Kenichi Suda1, Tetsuya Mitsudomi2, Yasushi Shintani3, Jiro Okami4, Hiroyuki Ito5, Takashi Ohtsuka6, Shinichi Toyooka7, Takeshi Mori8, Shun-Ichi Watanabe9, Hisao Asamura10, Masayuki Chida11, Hiroshi Date12, Shunsuke Endo13, Takeshi Nagayasu14, Ryoichi Nakanishi15, Etsuo Miyaoka16, Meinoshin Okumura17, Ichiro Yoshino18. 1. Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. Electronic address: ascaris@surg2.med.kyushu-u.ac.jp. 2. Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. 3. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan. 4. Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan. 5. Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan. 6. Division of Thoracic Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. 7. Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan. 8. Department of Thoracic Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan. 9. Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan. 10. Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Tokyo, Japan. 11. Department of General Thoracic Surgery, Dokkyo Medical University, Shimotsuga-gun, Japan. 12. Department of Thoracic Surgery, Kyoto University, Kyoto, Japan. 13. Department of Thoracic Surgery, Jichi Medical School, Shimotsuke, Japan. 14. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 15. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 16. Department of Mathematics, Tokyo University of Science, Tokyo, Japan. 17. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Japan. 18. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Abstract
BACKGROUND: To elucidate the clinical, pathologic, and prognostic impacts of epidermal growth factor receptor (EGFR) mutation and mutation subtypes in early-stage lung cancer, the study investigators conducted a retrospective analysis of the Japanese Joint Committee of Lung Cancer Registry database (a nationwide database for patients with surgically resected lung cancer; n = 18,973). METHODS: Of 13,951 patients classified as having nonsquamous non-small cell lung cancer in the database, 5780 patients (41.0%) had been tested for an EGFR mutation and were included in this study. RESULTS: An EGFR mutation was detected in 2410 patients (41.7%), and the presence of an EGFR mutation was significantly correlated with clinicopathologic factors such as the presence of ground-glass opacity (P < .001) and better prognosis. Analysis of initial recurrence sites identified significantly higher frequencies of brain and adrenal gland metastases in patients with and without an EGFR mutation, respectively. Of 2410 patients with EGFR mutations, 983 (40.8%) had an exon 19 deletion (Exon 19 Del), 1170 (48.5%) had an L858R mutation, and 257 (10.7%) had other EGFR mutations. A higher smoking rate was found in patients with other EGFR mutations (P = .02). In the comparison of Exon 19 Del and L858R, we found that Exon 19 Del correlated with younger age (P < .001), a higher rate of pure solid tumors (P < .001), advanced pathologic stage (trend P < .001), and poorer recurrence-free survival (P = .001). CONCLUSIONS: In addition to the clinicopathologic and prognostic impacts of EGFR mutation status, tumors with Exon 19 Del have a more aggressive phenotype and patients have a poorer prognosis than with L858R in early-stage lung cancers.
BACKGROUND: To elucidate the clinical, pathologic, and prognostic impacts of epidermal growth factor receptor (EGFR) mutation and mutation subtypes in early-stage lung cancer, the study investigators conducted a retrospective analysis of the Japanese Joint Committee of Lung Cancer Registry database (a nationwide database for patients with surgically resected lung cancer; n = 18,973). METHODS: Of 13,951 patients classified as having nonsquamous non-small cell lung cancer in the database, 5780 patients (41.0%) had been tested for an EGFR mutation and were included in this study. RESULTS: An EGFR mutation was detected in 2410 patients (41.7%), and the presence of an EGFR mutation was significantly correlated with clinicopathologic factors such as the presence of ground-glass opacity (P < .001) and better prognosis. Analysis of initial recurrence sites identified significantly higher frequencies of brain and adrenal gland metastases in patients with and without an EGFR mutation, respectively. Of 2410 patients with EGFR mutations, 983 (40.8%) had an exon 19 deletion (Exon 19 Del), 1170 (48.5%) had an L858R mutation, and 257 (10.7%) had other EGFR mutations. A higher smoking rate was found in patients with other EGFR mutations (P = .02). In the comparison of Exon 19 Del and L858R, we found that Exon 19 Del correlated with younger age (P < .001), a higher rate of pure solid tumors (P < .001), advanced pathologic stage (trend P < .001), and poorer recurrence-free survival (P = .001). CONCLUSIONS: In addition to the clinicopathologic and prognostic impacts of EGFR mutation status, tumors with Exon 19 Del have a more aggressive phenotype and patients have a poorer prognosis than with L858R in early-stage lung cancers.
Authors: Vincent Fallet; Lise Matton; Antoine Schernberg; Anthony Canellas; François H Cornelis; Jacques Cadranel Journal: Transl Lung Cancer Res Date: 2021-07
Authors: Raymond U Osarogiagbon; Ramon Rami-Porta; Ming Sound Tsao; Luis M Montuenga; Katherine K Nishimura; Dorothy J Giroux; William Travis; Hisao Asamura; Valerie Rusch; David P Carbone; Fred R Hirsch Journal: J Thorac Oncol Date: 2021-03-23 Impact factor: 20.121