TY - JOUR
T1 - Epidermal Growth Factor Receptor Mutation as a Risk Factor for Recurrence in Lung Adenocarcinoma
AU - Hayasaka, Kazuki
AU - Shiono, Satoshi
AU - Matsumura, Yuki
AU - Yanagawa, Naoki
AU - Suzuki, Hiroyuki
AU - Abe, Jiro
AU - Sagawa, Motoyasu
AU - Sakurada, Akira
AU - Katahira, Masato
AU - Takahashi, Satomi
AU - Endoh, Makoto
AU - Okada, Yoshinori
N1 - Funding Information:
Epidermal growth factor receptor (EGFR) gene mutations are important for the pathogenesis of lung adenocarcinoma, and the tyrosine kinase function of EGFR is a promising target for the treatment of non-small cell lung cancer. In patients with advanced lung adenocarcinoma, those harboring EGFR mutations have longer survival than those without EGFR mutations, mainly due to the use of EGFR tyrosine kinase inhibitors (TKI) [1–3]. In contrast, in patients with resectable lung adenocarcinoma, the prognostic role of EGFR mutations remains controversial. Some studies have reported that patients with EGFR mutations show longer overall survival (OS) or disease-free survival (DFS) than patients without EGFR mutations [4, 5]; however, meta-analyses have not supported this conclusion[6, 7].
Publisher Copyright:
© 2018 The Society of Thoracic Surgeons
PY - 2018/6
Y1 - 2018/6
N2 - Background: The presence of epidermal growth factor receptor (EGFR) mutations is an established prognostic factor for patients with advanced lung adenocarcinoma. Here, we examined whether EGFR mutation status is a prognostic factor for patients who had undergone surgery. Methods: Clinicopathologic data from 1,463 patients who underwent complete surgical resection for lung adenocarcinoma between 2005 and 2012 were collected. Differences in postoperative recurrence-free survival and overall survival according to EGFR mutation status were evaluated. Results: Of 835 eligible patients, the numbers of patients with wild-type EGFR (WT), exon 19 deletion (Ex19), and exon 21 L858R (Ex21) were 426, 175, and 234, respectively. Patients with Ex19 had a significantly higher incidence of extrathoracic recurrence than patients with Ex21 (p = 0.004). The 5-year recurrence-free survival rates for patients with WT, Ex19, and Ex21 were 63.0%, 67.5%, and 78.2%, respectively. The Ex21 group had a significantly longer recurrence-free survival than the WT group (p < 0.001) and the Ex19 group (p = 0.016). The 5-year overall survival for patients with WT, Ex19, and Ex21 were 76.9%, 86.5%, and 87.5%, respectively. Patients with Ex19 and Ex21 had a significantly longer overall survival than patients with WT (Ex19, p = 0.009; Ex21, p < 0.001). Multivariate analysis for recurrence-free survival showed that Ex19 was significantly associated with a worse prognosis than Ex21 (p = 0.019). Conclusions: Patients with Ex19 had significantly shorter recurrence-free survival and had extrathoracic recurrence more frequently than patients with Ex21 among patients with resected lung adenocarcinoma, implying that Ex19 could be a worse prognostic factor.
AB - Background: The presence of epidermal growth factor receptor (EGFR) mutations is an established prognostic factor for patients with advanced lung adenocarcinoma. Here, we examined whether EGFR mutation status is a prognostic factor for patients who had undergone surgery. Methods: Clinicopathologic data from 1,463 patients who underwent complete surgical resection for lung adenocarcinoma between 2005 and 2012 were collected. Differences in postoperative recurrence-free survival and overall survival according to EGFR mutation status were evaluated. Results: Of 835 eligible patients, the numbers of patients with wild-type EGFR (WT), exon 19 deletion (Ex19), and exon 21 L858R (Ex21) were 426, 175, and 234, respectively. Patients with Ex19 had a significantly higher incidence of extrathoracic recurrence than patients with Ex21 (p = 0.004). The 5-year recurrence-free survival rates for patients with WT, Ex19, and Ex21 were 63.0%, 67.5%, and 78.2%, respectively. The Ex21 group had a significantly longer recurrence-free survival than the WT group (p < 0.001) and the Ex19 group (p = 0.016). The 5-year overall survival for patients with WT, Ex19, and Ex21 were 76.9%, 86.5%, and 87.5%, respectively. Patients with Ex19 and Ex21 had a significantly longer overall survival than patients with WT (Ex19, p = 0.009; Ex21, p < 0.001). Multivariate analysis for recurrence-free survival showed that Ex19 was significantly associated with a worse prognosis than Ex21 (p = 0.019). Conclusions: Patients with Ex19 had significantly shorter recurrence-free survival and had extrathoracic recurrence more frequently than patients with Ex21 among patients with resected lung adenocarcinoma, implying that Ex19 could be a worse prognostic factor.
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U2 - 10.1016/j.athoracsur.2018.01.052
DO - 10.1016/j.athoracsur.2018.01.052
M3 - Article
C2 - 29486179
AN - SCOPUS:85046368951
VL - 105
SP - 1648
EP - 1654
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 6
ER -