Prognostic impact of postoperative recurrence in patients with epidermal growth factor receptor-positive non-small cell lung cancer.

Abstract

Abstract Background: There are no reports conducted with a long follow-up period on a large number of EGFR+ non small cell lung carcinoma (NSCLC) patients withpostoperative recurrence (PR). Methods: We conducted a retrospective review of the data of EGFR+ NSCLC patients with PR who had undergone surgery at the Shizuoka Cancer Center between October 2002 and November 2017. The post-recurrence overall survival (PRS) and postoperative overall survival (POS) were estimated using the Kaplan-Meier method. Multivariate analysis using a Cox proportional hazards model was performed to identify any associations between the clinical variables at recurrence and the PRS. Logistic regression analysis was performed to evaluate the associations between the variables at the baseline and the prognostic factors at recurrence. Results: The median observation time was 4.95 (range, 0.82-13.25) years. The median PRS was 5.17 years (95% CI, 3.90-5.61) and the POS was 7.07 years (95% CI, 5.88-8.01). Univariate analysis identified male gender (MST: 3.32 vs. 5.39 years; p<0.05), presence of bone metastasis (MST: 2.43 vs. 5.33 years; p<0.05), and presence of central nervous system (CNS) metastasis (MST: 3.05 vs. 5.39 years; p<0.05), and multivariate analysis identified the presence of bone metastasis (HR, 2.01; 95% CI, 1.23-3.28; p<0.05) and presence of CNS metastasis (HR. 1.84; 95% CI, 1.14-2.98; p<0.05) as poor prognostic factors. The pattern of recurrence was not prognostic factor. Logistic regression analysis revealed male was associated with the presence bone/CNS metastasis at recurrence. Conclusion: New treatment strategies require to be developed for patients with bone/CNS metastasis at first recurrence.