日本語フィールド
著者：*Ryo Miyata, Masatsugu Hamaji, Atsushi Kawaguchi, Yumeta Shimazu, Masaki Ikeda, Masashi Ishikawa, Hidenao Kayawake, Toshi Menju, Masashi Kobayashi, Norihito Okumura, Yasuto Sakaguchi, Makoto Sonobe, Akira Matsumoto, Tsuyoshi Shoji, Hiromichi Katakura, Ryota Sumitomo, Cheng-Long Huang, Mamoru Takahashi, Akihiro Aoyama, Yusuke Muranishi, Tomoya Kono, Ryo Miyahara, Naoki Date, Takuji Fujinaga, Ei Miyamoto, Tatsuo Nakagawa, Takahisa Fukada, Hiroaki Sakai, Hiroshi Date題名：Epidermal growth factor receptor tyrosine kinase inhibitors as first-line treatment for postoperative recurrent EGFR-mutated lung adenocarcinoma: a multi-institutional retrospective study発表情報：Eur J Cardiothorac Surg 巻: 62 号: 5 ページ: ezac430キーワード：epidermal growth factor receptor tyrosine kinase inhibitors; lung adenocarcinoma; postoperative recurrence概要：Objectives: To analyze the long-term survival outcomes and prognostic factors of patients receiving epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as first-line treatment for postoperative recurrent EGFR-mutated lung adenocarcinoma.
Methods: Using a multi-institutional database, we performed a retrospective chart review to identify all patients who had undergone complete resection of stage I-III EGFR-mutated lung adenocarcinoma at 11 acute care hospitals between 2009 and 2016, and had received first-line EGFR-TKI treatment for postoperative recurrence. Adverse events, progression-free survival (PFS), and overall survival (OS) were investigated. Survival outcomes were assessed using Kaplan-Meier analysis. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for PFS and OS.
Results: The study sample comprised 154 patients with a median age of 69. The total numbers of events were 101 for PFS and 60 for OS. The median PFS and OS were 26.1 months and 55.4 months, respectively. In the multivariable analysis, EGFR ex 21 L858R mutation (HR: 1.71, 95% CI: 1.15-2.55) and shorter disease-free intervals (HR: 0.98, 95% CI: 0.96-0.99) were significantly associated with shorter PFS. Age (HR: 1.03, 95% CI: 1.00-1.07), smoking history (HR: 2.31, 95% CI: 1.35-3.94) and pathological N2 disease at the initial surgery (HR: 2.30, 95% CI: 1.32-4.00) were significantly associated with shorter OS.
Conclusions: First-line EGFR-TKI treatment was generally associated with favorable survival outcomes in patients with postoperative recurrent EGFR-mutated lung adenocarcinoma. EGFR ex 21 L858R mutation may be an important prognostic factor for shorter PFS.抄録：英語フィールド
Author：*Ryo Miyata, Masatsugu Hamaji, Atsushi Kawaguchi, Yumeta Shimazu, Masaki Ikeda, Masashi Ishikawa, Hidenao Kayawake, Toshi Menju, Masashi Kobayashi, Norihito Okumura, Yasuto Sakaguchi, Makoto Sonobe, Akira Matsumoto, Tsuyoshi Shoji, Hiromichi Katakura, Ryota Sumitomo, Cheng-Long Huang, Mamoru Takahashi, Akihiro Aoyama, Yusuke Muranishi, Tomoya Kono, Ryo Miyahara, Naoki Date, Takuji Fujinaga, Ei Miyamoto, Tatsuo Nakagawa, Takahisa Fukada, Hiroaki Sakai, Hiroshi DateTitle：Epidermal growth factor receptor tyrosine kinase inhibitors as first-line treatment for postoperative recurrent EGFR-mutated lung adenocarcinoma: a multi-institutional retrospective studyAnnouncement information:Eur J Cardiothorac Surg Vol: 62 Issue: 5 Page: ezac430Keyword：epidermal growth factor receptor tyrosine kinase inhibitors; lung adenocarcinoma; postoperative recurrenceAn abstract：Objectives: To analyze the long-term survival outcomes and prognostic factors of patients receiving epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as first-line treatment for postoperative recurrent EGFR-mutated lung adenocarcinoma.
Methods: Using a multi-institutional database, we performed a retrospective chart review to identify all patients who had undergone complete resection of stage I-III EGFR-mutated lung adenocarcinoma at 11 acute care hospitals between 2009 and 2016, and had received first-line EGFR-TKI treatment for postoperative recurrence. Adverse events, progression-free survival (PFS), and overall survival (OS) were investigated. Survival outcomes were assessed using Kaplan-Meier analysis. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for PFS and OS.
Results: The study sample comprised 154 patients with a median age of 69. The total numbers of events were 101 for PFS and 60 for OS. The median PFS and OS were 26.1 months and 55.4 months, respectively. In the multivariable analysis, EGFR ex 21 L858R mutation (HR: 1.71, 95% CI: 1.15-2.55) and shorter disease-free intervals (HR: 0.98, 95% CI: 0.96-0.99) were significantly associated with shorter PFS. Age (HR: 1.03, 95% CI: 1.00-1.07), smoking history (HR: 2.31, 95% CI: 1.35-3.94) and pathological N2 disease at the initial surgery (HR: 2.30, 95% CI: 1.32-4.00) were significantly associated with shorter OS.
Conclusions: First-line EGFR-TKI treatment was generally associated with favorable survival outcomes in patients with postoperative recurrent EGFR-mutated lung adenocarcinoma. EGFR ex 21 L858R mutation may be an important prognostic factor for shorter PFS.