Background
In epidermal growth factor receptor (
EGFR
)âmutant nonâsmall cell lung cancer (NSCLC), brain metastasis is known as a poor prognosis factor. However, prognostic factors in the patients without brain metastasis remain unclear. In this study, we aimed to clarify the differences between metastatic site and prognosis in common
EGFR
âmutant NSCLC patients without brain metastasis.
Methods
ChemotherapyânaĂŻve, advanced
EGFR
âmutant NSCLC patients without brain metastasis diagnosed between January 2010 and March 2016 were enrolled. We evaluated prognosis according to the presence or absence of bone metastases, liver metastasis, and pleural effusion.
Results
A total of 50
EGFR
âmutant NSCLC patients without brain metastasis were enrolled. The median progressionâfree survival and overall survival were significantly shorter in patients with pleural effusion than in those patients without (progressionâfree survival 7.0 months, 95% confidence interval [CI] 3.7â13.0 vs. 13.0âmonths, 95% CI 9.1â21.7, hazard ratio [HR] 2.29, 95% CI 1.11â4.73,
P
=â0.020; overall survival 19.5 months, 95% CI 5.7â28.8 vs. 55.3âmonths, 95% CI 24.0ânot evaluable, HR 3.00, 95% CI 1.35â6.68,
P
=â0.005). Pleural effusion was an independent factor of poor prognosis for progressionâfree survival (HR 3.44, 95% CI 1.50â7.88,
P
=â0.003) and overall survival (HR 2.34, 95% CI 1.00â5.44,
P
=â0.049).
Conclusion
Pleural effusion might be a poor prognosis factor for advanced
EGFR
âmutant NSCLC patients without brain metastasis treated with firstâgeneration EGFRâtyrosine kinase inhibitors. Further precision medicine according to the metastatic site is required.