Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection
A definitive surgical resection is the preferred treatment for early-stage non-small cell lung cancer (NSCLC). Research on genetic alterations, including epidermal growth factor receptor (EGFR) mutations, in early-stage NSCLC remains insufficient. We investigated the prevalence of genetic alteration...
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MDPI AG
2023-11-01
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| Online Access: | https://www.mdpi.com/2072-6694/15/23/5679 |
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| author | Hwa Kyung Park Yoo Duk Choi Ju-Sik Yun Sang-Yun Song Kook-Joo Na Joon Young Yoon Chang-Seok Yoon Hyung-Joo Oh Young-Chul Kim In-Jae Oh |
| author_facet | Hwa Kyung Park Yoo Duk Choi Ju-Sik Yun Sang-Yun Song Kook-Joo Na Joon Young Yoon Chang-Seok Yoon Hyung-Joo Oh Young-Chul Kim In-Jae Oh |
| author_sort | Hwa Kyung Park |
| collection | DOAJ |
| description | A definitive surgical resection is the preferred treatment for early-stage non-small cell lung cancer (NSCLC). Research on genetic alterations, including epidermal growth factor receptor (EGFR) mutations, in early-stage NSCLC remains insufficient. We investigated the prevalence of genetic alterations in early-stage NSCLC and the association between EGFR mutations and recurrence after a complete resection. Between January 2019 and December 2021, 659 patients with NSCLC who underwent curative surgical resections at a single regional cancer center in Korea were recruited. We retrospectively compared the clinical and pathological data between the recurrence and non-recurrence groups. Among the 659 enrolled cases, the median age was 65.86 years old and the most common histology was adenocarcinoma (74.5%), followed by squamous cell carcinoma (21.7%). The prevalence of EGFR mutations was 43% (194/451). Among them, L858R point mutations and exon 19 deletions were 52.3% and 42%, respectively. Anaplastic lymphoma kinase (ALK) rearrangement was found in 5.7% of patients (26/453) and ROS proto-oncogene 1 (ROS1) fusion was found in 1.6% (7/441). The recurrence rate for the entire population was 19.7%. In the multivariate analysis, the presence of EGFR mutations (hazard ratio (HR): 2.698; 95% CI: 1.458–4.993; <i>p</i> = 0.002), stage II (HR: 2.614; 95% CI: 1.29–5.295; <i>p</i> = 0.008) or III disease (HR: 9.537; 95% CI: 4.825–18.852; <i>p</i> < 0.001) (vs. stage I disease), and the presence of a pathologic solid type (HR: 2.598; 95% CI: 1.405–4.803; <i>p</i> = 0.002) were associated with recurrence. Among the recurrence group, 86.5% of the patients with EGFR mutations experienced distant metastases compared with only 66.7% of the wild type (<i>p</i> = 0.016), with no significant difference in median disease-free survival (52.21 months vs. not reached; <i>p</i> = 0.983). In conclusion, adjuvant or neoadjuvant targeted therapy could be considered more actively because EGFR mutations were identified as an independent risk factor for recurrence and were associated with systemic recurrence. Further studies on perioperative therapy for other genetic alterations are necessary. |
| first_indexed | 2024-03-09T01:53:52Z |
| format | Article |
| id | doaj.art-704e6741f7934338a79a1d0a7c8d386a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T01:53:52Z |
| publishDate | 2023-11-01 |
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| series | Cancers |
| spelling | doaj.art-704e6741f7934338a79a1d0a7c8d386a2023-12-08T15:12:55ZengMDPI AGCancers2072-66942023-11-011523567910.3390/cancers15235679Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical ResectionHwa Kyung Park0Yoo Duk Choi1Ju-Sik Yun2Sang-Yun Song3Kook-Joo Na4Joon Young Yoon5Chang-Seok Yoon6Hyung-Joo Oh7Young-Chul Kim8In-Jae Oh9Lung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaLung Cancer Center, Chonnam National University Hwasun Hospital, Gwangju 58128, Republic of KoreaA definitive surgical resection is the preferred treatment for early-stage non-small cell lung cancer (NSCLC). Research on genetic alterations, including epidermal growth factor receptor (EGFR) mutations, in early-stage NSCLC remains insufficient. We investigated the prevalence of genetic alterations in early-stage NSCLC and the association between EGFR mutations and recurrence after a complete resection. Between January 2019 and December 2021, 659 patients with NSCLC who underwent curative surgical resections at a single regional cancer center in Korea were recruited. We retrospectively compared the clinical and pathological data between the recurrence and non-recurrence groups. Among the 659 enrolled cases, the median age was 65.86 years old and the most common histology was adenocarcinoma (74.5%), followed by squamous cell carcinoma (21.7%). The prevalence of EGFR mutations was 43% (194/451). Among them, L858R point mutations and exon 19 deletions were 52.3% and 42%, respectively. Anaplastic lymphoma kinase (ALK) rearrangement was found in 5.7% of patients (26/453) and ROS proto-oncogene 1 (ROS1) fusion was found in 1.6% (7/441). The recurrence rate for the entire population was 19.7%. In the multivariate analysis, the presence of EGFR mutations (hazard ratio (HR): 2.698; 95% CI: 1.458–4.993; <i>p</i> = 0.002), stage II (HR: 2.614; 95% CI: 1.29–5.295; <i>p</i> = 0.008) or III disease (HR: 9.537; 95% CI: 4.825–18.852; <i>p</i> < 0.001) (vs. stage I disease), and the presence of a pathologic solid type (HR: 2.598; 95% CI: 1.405–4.803; <i>p</i> = 0.002) were associated with recurrence. Among the recurrence group, 86.5% of the patients with EGFR mutations experienced distant metastases compared with only 66.7% of the wild type (<i>p</i> = 0.016), with no significant difference in median disease-free survival (52.21 months vs. not reached; <i>p</i> = 0.983). In conclusion, adjuvant or neoadjuvant targeted therapy could be considered more actively because EGFR mutations were identified as an independent risk factor for recurrence and were associated with systemic recurrence. Further studies on perioperative therapy for other genetic alterations are necessary.https://www.mdpi.com/2072-6694/15/23/5679epidermal growth factor receptorgenenon-small cell lung cancerrecurrencesurgery |
| spellingShingle | Hwa Kyung Park Yoo Duk Choi Ju-Sik Yun Sang-Yun Song Kook-Joo Na Joon Young Yoon Chang-Seok Yoon Hyung-Joo Oh Young-Chul Kim In-Jae Oh Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection Cancers epidermal growth factor receptor gene non-small cell lung cancer recurrence surgery |
| title | Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection |
| title_full | Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection |
| title_fullStr | Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection |
| title_full_unstemmed | Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection |
| title_short | Genetic Alterations and Risk Factors for Recurrence in Patients with Non-Small Cell Lung Cancer Who Underwent Complete Surgical Resection |
| title_sort | genetic alterations and risk factors for recurrence in patients with non small cell lung cancer who underwent complete surgical resection |
| topic | epidermal growth factor receptor gene non-small cell lung cancer recurrence surgery |
| url | https://www.mdpi.com/2072-6694/15/23/5679 |
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