Huang CY, et al. - Researchers investigated the prognostic factors to predict long-term survival of patients with metastatic lung adenocarcinoma in the era of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Retrospective analysis of data for long-term survivors (LTS; defined as patients who survived five years or more after the initial diagnosis of stage IV disease) and non-LTS was performed. A five-year survival of 5.0% was reported. In the LTS group vs in the non-LTS group, more contralateral or pleural/pericardial metastases but less extrathoracic spread was detected. Overall, for survivors who survived for more than 5 years, a crucial role was suggested of an age younger than 60 years, absence of extrathoracic spread and EGFR TKI treatment duration of more than one year.