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01-06-2014 | Research Paper

Features and prognostic impact of distant metastasis in patients with stage IV lung adenocarcinoma harboring EGFR mutations: importance of bone metastasis

Authors: Daichi Fujimoto, Hiroyuki Ueda, Ryoko Shimizu, Ryoji Kato, Takehiro Otoshi, Takahisa Kawamura, Koji Tamai, Yumi Shibata, Takeshi Matsumoto, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Nobuyuki Katakami, Keisuke Tomii

Published in: Clinical & Experimental Metastasis | Issue 5/2014

Abstract

Mutated epidermal growth factor receptor (EGFR) and signaling pathways were associated with multiple brain and intra-pulmonary metastases, oncogenic progression and metastasis. However, features of metastasis to other organs and the independent prognostic influence of metastatic lesions were not elucidated in patients with lung cancer harboring EGFR mutations. Between January 2007 and April 2012, we treated 277 patients diagnosed with stage IV lung adenocarcinoma. Studied were 246 patients with available tumor EGFR mutation data who also underwent radiographic evaluation of lung, abdominal, brain, and bone metastases. The EGFR mutated group (N = 98) had significantly more metastatic lesions in the brain and bone than the wild-type group (N = 148): brain, 3 (1–93) versus 2 (1–32) median (range), P = 0.023; bone, 3 (1–43) versus 2 (1–27), P = 0.035, respectively. In addition, EGFR mutations were significantly more frequent in patients with multiple than non-multiple lung metastases (24/40 vs. 12/42, P = 0.004). Multivariate analysis showed that bone metastasis was a significant independent negative predictive factor of overall survival (OS) in patients with mutated [hazard ratio (HR) 2.04; 95 % confidence interval (CI) 1.17–3.64; P = 0.011] and wild-type EGFR (HR 2.09; 95 % CI 1.37–3.20; P < 0.001). In conclusion, patients with mutated EGFR had more lung, brain, and bone metastases, and bone metastasis was an independent negative predictor of OS.

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Title: Features and prognostic impact of distant metastasis in patients with stage IV lung adenocarcinoma harboring EGFR mutations: importance of bone metastasis
Authors: Daichi Fujimoto
Hiroyuki Ueda
Ryoko Shimizu
Ryoji Kato
Takehiro Otoshi
Takahisa Kawamura
Koji Tamai
Yumi Shibata
Takeshi Matsumoto
Kazuma Nagata
Kyoko Otsuka
Atsushi Nakagawa
Kojiro Otsuka
Nobuyuki Katakami
Keisuke Tomii
Publication date: 01-06-2014
Publisher: Springer Netherlands
Published in: Clinical & Experimental Metastasis / Issue 5/2014
Print ISSN: 0262-0898
Electronic ISSN: 1573-7276
DOI: https://doi.org/10.1007/s10585-014-9648-3

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