Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations

Abstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from Jan...

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Autores principales:	Hyun Woo Lee, Young Sik Park, Sangshin Park, Chang-Hoon Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/42a26d4640764645aa4fd4e479833fb3
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spelling	oai:doaj.org-article:42a26d4640764645aa4fd4e479833fb32021-12-02T19:12:25ZPoor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations10.1038/s41598-020-71996-72045-2322https://doaj.org/article/42a26d4640764645aa4fd4e479833fb32020-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-71996-7https://doaj.org/toc/2045-2322Abstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from January 2011 to December 2014 were followed up for 5 years. Of the 2,289 NSCLC cases, 911 (39.8%) cases pertained to lower lobe cancers. Patients with lower lobe cancer showed a higher all-cause mortality rate than those with non-lower lobe cancer (48.6% vs. 40.3%, p < 0.001). Patients with lower lobe cancer had a lower proportion of adenocarcinoma histology and epidermal growth factor receptor (EGFR) mutations. Furthermore, compared to patients with non-lower lobe cancer, those with lower lobe cancer had a higher level of tumor markers (neuron-specific enolase and cytokeratin fragment 21-1). Mediation analysis revealed that the association between lower lobe cancer and higher all-cause mortality could be explained by an indirect pathway through EGFR mutations (percent mediated = 17.3%, p = 0.005). The sensitivity analysis for adenocarcinoma patients showed similar results (percent mediated = 18.8%, p = 0.021). Lower lobe cancer is associated with a higher all-cause mortality risk in patients with NSCLC, which is partly mediated by a lower proportion of EGFR mutations.Hyun Woo LeeYoung Sik ParkSangshin ParkChang-Hoon LeeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
description	Abstract It is controversial whether a tumor located in the lower lobe is related with worse outcome of non-small cell lung cancer (NSCLC). This study aimed to clarify the prognostic role of primary tumor location in NSCLC. Patients newly diagnosed with NSCLC in a tertiary referral hospital from January 2011 to December 2014 were followed up for 5 years. Of the 2,289 NSCLC cases, 911 (39.8%) cases pertained to lower lobe cancers. Patients with lower lobe cancer showed a higher all-cause mortality rate than those with non-lower lobe cancer (48.6% vs. 40.3%, p < 0.001). Patients with lower lobe cancer had a lower proportion of adenocarcinoma histology and epidermal growth factor receptor (EGFR) mutations. Furthermore, compared to patients with non-lower lobe cancer, those with lower lobe cancer had a higher level of tumor markers (neuron-specific enolase and cytokeratin fragment 21-1). Mediation analysis revealed that the association between lower lobe cancer and higher all-cause mortality could be explained by an indirect pathway through EGFR mutations (percent mediated = 17.3%, p = 0.005). The sensitivity analysis for adenocarcinoma patients showed similar results (percent mediated = 18.8%, p = 0.021). Lower lobe cancer is associated with a higher all-cause mortality risk in patients with NSCLC, which is partly mediated by a lower proportion of EGFR mutations.
format	article
author	Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee
author_facet	Hyun Woo Lee Young Sik Park Sangshin Park Chang-Hoon Lee
author_sort	Hyun Woo Lee
title	Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
title_short	Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
title_full	Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
title_fullStr	Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
title_full_unstemmed	Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations
title_sort	poor prognosis of nsclc located in lower lobe is partly mediated by lower frequency of egfr mutations
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/42a26d4640764645aa4fd4e479833fb3
work_keys_str_mv	AT hyunwoolee poorprognosisofnsclclocatedinlowerlobeispartlymediatedbylowerfrequencyofegfrmutations AT youngsikpark poorprognosisofnsclclocatedinlowerlobeispartlymediatedbylowerfrequencyofegfrmutations AT sangshinpark poorprognosisofnsclclocatedinlowerlobeispartlymediatedbylowerfrequencyofegfrmutations AT changhoonlee poorprognosisofnsclclocatedinlowerlobeispartlymediatedbylowerfrequencyofegfrmutations
_version_	1718377044943831040

Poor prognosis of NSCLC located in lower lobe is partly mediated by lower frequency of EGFR mutations

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