Non-Small Cell Lung Cancer Coverage from Every Angle

Prognostic Indicators Among Patients With EGFR-Positive NSCLC

By: Joseph Fanelli
Posted: Tuesday, November 12, 2019

Identifying independent prognostic indicators based on clinicopathologic parameters and routinely using immunohistochemical markers may predict overall and site-specific recurrence of non–small cell lung cancer (NSCLC), according to study results presented at the International Association for the Study of Lung Cancer 2019 World Conference on Lung Cancer (WCLC) in Barcelona (Abstract OA13.03). These findings, according to Zhengfei Zhu, MD, of the Fudan University Shanghai Cancer Center, and colleagues, can offer physicians guideposts to identify optimal candidates for adjuvant therapies and to develop surveillance strategies for patients with completely resected EGFR-positive NSCLC.

In this study, the investigators retrospectively enrolled 531 patients from the Fudan University Shanghai Cancer Center with curative resected NSCLC and confirmed EGFR mutations. The authors sorted initial recurrence sites into five categories: thoracic, brain, neck, abdominal, and bone.

After a median follow-up of 32 months, they found disease recurrence in 197 patients (37.1%), with a median recurrence-free survival of 19 months. The group with the highest rate of recurrence was those with thoracic recurrence (136 patients), followed by those with brain and bone recurrences (41 patients each), abdominal recurrence (14 patients), and neck recurrence (13 patients). The authors found that the patient’s sex, tumor size, the immunohistochemical marker Ki67, and N stage were all independent indicators of thoracic recurrence, whereas tumor size, N stage, and the immunohistochemical markers CK20 and Syn were all classified as independent indicators of brain recurrence.

Additionally, overall recurrence was associated with tumor size, the markers Ki67 and CK20, and N stage. The authors developed a nomogram based on these four factors to predict the 1-, 2-, and 3-year recurrence-free survival probability for this patient population.

Disclosure: The study authors’ disclosure information may be found at

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