Clinicopathologic features and prognostic value of epidermal growth factor receptor mutation in patients with pT1a and pT1b invasive lung adenocarcinoma after surgical resection

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.

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

“…In this analysis, no differences were reported in recurrence between patients with and without EGFR mutations. However, EGFR mutant patients showed prolonged overall survival in the entire cohort and in the analysis of the subgroups [16].…”

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

“…The prognostic impact of EGFR alterations on early-stage NSCLC outcomes is conflicting, and factors associated with relapse risk in patients with EGFR -mutated NSCLCs need further elucidation. 23 , 24 In an Asian cohort, prognostic EGFR mutation impact on DFS for patients with pT1a and pT1b invasive lung non-squamous cancers after surgical resection did not differ from that of patients whose tumors expressed wild-type EGFR ; however, among all patients, OS was significantly longer for those with EGFR -mutated NSCLCs, and N0 and N1–2-stage subgroups. 21 That observation is probably explained by the number of effective targeted treatment options for metastatic EGFR -mutated NSCLCs.…”

Clinical characteristics and prognostic value of EGFR mutation in stage I lung adenocarcinoma with spread through air spaces after surgical resection

“…However, the prognostic value of EGFR mutation is still controversial. Although most studies suggest that EGFR mutation is not a prognostic factor [14][15][16][17], and some studies believe that it is related to the low recurrence rate of stage I lung adenocarcinoma [14], STAS is a high-risk factor for poor prognosis of lung adenocarcinoma patients, and the prognosis of stage I patients with STAS is significantly worse [18][19][20]. Therefore, we retrospectively analyzed the clinical data of resected stage I lung adenocarcinoma patients with STAS, analyzed the relationship between clinical features and prognosis, and explored the influence of EGFR mutation status on the prognosis of these patients.…”

“…Previous studies have shown that EGFR mutation status can predict the prognosis of patients with lung adenocarcinoma [7][8][9][10][11]. On the contrary, some studies have claimed that EGFR mutation is not a risk factor for postoperative recurrence of lung adenocarcinoma [12][13][14]. In addition, most previous studies either did not consider the pathological stage of patients, or did not exclude the influence of histological subtypes, imaging features, EGFR-TKI treatment, and high-risk factors for recurrence [15][16][17].…”

“…For stage I lung adenocarcinoma, most studies suggest that EGFR mutation is not a prognostic factor [14][15][16][17], and some studies believe that this is related to the low recurrence rate of stage I lung adenocarcinoma [14]. However, spread through air spaces (STAS) is a high-risk factor for a poor prognosis of lung adenocarcinoma patients, and the prognosis of stage I lung adenocarcinoma patients with STAS is significantly poor [18][19][20].…”