BACKGROUND: Mutations of the epidermal growth factor hormone receptor (EGFR) gene have been associated with improved treatment response and prognosis in advanced non-small lung cancer (NSCLC). However, their prognostic role in early-stage NSCLC is not well defined. In this study we sought to identify the pure prognostic role of EGFR mutation in patients with completely resected stage I NSCLC who received no adjuvant therapy. METHODS: Mutation status was tested in treatment-naïve patients who had complete resection of stage I (T1-2aN0) NSCLC (from 2004 to 2011) using direct sequencing or multiplex polymerase chain reaction-based assay. Recurrence rates, disease-free survival, and overall survival were compared between EGFR-mutant and wild-type patients using Kaplan-Meier methods and Cox regression models. RESULTS: Three hundred seven patients were included in this study; 62 harbored tumors with EGFR mutations and 245 had wild-type EGFR. Tumors in patients with EGFR mutations were associated with a significantly lower recurrence rate (9.7% versus 21.6%; p=0.03), greater median disease-free survival (8.8 versus 7.0 years; p=0.0085), and improved overall 5-year survival (98% versus 73%; p=0.003) compared with wild-type tumors. Lobectomy was the most frequently performed procedure, accounting for 209 of 307 operations. Among these patients, EGFR mutation was associated with superior overall survival (hazard ratio, 0.45; 95% confidence interval, 0.13 to 0.83; p=0.017), with an estimated 5-year survival of 98% versus 70%. The presence of EGFR mutation (p=0.026) and tumor size less than 2 cm (p=0.04) were identified as independent prognostic markers for disease-free survival, whereas age, sex, and smoking status were not. CONCLUSIONS: Completely resected stage I EGFR mutation-positive NSCLC patients have a significant survival advantage compared with EGFR wild-type patients. Mutation of the EGFR gene is a positive prognostic marker in completely resected stage I NSCLC.
BACKGROUND: Mutations of the epidermal growth factor hormone receptor (EGFR) gene have been associated with improved treatment response and prognosis in advanced non-small lung cancer (NSCLC). However, their prognostic role in early-stage NSCLC is not well defined. In this study we sought to identify the pure prognostic role of EGFR mutation in patients with completely resected stage I NSCLC who received no adjuvant therapy. METHODS: Mutation status was tested in treatment-naïve patients who had complete resection of stage I (T1-2aN0) NSCLC (from 2004 to 2011) using direct sequencing or multiplex polymerase chain reaction-based assay. Recurrence rates, disease-free survival, and overall survival were compared between EGFR-mutant and wild-type patients using Kaplan-Meier methods and Cox regression models. RESULTS: Three hundred seven patients were included in this study; 62 harbored tumors with EGFR mutations and 245 had wild-type EGFR. Tumors in patients with EGFR mutations were associated with a significantly lower recurrence rate (9.7% versus 21.6%; p=0.03), greater median disease-free survival (8.8 versus 7.0 years; p=0.0085), and improved overall 5-year survival (98% versus 73%; p=0.003) compared with wild-type tumors. Lobectomy was the most frequently performed procedure, accounting for 209 of 307 operations. Among these patients, EGFR mutation was associated with superior overall survival (hazard ratio, 0.45; 95% confidence interval, 0.13 to 0.83; p=0.017), with an estimated 5-year survival of 98% versus 70%. The presence of EGFR mutation (p=0.026) and tumor size less than 2 cm (p=0.04) were identified as independent prognostic markers for disease-free survival, whereas age, sex, and smoking status were not. CONCLUSIONS: Completely resected stage I EGFR mutation-positive NSCLCpatients have a significant survival advantage compared with EGFR wild-type patients. Mutation of the EGFR gene is a positive prognostic marker in completely resected stage I NSCLC.
Authors: Jianjun Zhang; Kathryn A Gold; Heather Y Lin; Stephen G Swisher; Yan Xing; J Jack Lee; Edward S Kim; William N William Journal: J Thorac Oncol Date: 2015-04 Impact factor: 15.609
Authors: Kimberley S Mak; Justin F Gainor; Andrzej Niemierko; Kevin S Oh; Henning Willers; Noah C Choi; Jay S Loeffler; Lecia V Sequist; Alice T Shaw; Helen A Shih Journal: Neuro Oncol Date: 2014-07-22 Impact factor: 12.300
Authors: Whitney S Brandt; Ilies Bouabdallah; Kay See Tan; Bernard J Park; Prasad S Adusumilli; Daniela Molena; Manjit S Bains; James Huang; James M Isbell; Matthew J Bott; David R Jones Journal: J Thorac Cardiovasc Surg Date: 2017-11-13 Impact factor: 5.209
Authors: Susan Y Luo; Ko-Yung Sit; Alan D L Sihoe; Wai-Sing Suen; Wing-Kuk Au; Ximing Tang; Edmond S K Ma; Wai-Kong Chan; Ignacio I Wistuba; John D Minna; George S W Tsao; David C L Lam Journal: Lung Cancer Date: 2014-06-16 Impact factor: 5.705