Epidermal Growth Factor Receptor Mutation in Resectable Lung Cancer: Association With Survival Outcomes

Area of Science:

• Oncology
• Genetics
• Thoracic Surgery

Background:

• Existing case series suggest comparable long-term survival between epidermal growth factor receptor-mutant (EGFRmu) and wild-type (EGFRwt) lung cancer post-surgery.
• This study investigates surgical outcomes for stage I-III lung adenocarcinoma patients, hypothesizing similar long-term survival between EGFRmu and EGFRwt groups.

Purpose of the Study:

• To analyze and compare long-term survival trends between EGFR-mutant and EGFR-wild-type lung adenocarcinoma patients who underwent surgical resection.
• To identify prognostic factors influencing mortality in these patient groups.

Main Methods:

• Retrospective analysis of 578 stage I-III lung adenocarcinoma patients who underwent complete mutational analysis after lobectomy (2013-2023).
• Exclusion criteria included stage IV disease and inadequate EGFR testing.
• Comparison of baseline characteristics and survival trends between 112 EGFRmu and 466 EGFRwt patients.

Main Results:

• EGFRmu patients were predominantly female, never-smokers, and diagnosed with stage I disease.
• EGFRmu patients demonstrated significantly better 5- and 10-year survival rates (55% vs. 25%, P < .001) and 3-year disease-free survival (75% vs. 58%, P = .003).
• Multivariable analysis identified tumor stage, age, male sex, and EGFRwt status as mortality predictors; EGFRwt was associated with increased death risk after metastatic recurrence.

Conclusions:

• EGFR-mutant lung adenocarcinoma patients exhibit distinct clinical features and superior long-term survival post-surgery compared to EGFR-wild-type.
• Findings underscore the need for personalized strategies in lung cancer screening, research, and treatment based on EGFR mutational status.