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- Title
The mutations of the EGFR and K-ras genes in resected stage I lung adenocarcinoma and their clinical significance.
- Authors
Ohba, Taro; Toyokawa, Gouji; Kometani, Takuro; Nosaki, Kaname; Hirai, Fumihiko; Yamaguchi, Masafumi; Hamatake, Motoharu; Seto, Takashi; Ichinose, Yukito; Sugio, Kenji
- 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.
- Subjects
EPIDERMAL growth factor receptors; GENETIC mutation; ADENOCARCINOMA; MULTIVARIATE analysis; PROGNOSIS; PATIENTS
- Publication
Surgery Today, 2014, Vol 44, Issue 3, p478
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-013-0589-2