Epidermal Growth Factor Receptor Mutation as a Risk Factor for Recurrence in Lung Adenocarcinoma
Epidermal Growth Factor Receptor Mutation as a Risk Factor for Recurrence in Lung Adenocarcinoma
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DOI：
10.1016/j.athoracsur.2018.01.052
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发表时间：
2018-06-01
影响因子：
4.6
通讯作者：
Okada, Yoshinori
中科院分区：
文献类型：
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作者：
Hayasaka, Kazuki;Shiono, Satoshi;Okada, Yoshinori
背景资料。表皮生长因子受体(EGFR)突变的存在是晚期肺腺癌患者公认的预后因素。在这里，我们研究了EGFR突变状态是否是手术后患者的预后因素。收集了2005-2012年间1,463例接受完全性肺腺癌手术的患者的临床病理资料。根据EGFR突变状态评估术后无复发生存率和总生存率的差异。在835例符合条件的患者中，野生型EGFR(WT)426例，外显子19缺失(EX19)175例，外显子21(EX21)L858R(EX21)234例。EX19组胸外复发率明显高于EX21组(p=0.004)。WT、EX19和EX21的5年无复发生存率分别为63.0%、67.5%和78.2%。EX21组的无复发生存期显著长于WT组(p<；0.001)和EX19组(p=0.016)。WT、EX19和EX21患者的5年总生存率分别为76.9%、86.5%和87.5%。EX19和EX21患者的总体生存时间显著长于WT患者(EX19，p=0.009；EX21，p<；0.001)。对无复发生存率的多因素分析显示，EX19与EX21的预后显著相关(p=0.019)。在切除的肺腺癌患者中，EX19患者的无复发生存期显著短于EX21患者，且胸外复发的频率高于EX21患者，这意味着EX19可能是一个更差的预后因素。(C)2018年，由胸外科医生学会主办
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. (C) 2018 by The Society of Thoracic Surgeons