Clinicopathologic Features and Prognostic Value of Epidermal Growth Factor Receptor Mutation in Patients with PT1a and PT1b Invasive Lung Adenocarcinoma After Surgical Resection

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2021 Oct 18

PMID 34659816

Citations 2

Authors

Shiqi Chen

Siqian Yang

Yang Zhang

Jiaqing Xiang

Yawei Zhang

Hong Hu

Yihua Sun

Fangqiu Fu

Chaoqiang Deng

Shengping Wang

Qiao Li

Yajia Gu

Yuan Li

Xuxia Shen

Ting Ye

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies have evaluated the prognostic value of epidermal growth factor receptor (EGFR) mutation in different subgroups of lung adenocarcinoma, but there remains controversial on this issue. We conduct this study aimed to reveal the prognostic value of EGFR mutation in patients with pT1a and pT1b invasive lung adenocarcinoma.

Methods: From August 2009 to February 2015, 338 patients with pT1a and pT1b invasive lung adenocarcinoma who underwent EGFR mutation analysis were enrolled into this study. According to clinicopathologic and radiologic characteristics, survival analysis was conducted in different subgroups using Kaplan-Meier methods and Cox regression models.

Results: EGFR mutation was detected in 216 (63.9%) patients. In the entire cohort, EGFR mutation was significantly frequent in female (P=0.011), never smoking (P=0.014) patients, patients with part-solid nodules (P=0.005) and patients with lepidic pattern-predominant adenocarcinoma (LPA)/acinar pattern-predominant adenocarcinoma (APA)/papillary pattern-predominant adenocarcinoma (PPA) (P=0.005). No difference in recurrence-free survival (RFS) was seen between patients harboring EGFR mutation and patients without EGFR mutation in the entire cohort (P=0.664) and the subgroup cohorts. Patients with EGFR mutation had a longer overall survival (OS) compared with patients without EGFR mutation in the entire cohort (P=0.005) and the subgroups of N0 stage cohort (P=0.013), N1-2 stage cohort (P=0.033), APA/PPA/invasive mucinous adenocarcinoma (IMA) cohort (P=0.011) and pT1b cohort (P=0.002). Tyrosine kinase inhibitors (TKIs) could significantly prolong the OS in patients with EGFR mutation after recurrence (P=0.04).

Conclusions: EGFR mutation was not a risk factor for recurrence of patients with pT1a and pT1b invasive lung adenocarcinoma.

Citing Articles

Resected -mutated non-small-cell lung cancers: incidence and outcomes in a European population (GFPC Exerpos Study).

Auliac J, Thomas P, Bylicki O, Guisier F, Curcio H, AlainVegnenegre Ther Adv Med Oncol. 2024; 16:17588359241236451.

PMID: 38455711 PMC: 10919127. DOI: 10.1177/17588359241236451.

Analysis of Molecular Biomarkers in Resected Early-Stage Non-Small Cells Lung Cancer: A Narrative Review.

Gallina F, Bertolaccini L, Forcella D, Mohamed S, Ceddia S, Melis E Cancers (Basel). 2022; 14(8).

PMID: 35454856 PMC: 9024905. DOI: 10.3390/cancers14081949.

References

Fu F, Zhang Y, Wen Z, Zheng D, Gao Z, Han H . Distinct Prognostic Factors in Patients with Stage I Non-Small Cell Lung Cancer with Radiologic Part-Solid or Solid Lesions. J Thorac Oncol. 2019; 14(12):2133-2142. DOI: 10.1016/j.jtho.2019.08.002. View

Mitsudomi T, Kosaka T, Endoh H, Horio Y, Hida T, Mori S . Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence. J Clin Oncol. 2005; 23(11):2513-20. DOI: 10.1200/JCO.2005.00.992. View

DAngelo S, Janjigian Y, Ahye N, Riely G, Chaft J, Sima C . Distinct clinical course of EGFR-mutant resected lung cancers: results of testing of 1118 surgical specimens and effects of adjuvant gefitinib and erlotinib. J Thorac Oncol. 2012; 7(12):1815-1822. DOI: 10.1097/JTO.0b013e31826bb7b2. View

Ito M, Miyata Y, Kushitani K, Yoshiya T, Kai Y, Tsutani Y . Increased risk of recurrence in resected EGFR-positive pN0M0 invasive lung adenocarcinoma. Thorac Cancer. 2018; 9(12):1594-1602. PMC: 6275825. DOI: 10.1111/1759-7714.12866. View

Kosaka T, Yatabe Y, Endoh H, Kuwano H, Takahashi T, Mitsudomi T . Mutations of the epidermal growth factor receptor gene in lung cancer: biological and clinical implications. Cancer Res. 2004; 64(24):8919-23. DOI: 10.1158/0008-5472.CAN-04-2818. View

Mitsudomi T, Kosaka T, Yatabe Y . Biological and clinical implications of EGFR mutations in lung cancer. Int J Clin Oncol. 2006; 11(3):190-8. DOI: 10.1007/s10147-006-0583-4. View

Matsumura Y, Suzuki H, Ohira T, Shiono S, Abe J, Sagawa M . Matched-pair analysis of a multi-institutional cohort reveals that epidermal growth factor receptor mutation is not a risk factor for postoperative recurrence of lung adenocarcinoma. Lung Cancer. 2017; 114:23-30. DOI: 10.1016/j.lungcan.2017.09.003. View

Liu W, Zhao L, Pang Q, Yuan Z, Li B, Wang P . Prognostic value of epidermal growth factor receptor mutations in resected lung adenocarcinomas. Med Oncol. 2013; 31(1):771. DOI: 10.1007/s12032-013-0771-9. View

Kudo Y, Shimada Y, Saji H, Kato Y, Yoshida K, Matsubayashi J . Prognostic Factors for Survival After Recurrence in Patients With Completely Resected Lung Adenocarcinoma: Important Roles of Epidermal Growth Factor Receptor Mutation Status and the Current Staging System. Clin Lung Cancer. 2015; 16(6):e213-21. DOI: 10.1016/j.cllc.2015.04.005. View

10.

Ohba T, Toyokawa G, Kometani T, Nosaki K, Hirai F, Yamaguchi M . Mutations of the EGFR and K-ras genes in resected stage I lung adenocarcinoma and their clinical significance. Surg Today. 2013; 44(3):478-86. DOI: 10.1007/s00595-013-0589-2. View

11.

Yoshimi I, Ohshima A, Ajiki W, Tsukuma H, Sobue T . A comparison of trends in the incidence rate of lung cancer by histological type in the Osaka Cancer Registry, Japan and in the Surveillance, Epidemiology and End Results Program, USA. Jpn J Clin Oncol. 2003; 33(2):98-104. DOI: 10.1093/jjco/hyg019. View

12.

Kosaka T, Yatabe Y, Onozato R, Kuwano H, Mitsudomi T . Prognostic implication of EGFR, KRAS, and TP53 gene mutations in a large cohort of Japanese patients with surgically treated lung adenocarcinoma. J Thorac Oncol. 2008; 4(1):22-9. DOI: 10.1097/JTO.0b013e3181914111. View

13.

Deng C, Zhang Y, Ma Z, Fu F, Deng L, Li Y . Prognostic value of epidermal growth factor receptor gene mutation in resected lung adenocarcinoma. J Thorac Cardiovasc Surg. 2020; 162(3):664-674.e7. DOI: 10.1016/j.jtcvs.2020.05.099. View

14.

Ettinger D, Aisner D, Wood D, Akerley W, Bauman J, Chang J . NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw. 2018; 16(7):807-821. DOI: 10.6004/jnccn.2018.0062. View

15.

Zhang Z, Wang T, Zhang J, Cai X, Pan C, Long Y . Prognostic value of epidermal growth factor receptor mutations in resected non-small cell lung cancer: a systematic review with meta-analysis. PLoS One. 2014; 9(8):e106053. PMC: 4146589. DOI: 10.1371/journal.pone.0106053. View

16.

Sonobe M, Manabe T, Wada H, Tanaka F . Mutations in the epidermal growth factor receptor gene are linked to smoking-independent, lung adenocarcinoma. Br J Cancer. 2005; 93(3):355-63. PMC: 2361570. DOI: 10.1038/sj.bjc.6602707. View

17.

Kaseda K, Asakura K, Kazama A, Ozawa Y . Clinicopathological and prognostic features of surgically resected pathological stage I lung adenocarcinoma harboring epidermal growth factor receptor and K-ras mutation. Thorac Cancer. 2017; 8(3):229-237. PMC: 5415485. DOI: 10.1111/1759-7714.12428. View

18.

Zhang Y, Jheon S, Li H, Zhang H, Xie Y, Qian B . Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg. 2020; 160(3):824-831.e4. DOI: 10.1016/j.jtcvs.2019.10.145. View

19.

Ito M, Miyata Y, Tsutani Y, Ito H, Nakayama H, Imai K . Positive EGFR mutation status is a risk of recurrence in pN0-1 lung adenocarcinoma when combined with pathological stage and histological subtype: A retrospective multi-center analysis. Lung Cancer. 2020; 141:107-113. DOI: 10.1016/j.lungcan.2020.01.018. View

20.

Ragusa M, Vannucci J, Ludovini V, Bianconi F, Treggiari S, Tofanetti F . Impact of epidermal growth factor receptor and KRAS mutations on clinical outcome in resected non-small cell lung cancer patients. Am J Clin Oncol. 2013; 37(4):343-9. DOI: 10.1097/COC.0b013e31827a7e7a. View