Mutations of the EGFR and K-ras genes in resected stage I lung adenocarcinoma and their clinical significance. Academic Article uri icon

Overview

abstract

  • PURPOSE: This study retrospectively assessed the mutations of the epidermal growth factor receptor (EGFR) and K-ras genes and their clinical significance in patients with resected stage I adenocarcinomas. METHODS: A total of 354 patients with resected lung adenocarcinomas were included, and 256 patients with stage I disease were analyzed for the prognostic and predictive value of these mutations. RESULTS: Mutations of EGFR and K-ras genes were detected in 149 (41.1 %) and 23 (6.4 %) of all tumors, and in 122 (47.6 %) and 14 (5.5 %) of stage I tumors, respectively. There were no significant differences in the disease-free survival (DFS) and overall survival (OS) between the EGFR-mutant and wild-type groups. However, the DFS and OS were significantly shorter in patients with K-ras mutations than in those without (5-year DFS: 50.8 vs. 76.9 %, 5-year OS: 70.0 vs. 86.6 %, p < 0.01). A multivariate analysis showed that K-ras mutations were an independent poor prognostic factor. Twenty-four of the 41 patients with recurrent disease after surgery were treated with an EGFR-TKI. Fifteen EGFR-mutant patients treated with an EGFR-TKI had a better prognosis than did the nine EGFR-wild-type patients. CONCLUSION: The presence of an EGFR gene mutation was a predictive factor for the response to EGFR-TKI treatment in patients with resected stage I adenocarcinoma, but was not a prognostic factor. The presence of a K-ras gene mutation was a poor prognostic factor.

publication date

  • April 23, 2013

Research

keywords

  • Adenocarcinoma
  • ErbB Receptors
  • Genes, ras
  • Lung Neoplasms
  • Mutation
  • Protein-Tyrosine Kinases

Identity

Scopus Document Identifier

  • 84896698413

Digital Object Identifier (DOI)

  • 10.1007/s00595-013-0589-2

PubMed ID

  • 23609009

Additional Document Info

volume

  • 44

issue

  • 3