Predicting Survival in Patients with Advanced Non-squamous Non-small Cell Lung Cancer: Validating the Extent of Metastasis.
- Author:
Dong Soo LEE
1
;
Jin Hyoung KANG
;
Chang Geol LEE
;
Seoung Jun KIM
;
Young Jin CHOI
;
Kyo Young LEE
;
Yeon Sil KIM
Author Information
1. Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. yeonkim7@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Epidermal growth factor receptor;
Mutation;
Adenocarcinoma of lung;
Neoplasm metastasis;
Non-small cell lung carcinoma;
Prognosis
- MeSH:
Adenocarcinoma;
Carcinoma, Non-Small-Cell Lung;
Cohort Studies;
Exons;
Humans;
Lung;
Lung Neoplasms;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Prognosis;
Receptor, Epidermal Growth Factor;
Retrospective Studies
- From:Cancer Research and Treatment
2013;45(2):95-102
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: A number of factors related to overall survival (OS) have been addressed in advanced non-small cell lung cancer (NSCLC). This study was conducted to determine the impact of whole-body metastatic regions on survival outcome in advanced non-squamous NSCLC. MATERIALS AND METHODS: Between March 2005 and February 2011, 112 eligible patients with newly confirmed stage IV non-squamous NSCLC, available for epidermal growth factor receptor (EGFR) mutation status 18-21 analysis, and accessible for the determination of pretreatment whole-body metastatic regions were enrolled in this retrospective study. The total number of synchronous metastatic regions was scored according to the following disease sites: abdomen/pelvis, lung to lung/pulmonary lymphangitic spread, bone, pleura/pleural effusion/pericardial effusion, neck/axillary lymph nodes, other soft tissue, brain. RESULTS: The median age of the cohort was 65 years (range, 31 to 88 years). The median whole-body metastatic score was 2 (range, 1 to 6), and bone and lung to lung were the most common metastatic sites. EGFR mutations were observed in 40 (35.7%) patients with a deletion in exon 19 and Leu858Arg mutation in exon 21 being detected in 16 (40.0%) and 19 (47.5%) patients, respectively. Multivariate analysis for OS revealed that treatment factors (p=0.005), performance status (p=0.006), whole-body metastatic score (p<0.001), and EGFR mutation status (p=0.095) were significantly or marginally associated with OS. CONCLUSION: The results of the present study demonstrated that whole-body metastatic extent strongly affects survival outcome, even after adjustment for other significant variables in advanced non-squamous NSCLC. The clinical validity of more curative multimodal approaches in cohorts with limited metastases remains to be explored.