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Background  We explored correlations between the new  I nternational  A ssociation for the  S tudy of  L ung  C ancer/ A merican  T horacic  S ociety/ E uropean  R espiratory  S ociety classification, epidermal growth factor receptor ( EGFR ) mutation status, and prognosis.    Methods  Data from 293 patients with lung adenocarcinoma were classified according to the new classification.  F isher’s exact, χ 2 , and log‐rank tests and  C ox regression analysis were used to analyze correlations between  EGFR  mutation status, lung cancer prognosis, and the new histologic subtype. Disease‐free survival and progression‐free survival ( PFS ) were estimated using the  K aplan– M eier method.    Results   L epidic and non‐solid adenocarcinomas showed significantly elevated  EGFR  mutation rates (79.0% and 65.8%, respectively;  P  < 0.05).  EGFR  mutation status was only associated with gender ( P  < 0.001).  EGFR  mutation‐positive patients who received targeted therapy had better median  PFS  than those who received chemotherapy as first‐line treatment ( P  < 0.001). The median  PFS  of patients with exon 19 and exon 21 mutations who received first‐line targeted therapy were 12.5 and 9.5 months, respectively ( P  = 0.970). Patients with micropapillary predominant adenocarcinomas had the shortest disease‐free survival (<18 months) and  PFS . Histologic subtype ( P  = 0.036), treatment type ( P  = 0.031), and  EGFR  mutation status ( P  = 0.019) might be good prognostic factors for lung adenocarcinoma.    Conclusion  Patients with exon 19 mutations obtained greater benefits from targeted therapy. In the new classification,  EGFR  mutation rates are higher in lepidic cases and in cases without the solid subtype. The micropapillary subtype of adenocarcinoma has the worst prognosis, while the lepidic subtype has the best.

thoracic cancer

Clinical value of the new  I nternational  A ssociation for the  S tudy of  L ung  C ancer/ A merican  T horacic  S ociety /E uropean  R espiratory  S ociety classification of lung adenocarcinoma