OBJECTIVES Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors were recently reported to be effective as adjuvant therapy for resected lung adenocarcinoma (ADC) harbouring common EGFR mutations. However, whether the EGFR mutation is a direct risk factor for postoperative recurrence remains unknown. Therefore, we conducted a multi-institutional observational study to compare postoperative survival according to EGFR mutation status. METHODS We collected the medical records of consecutive patients who underwent surgical resection for ADC between 2005 and 2012 at 4 participating institutions. Recurrence-free survival (RFS) and overall survival (OS) associated with EGFR mutation status were evaluated. We further analysed survival after pair-matching patients' clinicopathological characteristics. RESULTS EGFR mutations were harboured by 401 of 840 (48%) enrolled patients. The number of patients with an EGFR mutation (M group) differed from that with the EGFR wild-type sequence (W group) in terms of sex, smoking history and pathological stage. The median follow-up period was 85 months. The five-year RFS/OS rates of the M and W groups were 70%/85% and 61%/75%, respectively (P < 0.001 for both groups). However, multivariable analysis revealed that EGFR mutation status was not independently related with both RFS and OS. In pair-matched analysis, the RFS and OS curves of the patients with an EGFR mutation and wild-type sequence were not statistically different, either. CONCLUSIONS Long-term follow-up of consecutive patients did not show that a common EGFR mutation was an independent risk factor of recurrence or prognostic factor for completely resected lung ADC.

中文翻译：

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对连续队列的长期随访证实表皮生长因子受体突变是肺腺癌术后复发的独立危险因素。

目的 最近据报道，第三代表皮生长因子受体 (EGFR) 酪氨酸激酶抑制剂可有效辅助治疗携带常见 EGFR 突变的切除肺腺癌 (ADC)。然而，EGFR突变是否是术后复发的直接危险因素仍不清楚。因此，我们进行了一项多机构观察性研究，根据 EGFR 突变状态比较术后生存率。方法 我们收集了 2005 年至 2012 年间在 4 个参与机构连续接受 ADC 手术切除的患者的病历。评估了与 EGFR 突变状态相关的无复发生存期 (RFS) 和总生存期 (OS)。我们进一步分析配对患者临床病理特征后的生存率。结果 840 名入组患者中有 401 名 (48%) 携带 EGFR 突变。EGFR突变患者（M组）与EGFR野生型序列患者（W组）在性别、吸烟史、病理分期等方面存在差异。中位随访期为 85 个月。M 组和 W 组的五年 RFS/OS 率分别为 70%/85% 和 61%/75%（两组 P < 0.001）。然而，多变量分析显示 EGFR 突变状态与 RFS 和 OS 并不独立相关。在配对分析中，EGFR突变和野生型序列患者的RFS和OS曲线也没有统计学差异。结论 对连续患者的长期随访并未显示常见 EGFR 突变是完全切除的肺 ADC 复发的独立危险因素或预后因素。