Saji H, et al. – By employing a different database, epidermal growth factor receptor (EGFR) mutation status and p–stage, which affect postoperative recurrence survival (PRS) and overall survival (OS) in patients with completely resected lung adenocarcinoma, were examined. For estimating PRS using this database, EGFR status and p–stage were found to be essential prognostic factors. Results revealed a statistically significant association of the recurrent patients with EGFR M and EGFR–TKI therapy with favorable PRS.

Methods

• 56 consecutive lung adenocarcinoma patients with disease recurrence in St. Marianna University Hospital between January 2010 and December 2014, were retrospectively reviewed.

Results

• In 16/56 patients (29%), EGFR mutants (M) were detected.
• As compared to those with EGFR wild-type (WT) status (5-year survival: 50.3% vs 43.1, P=0.133), the patients with EGFR M had a better OS.
• No significant difference was observed in the 3-year recurrence-free survival rate between patients with M and WT (6.3% vs 7.7%, P=0.656).
• In addition, the patients with EGFR M had a significantly better 3-year PRS than those with WT (77.4% vs 51.7%, P=0.033).
• Results revealed better 3-year PRS rate for patients with M/pathologic stage (p-stage) I–II (87.5%) than that for patients with M/p-stage III (60.0%), WT/p-stage I–II (52.7%), and WT/p-stage III (43.8%).
• A significant difference was found between patients with M/p-stage I and WT/p-stage I–II or WT/p-stage III (P=0.021 and 0.030, respectively).
• Of the 16 patients with mutants, 12 patients (75%) received EGFR-tyrosine kinase inhibitor (TKI) therapy and among the 40 patients with WT, no patient received EGFR-TKI therapy, during the study period.
• A statistically significant association was observed between patients with EGFR-TKI therapy and favorable PRS (hazard ratio 0.271; 95% confidence interval 0.074–1.000; P=0.050).