Clinical Impacts of EGFR Mutation Status: Analysis of 5780 Surgically Resected Lung Cancer Cases.

Aged Carcinoma, Non-Small-Cell Lung / diagnosis Female Genes, erbB-1 / genetics Humans Lung Neoplasms / diagnosis Male Mutation Prognosis Retrospective Studies

Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
01 2021
Historique:
received: 23 12 2019
revised: 04 04 2020
accepted: 01 05 2020
pubmed: 3 7 2020
medline: 29 1 2021
entrez: 3 7 2020
Statut: ppublish

Résumé

To elucidate the clinical, pathologic, and prognostic impacts of epidermal growth factor receptor (EGFR) mutation and mutation subtypes in early-stage lung cancer, the study investigators conducted a retrospective analysis of the Japanese Joint Committee of Lung Cancer Registry database (a nationwide database for patients with surgically resected lung cancer; n = 18,973). Of 13,951 patients classified as having nonsquamous non-small cell lung cancer in the database, 5780 patients (41.0%) had been tested for an EGFR mutation and were included in this study. An EGFR mutation was detected in 2410 patients (41.7%), and the presence of an EGFR mutation was significantly correlated with clinicopathologic factors such as the presence of ground-glass opacity (P < .001) and better prognosis. Analysis of initial recurrence sites identified significantly higher frequencies of brain and adrenal gland metastases in patients with and without an EGFR mutation, respectively. Of 2410 patients with EGFR mutations, 983 (40.8%) had an exon 19 deletion (Exon 19 Del), 1170 (48.5%) had an L858R mutation, and 257 (10.7%) had other EGFR mutations. A higher smoking rate was found in patients with other EGFR mutations (P = .02). In the comparison of Exon 19 Del and L858R, we found that Exon 19 Del correlated with younger age (P < .001), a higher rate of pure solid tumors (P < .001), advanced pathologic stage (trend P < .001), and poorer recurrence-free survival (P = .001). In addition to the clinicopathologic and prognostic impacts of EGFR mutation status, tumors with Exon 19 Del have a more aggressive phenotype and patients have a poorer prognosis than with L858R in early-stage lung cancers.

Sections du résumé

BACKGROUND
To elucidate the clinical, pathologic, and prognostic impacts of epidermal growth factor receptor (EGFR) mutation and mutation subtypes in early-stage lung cancer, the study investigators conducted a retrospective analysis of the Japanese Joint Committee of Lung Cancer Registry database (a nationwide database for patients with surgically resected lung cancer; n = 18,973).
METHODS
Of 13,951 patients classified as having nonsquamous non-small cell lung cancer in the database, 5780 patients (41.0%) had been tested for an EGFR mutation and were included in this study.
RESULTS
An EGFR mutation was detected in 2410 patients (41.7%), and the presence of an EGFR mutation was significantly correlated with clinicopathologic factors such as the presence of ground-glass opacity (P < .001) and better prognosis. Analysis of initial recurrence sites identified significantly higher frequencies of brain and adrenal gland metastases in patients with and without an EGFR mutation, respectively. Of 2410 patients with EGFR mutations, 983 (40.8%) had an exon 19 deletion (Exon 19 Del), 1170 (48.5%) had an L858R mutation, and 257 (10.7%) had other EGFR mutations. A higher smoking rate was found in patients with other EGFR mutations (P = .02). In the comparison of Exon 19 Del and L858R, we found that Exon 19 Del correlated with younger age (P < .001), a higher rate of pure solid tumors (P < .001), advanced pathologic stage (trend P < .001), and poorer recurrence-free survival (P = .001).
CONCLUSIONS
In addition to the clinicopathologic and prognostic impacts of EGFR mutation status, tumors with Exon 19 Del have a more aggressive phenotype and patients have a poorer prognosis than with L858R in early-stage lung cancers.

Identifiants

DOI: 10.1016/j.athoracsur.2020.05.041 PMID: 32615091
pubmed: 32615091
pii: S0003-4975(20)30982-6
doi: 10.1016/j.athoracsur.2020.05.041
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

269-276

Informations de copyright

Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Kenichi Suda (K)

Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. Electronic address: ascaris@surg2.med.kyushu-u.ac.jp.

Tetsuya Mitsudomi (T)

Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.

Yasushi Shintani (Y)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

Jiro Okami (J)

Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan.

Hiroyuki Ito (H)

Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.

Takashi Ohtsuka (T)

Division of Thoracic Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.

Shinichi Toyooka (S)

Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan.

Takeshi Mori (T)

Department of Thoracic Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.

Shun-Ichi Watanabe (SI)

Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.

Hisao Asamura (H)

Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.

Masayuki Chida (M)

Department of General Thoracic Surgery, Dokkyo Medical University, Shimotsuga-gun, Japan.

Hiroshi Date (H)

Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.

Shunsuke Endo (S)

Department of Thoracic Surgery, Jichi Medical School, Shimotsuke, Japan.

Takeshi Nagayasu (T)

Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Ryoichi Nakanishi (R)

Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Etsuo Miyaoka (E)

Department of Mathematics, Tokyo University of Science, Tokyo, Japan.

Meinoshin Okumura (M)

Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Japan.

Ichiro Yoshino (I)

Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Tumeurs de l'appareil respiratoire › Tumeurs du poumon › Tumeurs des bronches › Carcinome bronchogénique › Carcinome pulmonaire non à petites cellules › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Phénomènes génétiques › Structures génétiques › Génome › Composants de génome › Gènes › Gènes tumoraux › Oncogènes › Proto-oncogènes › Gènes erbB › Gènes erbB-1 › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Tumeurs de l'appareil respiratoire › Tumeurs du poumon › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Phénomènes génétiques › Variation génétique › Mutation › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Diagnostic › Pronostic › Clinical Impacts of EGFR Mutation Status:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Clinical Impacts of EGFR Mutation Status:...