The prognostic implications of EGFR mutation and ALK rearrangement for the long‐term outcomes of patients with resected lung adenocarcinomas

Thoracic Cancer

Kwang Gi Kim¹  Young Jae Kim¹  Yoon Kyung Jeon²  Hyungjin Kim³  Hyun‐Ju Lee³  Young Tae Kim⁴  Hyunsook Hong⁵ 

[1] Department of Biomedical Engineering Gachon University College of Medicine Incheon Korea;Department of Pathology Seoul National University Hospital Seoul Korea;Department of Radiology Seoul National University Hospital Seoul Korea;Department of Thoracic and Cardiovascular Surgery Seoul National University College of Medicine Seoul Korea;Medical Research Collaborating Center Seoul National University Hospital Seoul Korea;

关键词: Adenocarcinoma;    anaplastic lymphoma kinase;    epidermal growth factor receptor;    prognosis;    survival analysis;   

DOI  :  10.1111/1759-7714.13128

来源: DOAJ

【 摘 要 】

Background To investigate the prognostic impact of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement for the overall survival (OS) of patients with surgically treated lung adenocarcinomas. Methods A total of 689 patients with stage I–III lung adenocarcinomas (male:female = 334:355; median age, 64 years) underwent complete surgical resection between 2007 and 2013. The prognostic impact of EGFR mutation and ALK rearrangement on OS was analyzed using Cox regression analysis. Certain clinicopathological prognostic factors (i.e., age, sex, smoking status, nodule type, solid portion size, pathologic stage, adenocarcinoma subtype, and history of adjuvant chemotherapy) were included for adjustments of the hazard ratio (HR). Results EGFR mutation was observed in 438 patients (64%) and ALK rearrangement was seen in 28 patients (4%). Multivariable‐adjusted Cox regression demonstrated that the prognostic effect of EGFR mutation on OS differed by age (HR, exp.[−5.199 + 0.064*age]). The adjusted HR for EGFR mutation was 0.14 (95% CI: 0.05–0.36; P < 0.001) at 50 years, 0.26 (95% CI: 0.15–0.46; P < 0.001) at 60 years, and 0.50 (95% CI: 0.31–0.81; P = 0.005) at 70 years. However, the effect of ALK rearrangement on OS was without statistical significance (P > 0.05). Conclusions EGFR mutation was independently prognostic of the long‐term outcomes of patients with surgically treated lung adenocarcinomas. A more favorable prognostic effect was seen in younger than in older patients. ALK rearrangement was not associated with OS.

【 授权许可】

Unknown