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03-02-2025 | NSCLC | Original Article

Effect of ground-glass opacity components on the recurrence of pathological stage IB non-small cell lung cancer harboring epidermal growth factor receptor mutations

Authors: Yukio Watanabe, Takuo Hayashi, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Momoko Tonosaki, Kazuya Takamochi, Kenji Suzuki

Published in: Surgery Today

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Abstract

Purpose

This study aimed to examine the influence of ground-glass opacity (GGO) on the prognosis of epidermal growth factor receptor (EGFR)-mutated pathological (p)-stage IB non-small cell lung cancer (NSCLC).

Methods

Between 2009 and 2021, 115 patients underwent complete anatomical lung resection with mediastinal lymphadenectomy for p-stage IB non-squamous NSCLC harboring common EGFR mutations. The patients were classified into the part-solid and pure-solid arms based on the presence of GGO components.

Results

The median follow-up time was 70.2 months. Sixty-seven patients (58%) had pure-solid tumors and 112 (97%) were diagnosed with adenocarcinoma. No patients received adjuvant EGFR–tyrosine kinase inhibitors (TKIs). The 5-year disease-free survival (DFS) rates in the pure-solid arm were significantly lower than those in the part-solid arm (5-year DFS: 45.3% vs. 86.8%, p < 0.01). The 5-year cumulative incidence of recurrence was higher in the pure-solid arm than that in the part-solid arm (49.9% vs. 9.0%, p < 0.01). A multivariable analysis revealed that pure-solid tumors were an independent prognostic predictor of disease-free survival, whereas pathological factors were not.

Conclusions

In EGFR-mutated p-stage IB NSCLC, pure-solid tumors were significant predictors of DFS. The presence of GGO components should be considered in the decision criteria for adjuvant therapy with TKIs.
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Literature
1.
go back to reference Mitsudomi T, Kosaka T, Yatabe Y. Biological and clinical implications of EGFR mutations in lung cancer. Int J Clin Oncol. 2006;11(3):190–8.CrossRefPubMed Mitsudomi T, Kosaka T, Yatabe Y. Biological and clinical implications of EGFR mutations in lung cancer. Int J Clin Oncol. 2006;11(3):190–8.CrossRefPubMed
2.
go back to reference Takamochi K, Oh S, Matsunaga T, Suzuki K. Prognostic impacts of EGFR mutation status and subtype in patients with surgically resected lung adenocarcinoma. J Thorac Cardiovasc Surg. 2017;154(5):1768-74.e1.CrossRefPubMed Takamochi K, Oh S, Matsunaga T, Suzuki K. Prognostic impacts of EGFR mutation status and subtype in patients with surgically resected lung adenocarcinoma. J Thorac Cardiovasc Surg. 2017;154(5):1768-74.e1.CrossRefPubMed
3.
go back to reference Mitsudomi T, Kosaka T, Endoh H, Horio Y, Hida T, Mori S, et al. Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence. J Clin Oncol. 2005;23(11):2513–20.CrossRefPubMed Mitsudomi T, Kosaka T, Endoh H, Horio Y, Hida T, Mori S, et al. Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence. J Clin Oncol. 2005;23(11):2513–20.CrossRefPubMed
4.
go back to reference Ramalingam SS, Vansteenkiste J, Planchard D, Cho BC, Gray JE, Ohe Y, et al. Overall survival with osimertinib in untreated, EGFR-mutated advanced NSCLC. N Engl J Med. 2020;382(1):41–50.CrossRefPubMed Ramalingam SS, Vansteenkiste J, Planchard D, Cho BC, Gray JE, Ohe Y, et al. Overall survival with osimertinib in untreated, EGFR-mutated advanced NSCLC. N Engl J Med. 2020;382(1):41–50.CrossRefPubMed
5.
go back to reference Herbst RS, Wu YL, John T, Grohe C, Majem M, Wang J, et al. Adjuvant osimertinib for resected EGFR-mutated stage IB-IIIA non-small-cell lung cancer: updated results from the phase III randomized ADAURA trial. J Clin Oncol. 2023;41(10):1830–40.CrossRefPubMedPubMedCentral Herbst RS, Wu YL, John T, Grohe C, Majem M, Wang J, et al. Adjuvant osimertinib for resected EGFR-mutated stage IB-IIIA non-small-cell lung cancer: updated results from the phase III randomized ADAURA trial. J Clin Oncol. 2023;41(10):1830–40.CrossRefPubMedPubMedCentral
6.
go back to reference Tsuboi M, Herbst RS, John T, Kato T, Majem M, Grohé C, et al. Overall survival with osimertinib in resected EGFR-mutated NSCLC. N Engl J Med. 2023;389(2):137–47.CrossRefPubMed Tsuboi M, Herbst RS, John T, Kato T, Majem M, Grohé C, et al. Overall survival with osimertinib in resected EGFR-mutated NSCLC. N Engl J Med. 2023;389(2):137–47.CrossRefPubMed
7.
go back to reference Watanabe Y, Hattori A, Nojiri S, Matsunaga T, Takamochi K, Oh S, Suzuki K. Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2022;163(3):791-801.e4.CrossRefPubMed Watanabe Y, Hattori A, Nojiri S, Matsunaga T, Takamochi K, Oh S, Suzuki K. Clinical impact of a small component of ground-glass opacity in solid-dominant clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2022;163(3):791-801.e4.CrossRefPubMed
8.
go back to reference Hattori A, Suzuki K, Takamochi K, Wakabayashi M, Aokage K, Saji H, Watanabe SI. Prognostic impact of a ground-glass opacity component in clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2021;161(4):1469–80.CrossRefPubMed Hattori A, Suzuki K, Takamochi K, Wakabayashi M, Aokage K, Saji H, Watanabe SI. Prognostic impact of a ground-glass opacity component in clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2021;161(4):1469–80.CrossRefPubMed
9.
go back to reference Suda K, Mitsudomi T, Shintani Y, Okami J, Ito H, Ohtsuka T, et al. Clinical impacts of egfr mutation status: analysis of 5780 surgically resected lung cancer cases. Ann Thorac Surg. 2021;111(1):269–76.CrossRefPubMed Suda K, Mitsudomi T, Shintani Y, Okami J, Ito H, Ohtsuka T, et al. Clinical impacts of egfr mutation status: analysis of 5780 surgically resected lung cancer cases. Ann Thorac Surg. 2021;111(1):269–76.CrossRefPubMed
10.
go back to reference Yatabe Y, Borczuk AC, Powell CA. Do all lung adenocarcinomas follow a stepwise progression? Lung Cancer. 2011;74(1):7–11.CrossRefPubMed Yatabe Y, Borczuk AC, Powell CA. Do all lung adenocarcinomas follow a stepwise progression? Lung Cancer. 2011;74(1):7–11.CrossRefPubMed
11.
go back to reference Kobayashi Y, Mitsudomi T, Sakao Y, Yatabe Y. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: the differences between nodules with and without growth. Ann Oncol. 2015;26(1):156–61.CrossRefPubMed Kobayashi Y, Mitsudomi T, Sakao Y, Yatabe Y. Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules: the differences between nodules with and without growth. Ann Oncol. 2015;26(1):156–61.CrossRefPubMed
12.
go back to reference Aokage K, Miyoshi T, Wakabayashi M, Ikeno T, Suzuki J, Tane K, et al. Prognostic influence of epidermal growth factor receptor mutation and radiological ground glass appearance in patients with early-stage lung adenocarcinoma. Lung Cancer. 2021;160:8–16.CrossRefPubMed Aokage K, Miyoshi T, Wakabayashi M, Ikeno T, Suzuki J, Tane K, et al. Prognostic influence of epidermal growth factor receptor mutation and radiological ground glass appearance in patients with early-stage lung adenocarcinoma. Lung Cancer. 2021;160:8–16.CrossRefPubMed
13.
go back to reference Deng C, Zhang Y, Ma Z, Fu F, Deng L, Li Y, Chen H. Prognostic value of epidermal growth factor receptor gene mutation in resected lung adenocarcinoma. J Thorac Cardiovasc Surg. 2021;162(3):664-74.e7.CrossRefPubMed Deng C, Zhang Y, Ma Z, Fu F, Deng L, Li Y, Chen H. Prognostic value of epidermal growth factor receptor gene mutation in resected lung adenocarcinoma. J Thorac Cardiovasc Surg. 2021;162(3):664-74.e7.CrossRefPubMed
14.
go back to reference Hattori A, Matsunaga T, Fukui M, Takamochi K, Suzuki K. Prognosis of epidermal growth factor receptor-mutated stage I lung adenocarcinoma with radiologically solid features. Eur J Cardiothorac Surg. 2022;61(4):769–77.CrossRefPubMed Hattori A, Matsunaga T, Fukui M, Takamochi K, Suzuki K. Prognosis of epidermal growth factor receptor-mutated stage I lung adenocarcinoma with radiologically solid features. Eur J Cardiothorac Surg. 2022;61(4):769–77.CrossRefPubMed
16.
go back to reference WHO Classification of Tumors Editorial Board. WHO classification of tumours: thoracic tumours. 5th ed. Lyon, France.: International Agency for Research on Cancer; 2021.; 2021. WHO Classification of Tumors Editorial Board. WHO classification of tumours: thoracic tumours. 5th ed. Lyon, France.: International Agency for Research on Cancer; 2021.; 2021.
17.
go back to reference Nagai Y, Miyazawa H, Huqun TT, Udagawa K, Kato M, et al. Genetic heterogeneity of the epidermal growth factor receptor in non-small cell lung cancer cell lines revealed by a rapid and sensitive detection system, the peptide nucleic acid-locked nucleic acid PCR clamp. Cancer Res. 2005;65(16):7276–82.CrossRefPubMed Nagai Y, Miyazawa H, Huqun TT, Udagawa K, Kato M, et al. Genetic heterogeneity of the epidermal growth factor receptor in non-small cell lung cancer cell lines revealed by a rapid and sensitive detection system, the peptide nucleic acid-locked nucleic acid PCR clamp. Cancer Res. 2005;65(16):7276–82.CrossRefPubMed
18.
go back to reference Hattori A, Hirayama S, Matsunaga T, Hayashi T, Takamochi K, Oh S, Suzuki K. Distinct clinicopathologic characteristics and prognosis based on the presence of ground glass opacity component in clinical stage IA lung adenocarcinoma. J Thorac Oncol. 2019;14(2):265–75.CrossRefPubMed Hattori A, Hirayama S, Matsunaga T, Hayashi T, Takamochi K, Oh S, Suzuki K. Distinct clinicopathologic characteristics and prognosis based on the presence of ground glass opacity component in clinical stage IA lung adenocarcinoma. J Thorac Oncol. 2019;14(2):265–75.CrossRefPubMed
19.
go back to reference Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer. 1995;75(12):2844–52.CrossRefPubMed Noguchi M, Morikawa A, Kawasaki M, Matsuno Y, Yamada T, Hirohashi S, et al. Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer. 1995;75(12):2844–52.CrossRefPubMed
20.
go back to reference Suehisa H, Toyooka S, Hotta K, Uchida A, Soh J, Fujiwara Y, et al. Epidermal growth factor receptor mutation status and adjuvant chemotherapy with uracil-tegafur for adenocarcinoma of the lung. J Clin Oncol. 2007;25(25):3952–7.CrossRefPubMed Suehisa H, Toyooka S, Hotta K, Uchida A, Soh J, Fujiwara Y, et al. Epidermal growth factor receptor mutation status and adjuvant chemotherapy with uracil-tegafur for adenocarcinoma of the lung. J Clin Oncol. 2007;25(25):3952–7.CrossRefPubMed
21.
go back to reference Tsutani Y, Ito M, Shimada Y, Ito H, Ikeda N, Nakayama H, Okada M. The impact of epidermal growth factor receptor mutation status on adjuvant chemotherapy for patients with high-risk stage I lung adenocarcinoma. J Thorac Cardiovasc Surg. 2022;164(5):1306-15.e4.CrossRefPubMed Tsutani Y, Ito M, Shimada Y, Ito H, Ikeda N, Nakayama H, Okada M. The impact of epidermal growth factor receptor mutation status on adjuvant chemotherapy for patients with high-risk stage I lung adenocarcinoma. J Thorac Cardiovasc Surg. 2022;164(5):1306-15.e4.CrossRefPubMed
Metadata
Title
Effect of ground-glass opacity components on the recurrence of pathological stage IB non-small cell lung cancer harboring epidermal growth factor receptor mutations
Authors
Yukio Watanabe
Takuo Hayashi
Aritoshi Hattori
Mariko Fukui
Takeshi Matsunaga
Momoko Tonosaki
Kazuya Takamochi
Kenji Suzuki
Publication date
03-02-2025
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-025-03006-0
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