Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020

ObjectivesWe report the first case of hepatoid adenocarcinoma of the lung (HAL) with PIK3CA mutation. In addition, we analyzed data from HAL cases over the past 40 years to study its main treatment methods, prognosis, and the relationship between prognosis and the serum alpha-fetoprotein (AFP) level...

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Main Authors: Zan Hou, Jiaqing Xie, Li Zhang, Gangyi Dai, Yuanhang Chen, Lang He
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-08-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2021.702216/full
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author Zan Hou
Zan Hou
Jiaqing Xie
Li Zhang
Gangyi Dai
Yuanhang Chen
Lang He
author_facet Zan Hou
Zan Hou
Jiaqing Xie
Li Zhang
Gangyi Dai
Yuanhang Chen
Lang He
author_sort Zan Hou
collection DOAJ
description ObjectivesWe report the first case of hepatoid adenocarcinoma of the lung (HAL) with PIK3CA mutation. In addition, we analyzed data from HAL cases over the past 40 years to study its main treatment methods, prognosis, and the relationship between prognosis and the serum alpha-fetoprotein (AFP) level before treatment.MethodsWe report a 66-year-old male case who was diagnosed with locally advanced HAL with PIK3CA mutation and carried out a systematic literature search for HAL cases documented between 1981 and 2020. General patient information including case characteristics was extracted and summarized. The median OS (mOS) of HAL patients was determined using the KM survival curve. The Cox proportional hazards regression model was used to evaluate the effect of tumor size, location, and serum AFP value before treatment and radical surgery (RS) on the prognosis of patients.ResultsA total of 46 studies including 51 HAL patients was included in our review. Our study revealed that 52.9% of tumors were located in the upper lobe of the right lung. The proportion of serum AFP-positive patients before treatment, early-stage patients (TNM stage I and II), and patients who had received surgery were 69.2%, 34.1%, and 40%, respectively. The mOS of HAL patients was 16.0 months. The 2-year and 5-year survival rates of the patients were 35.3% and 8.0%, respectively. In the subgroup analysis, the 2-year survival rate for patients who received RS was 62.5%, while for patients who were unable to undergo RS, it was only 12.5% (p = 0.009). The Cox proportional hazards regression model indicated that RS can significantly improve the prognosis of HAL patients (p = 0.011), although the location and size of tumor as well as the serum AFP value before treatment had no significant effect on their prognosis (p = 0.82, p = 0.96, p = 0.25).ConclusionsHAL patients have a poor prognosis, and the survival benefits for patients receiving chemoradiotherapy or chemotherapy alone appear to be limited. We demonstrate statistically for the first time that pretreatment serum AFP values are not related to the prognosis of HAL patients and RS can significantly improve patient prognosis.
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spelling doaj.art-8053556d4f624386a0d8436d587b749e2022-12-21T18:40:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-08-011110.3389/fonc.2021.702216702216Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020Zan Hou0Zan Hou1Jiaqing Xie2Li Zhang3Gangyi Dai4Yuanhang Chen5Lang He6Department of Oncology, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaDepartment of Clinical Laboratory, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Pathology, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Oncology, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Oncology, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaDepartment of Oncology, The Affiliated Fifth People’s Hospital of Chengdu University of TCM, Chengdu Fifth People’s Hospital, Chengdu, ChinaObjectivesWe report the first case of hepatoid adenocarcinoma of the lung (HAL) with PIK3CA mutation. In addition, we analyzed data from HAL cases over the past 40 years to study its main treatment methods, prognosis, and the relationship between prognosis and the serum alpha-fetoprotein (AFP) level before treatment.MethodsWe report a 66-year-old male case who was diagnosed with locally advanced HAL with PIK3CA mutation and carried out a systematic literature search for HAL cases documented between 1981 and 2020. General patient information including case characteristics was extracted and summarized. The median OS (mOS) of HAL patients was determined using the KM survival curve. The Cox proportional hazards regression model was used to evaluate the effect of tumor size, location, and serum AFP value before treatment and radical surgery (RS) on the prognosis of patients.ResultsA total of 46 studies including 51 HAL patients was included in our review. Our study revealed that 52.9% of tumors were located in the upper lobe of the right lung. The proportion of serum AFP-positive patients before treatment, early-stage patients (TNM stage I and II), and patients who had received surgery were 69.2%, 34.1%, and 40%, respectively. The mOS of HAL patients was 16.0 months. The 2-year and 5-year survival rates of the patients were 35.3% and 8.0%, respectively. In the subgroup analysis, the 2-year survival rate for patients who received RS was 62.5%, while for patients who were unable to undergo RS, it was only 12.5% (p = 0.009). The Cox proportional hazards regression model indicated that RS can significantly improve the prognosis of HAL patients (p = 0.011), although the location and size of tumor as well as the serum AFP value before treatment had no significant effect on their prognosis (p = 0.82, p = 0.96, p = 0.25).ConclusionsHAL patients have a poor prognosis, and the survival benefits for patients receiving chemoradiotherapy or chemotherapy alone appear to be limited. We demonstrate statistically for the first time that pretreatment serum AFP values are not related to the prognosis of HAL patients and RS can significantly improve patient prognosis.https://www.frontiersin.org/articles/10.3389/fonc.2021.702216/fullhepatoid adenocarcinoma of the lungclinical featurestreatmentprognosiscase reportsystematic review
spellingShingle Zan Hou
Zan Hou
Jiaqing Xie
Li Zhang
Gangyi Dai
Yuanhang Chen
Lang He
Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
Frontiers in Oncology
hepatoid adenocarcinoma of the lung
clinical features
treatment
prognosis
case report
systematic review
title Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
title_full Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
title_fullStr Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
title_full_unstemmed Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
title_short Hepatoid Adenocarcinoma of the Lung: A Systematic Review of the Literature From 1981 to 2020
title_sort hepatoid adenocarcinoma of the lung a systematic review of the literature from 1981 to 2020
topic hepatoid adenocarcinoma of the lung
clinical features
treatment
prognosis
case report
systematic review
url https://www.frontiersin.org/articles/10.3389/fonc.2021.702216/full
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AT jiaqingxie hepatoidadenocarcinomaofthelungasystematicreviewoftheliteraturefrom1981to2020
AT lizhang hepatoidadenocarcinomaofthelungasystematicreviewoftheliteraturefrom1981to2020
AT gangyidai hepatoidadenocarcinomaofthelungasystematicreviewoftheliteraturefrom1981to2020
AT yuanhangchen hepatoidadenocarcinomaofthelungasystematicreviewoftheliteraturefrom1981to2020
AT langhe hepatoidadenocarcinomaofthelungasystematicreviewoftheliteraturefrom1981to2020