The number of brain metastases predicts the survival of non-small cell lung cancer patients with EGFR mutation status

Abstract

Background: Lung cancer is the common cause of cancer-related deaths throughout the world, and brain is a frequent metastatic site of lung cancer.

Aim: This research sought to evaluate the impact of the number of brain metastases in prognosticating non-small cell lung cancer (NSCLC) patients accounting to the role of epidermal growth factor receptor (EGFR) mutations.

Methods and results: NSCLC patients with brain metastases diagnosed/treated in West China Hospital, Sichuan University between 2009 and 2017 were identified retrospectively. Kaplan-Meier approach was adopted to estimate OS. And we performed univariate and multivariate Cox proportional hazards regression analyses of characteristics related to overall survival (OS) in both EGFR-mutated and wild-type cohorts. In total, this study included 611 eligible NSCLC patients with brain metastases. Extracranial metastases and chemotherapy were independent prognostic factors of OS in both cohorts. As the disease progressed, EGFR-mutated patients had brain metastasis significantly earlier (P < .0001), but they also had notably better survival outcomes than wild-type patients (P < .0001). And the number of brain metastases impacted the survival incidence in the progression significantly in both EGFR-mutated and wild-type groups (P = .0087/.037, respectively).

Conclusion: The number of brain metastases was a prognostic factor for lung cancer patients either with EGFR mutations or with wild-type EGFR, with larger number indicating more unfavorble clinical outcomes. Patients with EGFR mutations had a better survival.

Keywords: EGFR mutation; lung cancer; number of brain metastases; survival.