Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
Abstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from Jan...
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| Format: | Article |
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Nature Portfolio
2020-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-020-71996-7 |
| _version_ | 1818570620325068800 |
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| author | Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee |
| author_facet | Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee |
| author_sort | Hyun Woo Lee |
| collection | DOAJ |
| description | Abstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from January 2011 to December 2014 were followed up for 5 years. Of the 2,289 NSCLC cases, 911 (39.8%) cases pertained to lower lobe cancers. Patients with lower lobe cancer showed a higher all-cause mortality rate than those with non-lower lobe cancer (48.6% vs. 40.3%, p < 0.001). Patients with lower lobe cancer had a lower proportion of adenocarcinoma histology and epidermal growth factor receptor (EGFR) mutations. Furthermore, compared to patients with non-lower lobe cancer, those with lower lobe cancer had a higher level of tumor markers (neuron-specific enolase and cytokeratin fragment 21-1). Mediation analysis revealed that the association between lower lobe cancer and higher all-cause mortality could be explained by an indirect pathway through EGFR mutations (percent mediated = 17.3%, p = 0.005). The sensitivity analysis for adenocarcinoma patients showed similar results (percent mediated = 18.8%, p = 0.021). Lower lobe cancer is associated with a higher all-cause mortality risk in patients with NSCLC, which is partly mediated by a lower proportion of EGFR mutations. |
| first_indexed | 2024-12-14T13:44:21Z |
| format | Article |
| id | doaj.art-42a26d4640764645aa4fd4e479833fb3 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T13:44:21Z |
| publishDate | 2020-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-42a26d4640764645aa4fd4e479833fb32022-12-21T22:59:22ZengNature PortfolioScientific Reports2045-23222020-09-011011810.1038/s41598-020-71996-7Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutationsHyun Woo Lee0Young Sik Park1Sangshin Park2Chang-Hoon Lee3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University HospitalDepartment of Pediatrics, Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown UniversityDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University HospitalAbstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from January 2011 to December 2014 were followed up for 5 years. Of the 2,289 NSCLC cases, 911 (39.8%) cases pertained to lower lobe cancers. Patients with lower lobe cancer showed a higher all-cause mortality rate than those with non-lower lobe cancer (48.6% vs. 40.3%, p < 0.001). Patients with lower lobe cancer had a lower proportion of adenocarcinoma histology and epidermal growth factor receptor (EGFR) mutations. Furthermore, compared to patients with non-lower lobe cancer, those with lower lobe cancer had a higher level of tumor markers (neuron-specific enolase and cytokeratin fragment 21-1). Mediation analysis revealed that the association between lower lobe cancer and higher all-cause mortality could be explained by an indirect pathway through EGFR mutations (percent mediated = 17.3%, p = 0.005). The sensitivity analysis for adenocarcinoma patients showed similar results (percent mediated = 18.8%, p = 0.021). Lower lobe cancer is associated with a higher all-cause mortality risk in patients with NSCLC, which is partly mediated by a lower proportion of EGFR mutations.https://doi.org/10.1038/s41598-020-71996-7 |
| spellingShingle | Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations Scientific Reports |
| title | Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations |
| title_full | Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations |
| title_fullStr | Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations |
| title_full_unstemmed | Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations |
| title_short | Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations |
| title_sort | poor prognosis of nsclc located in lower lobe is partly mediated by lower frequency of egfr mutations |
| url | https://doi.org/10.1038/s41598-020-71996-7 |
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