EGFR Mutation is a Prognostic Factor in Lung Cancer Patients with Pleural Dissemination Detected During or After Surgery

Background Primary lung tumors are sometimes resected when either pleural dissemination (PD) or malignant pleural effusion (MPE) exists. This study clarified the prognostic factors for non-small cell lung cancer (NSCLC) with either PD and MPE, or both, detected during or after surgery. Patients and...

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Bibliographic Details
Published in:Annals of surgical oncology 2023-10, Vol.30 (11), p.6697-6702
Main Authors: Fujiwara, Toshiya, Shien, Kazuhiko, Matsuura, Motoki, Soh, Junichi, Yamamoto, Hiromasa, Takao, Soshi, Maki, Yuho, Ueno, Tsuyoshi, Sugimoto, Ryujiro, Suzawa, Ken, Okazaki, Mikio, Tao, Hiroyuki, Hayama, Makio, Kataoka, Masafumi, Sano, Yoshifumi, Inokawa, Hidetoshi, Yamashita, Motohiro, Kawamata, Osamu, Kataoka, Kazuhiko, Toyooka, Shinichi
Format: Article
Language:English
Subjects:
Adenocarcinoma
Chemotherapy
Epidermal growth factor receptors
Lung cancer
Lymph nodes
Lymphatic system
Medical prognosis
Medicine
Medicine & Public Health
Metastases
Metastasis
Multivariate analysis
Mutation
Non-small cell lung carcinoma
Oncology
Ostomy
Pleural effusion
Protein-tyrosine kinase
Small cell lung carcinoma
Surgery
Surgical Oncology
Thoracic Oncology
Tumors
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Summary:Background Primary lung tumors are sometimes resected when either pleural dissemination (PD) or malignant pleural effusion (MPE) exists. This study clarified the prognostic factors for non-small cell lung cancer (NSCLC) with either PD and MPE, or both, detected during or after surgery. Patients and Methods We examined patients with NSCLC from a multicenter database who had either PD, MPE, or both, detected during or after surgery between 2005 and 2015. Hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model adjusted for potential confounding factors. Results Among 9463 registered patients, PD, MPE, or both, were found in 114 patients with NSCLC during or after surgery. Primary tumor resection and exploratory thoracotomy were performed in 65 and 49 patients, respectively. In univariate analysis, adenocarcinoma, clinically undetected lymph node metastasis (c-N0 or unknown), EGFR mutation, and combination of chemotherapy or tyrosine kinase inhibitors after surgery were better prognostic factors for overall survival (OS), whereas in the multivariate analysis, adenocarcinoma, clinically undetected lymph node metastasis, and EGFR mutation were favorable independent prognostic factors in OS. Additionally, limited to patients with EGFR mutation, patients with primary lung tumor resection showed a significantly better 5-year OS than those with exploratory thoracotomy (86.4 vs. 44.8%; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-023-13791-y