Wang Long, Shi Tiantian, Feng Li, Fan Zhisong, Xu Xiaoli, Zhou Xinliang, Zhang Xue, Han Jing, Jing Li, Liu Jiayin, Shan Yujie, Liu Fengling, Zuo Jing, Wang Yudong
Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People's Republic of China.
Department of Medical Records, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, People's Republic of China.
Cancer Manag Res. 2021 Mar 18;13:2613-2622. doi: 10.2147/CMAR.S298579. eCollection 2021.
Several studies have revealed the prognostic value distant metastasis in non-small-cell lung cancer (NSCLC) patients receiving first-line epidermal growth factor receptor (EGFR) inhibitors. However, the question of whether the specific metastatic site could predict survival outcomes remain elusive. This study evaluated the prognostic value of specific metastatic site at diagnosis in first-line icotinib-treated patients with -mutated advanced NSCLC.
A total of 216 patients with -mutated stage IV NSCLC who received first-line icotinib treatment were retrospectively enrolled. The associations between the presence of distant metastasis to certain organs at diagnosis and survival outcomes were analyzed.
The presence of distant metastases was not associated with progression-free survival. Patients with liver metastasis showed a significantly shorter OS than those without liver metastasis (14.6m vs 33.0m, p=0.024). Patients with brain metastasis showed a marginally shorter OS than those without brain metastasis (26.5m vs 33.8m, p=0.051). Patients with lung metastasis showed a significantly longer OS than those without lung metastasis (36.0m vs 28.6m, p=0.038). Multivariable Cox regression analysis showed the presence of liver metastasis (HR [hazard ratio]: 2.265, 95% CI [confidence interval]: 1.239-4.139, p=0.008) and brain metastasis (HR: 1.493, 95% CI: 1.012-2.202, p=0.043) were independent predictors for unfavorable OS, while lung metastasis (HR: 0.669, 95% CI: 0.460-0.971, p=0.034) was an independent predictor for favorable OS.
The presence of liver and brain metastasis predicted unfavorable OS, while the presence of lung metastasis predicted favorable OS in first-line icotinib-treated patients with -mutated stage IV NSCLC.
多项研究揭示了远处转移在接受一线表皮生长因子受体（EGFR）抑制剂治疗的非小细胞肺癌（NSCLC）患者中的预后价值。然而，特定转移部位是否能预测生存结果的问题仍不明确。本研究评估了在一线接受埃克替尼治疗的EGFR突变晚期NSCLC患者中，诊断时特定转移部位的预后价值。
回顾性纳入了216例接受一线埃克替尼治疗的EGFR突变IV期NSCLC患者。分析了诊断时远处转移至某些器官与生存结果之间的关联。
远处转移的存在与无进展生存期无关。肝转移患者的总生存期显著短于无肝转移患者（14.6个月对33.0个月，p = 0.024）。脑转移患者的总生存期略短于无脑转移患者（26.5个月对33.8个月，p = 0.051）。肺转移患者的总生存期显著长于无肺转移患者（36.0个月对28.6个月）。多变量Cox回归分析显示，肝转移（风险比[HR]：2.265，95%置信区间[CI]：1.239 - 4.139，p = 0.008）和脑转移（HR：1.493，95% CI：1.012 - 2.202，p = 0.043）是总生存期不良的独立预测因素，而肺转移（HR：0.669，95% CI：0.460 - 0.971，p = 0.034）是总生存期良好的独立预测因素。
在一线接受埃克替尼治疗的EGFR突变IV期NSCLC患者中，肝转移和脑转移的存在预示总生存期不良，而肺转移的存在预示总生存期良好。
