Cancer Res Treat.  2013 Jun;45(2):95-102.

Predicting Survival in Patients with Advanced Non-squamous Non-small Cell Lung Cancer: Validating the Extent of Metastasis

• Lee DS
• Kang JH
• Lee CG
• Kim SJ
• Choi YJ
• Lee KY
• Kim YS

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.

Keyword

Epidermal growth factor receptor; Mutation; Adenocarcinoma of lung; Neoplasm metastasis; Non-small cell lung carcinoma; Prognosis

MeSH Terms

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
Adenocarcinoma
Lung Neoplasms
Receptor, Epidermal Growth Factor

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