Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Features and prognostic impact of distant metastasis in patients with stage IV lung adenocarcinoma harboring EGFR mutations: importance of bone metastasis
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.