Oncotarget

Research Papers:

Applicability of graded prognostic assessment of lung cancer using molecular markers to lung adenocarcinoma patients with brain metastases

Hongwei Li _, Jianhong Lian, Songyan Han, Weili Wang, Haixia Jia, Jianzhong Cao, Xiaqin Zhang, Xin Song, Sufang Jia, Jiwei Ren, Weihua Yang, Yanfeng Xi and Shengmin Lan

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Oncotarget. 2017; 8:70727-70735. https://doi.org/10.18632/oncotarget.19980

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Abstract

Hongwei Li1,*, Jianhong Lian2, Songyan Han3,*, Weili Wang1, Haixia Jia1, Jianzhong Cao1, Xiaqin Zhang1, Xin Song1, Sufang Jia1, Jiwei Ren5, Weihua Yang3, Yanfeng Xi4 and Shengmin Lan1

1Department of Radiation Oncology, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan, Shanxi Province 030013, People’s Republic of China

2Department of Surgery, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan, Shanxi Province 030013, People’s Republic of China

3Department of Chemotherapy, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan, Shanxi Province 030013, People’s Republic of China

4Department of Pathology, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan, Shanxi Province 030013, People’s Republic of China

5Department of Medical Imageology, Shanxi Provincial Cancer Hospital, Shanxi Medical University, Taiyuan, Shanxi Province 030013, People’s Republic of China

*These authors have contributed equally to this work

Correspondence to:

Hongwei Li, email: [email protected]

Jianhong Lian, email: [email protected]

Keywords: lung cancer, adenocarcinoma, brain metastass, gene alterations, prognosis

Received: February 28, 2017    Accepted: July 11, 2017    Published: August 07, 2017

ABSTRACT

Several scoring systems are available to estimate prognosis and assist in selecting treatment methods for non-small cell lung cancer (NSCLC) patients with brain metastasis, including recursive partitioning analysis (RPA), basic score for brain metastases (BS-BM), and diagnosis-specific graded prognostic assessment (DS-GPA). Lung-molGPA is an update of the DS-GPA that incorporates EGFR and/or ALK mutation status. The present study tested the applicability of these four indexes in 361 lung adenocarcinoma patients with brain metastasis. Potential predictive factors in our independent multivariate analysis included patient age, Karnofsky performance status, EGFR and ALK mutation status, and use of targeted therapy. In the log-rank test, all four systems predicted overall survival (OS) (P<0.001). Harrells C indexes were 0.732, 0.724, 0.729, and 0.747 for RPA, BS-BM, DS-GPA, and Lung-molGPA, respectively. Our results confirmed that the Lung-molGPA index was useful for estimating OS in our patient cohort, and appeared to provide the most accurate predictions. However, the independent prognostic factors identified in our study were not entirely in agreement with the Lung-molGPA factors. In an era of targeted therapy, Lung-molGPA must be further updated to incorporate more specific prognostic factors based on additional patient data.


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