by adjuvant therapy from 2011 to 2017 were analyzed. CH status was evaluated using targeted deep sequencing of blood samples collected before surgery. To minimize the possible selection bias between the two groups according to CH status, a propensity score matching (PSM) was adopted. Early-stage patients were further analyzed with additional matched cohort of patients who did not receive adjuvant therapy.
Results: CH was detected in 21% (86/415) of patients with NSCLC before adjuvant therapy. Patients with CH mutations had worse overall survival (OS) than those without (hazard ratio [95% confidence interval] = 1.56 [1.07-2.28], p = 0.020), which remained significant after the multivariable analysis (1.58 [1.08-2.32], p = 0.019). Of note, the presence of CH was associated with non-cancer mortality (p = 0.042) and mortality of unknown origin (p = 0.018). In patients with stage IIB NSCLC, there was a significant interaction on OS between CH and adjuvant therapy after the adjustment with several cofactors through the multivariable analysis (HR 1.19, 95% CI 1.00-1.1.41, p = 0.041).
Conclusions: In resected NSCLC, existence of preoperative CH might amplify CH-related adverse outcomes through adjuvant treatments, resulting in poor survival results.
논문정보
- Research article
- 2023년 12월 (BRIC 등록일 2023-12-15)
- 국내 연구진
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