Hong Tao¹, Zhe Liu², Yiran Cai², Liang Shi², Junfang Tang²

¹Department of Oncology, Beijing Chest Hospital, Capital Medical University, ²Capital Medical University, Beijing Chest Hospital

Objective:Along with the research progress of lung cancer-related driver genes, echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinas (EML4-ALK) positive non-small cell lung cancer (NSCLC), which is a distinctive molecular subtype, has been concerned. In this study weevaluated the clinical features of EML4-ALK positive and postoperative lung adenocarcinoma patients. The characteristic of distant metastasis and survival informations were also be analysed. Method: Clinical data of 40 patients with EML4-ALKpositive, postsurgical lung adenocarcinoma patients were retrospectively analyzed. We observed the organs of distant metastasis, analysed the relationship between clinical characteristics and disease free survival (DFS), overall survival (OS). Result: EML4-ALK positive patients are relative young, most of them are never-smokers, with peripheral type tumor. The tumors were either moderately differentiated or poorly differentiated. Well differentiated lung cancer have not been found. The most common organ of distant metastasis was brain. The median time from operation to brain metastasis was 17.2 months. The median post brain metastasis OS was 9.4 months. The DFS of earlier stage, peripheral type, without lymph node metastasis and with adjuvant treatment patients were significant longer than those of later stage (30.3months vs.12.8months, P=0.015), center type (27.4months vs. 7.3months, P=0.000), with lymph node metastasis (30.0months vs. 12.8months, P=0.026) and without adjuvant treatment (17.4months vs.1.4months, P=0.000) patients. Earlier stage, peripheral type and with adjuvant treatment patients obtained longer OS than later stage, center type andwithout adjuvant treatment counterparts (respectively 55.5months vs. 26.2months, P=0.021; 39.2months vs. 20.9months, P=0.003; 33.4months vs. 8.9months, P=0.006). Conclusion: EML4-ALK positive, postoperative lung adenocarcinoma patients patientshave distinctive clinical characteristics. The most common location of extrapulmonary metastasis was brain. DFS was associated with TNM stage, tumor location, lymphnode metastasis and adjuvant therapy. OS was related to TNM stage, tumorlocation and adjuvant therapy.

Key Words: ALK positive  Lung cancer  Postoperative