What question did this study set out to answer?

The aim is to identify risk factors for recurrence in patients with early-stage lung adenocarcinoma and uncommon EGFR mutations after surgical resection.

May 29, 2026

Analysis of recurrence and risk factors in resectable early-stage adenocarcinoma with uncommon EGFR mutations: A comprehensive cohort study in South Korea.

Key Points

The aim is to identify risk factors for recurrence in patients with early-stage lung adenocarcinoma and uncommon EGFR mutations after surgical resection.
Conducted a multicenter retrospective cohort study including patients with stage I-III lung adenocarcinoma harboring uncommon EGFR mutations.
Analyzed recurrence-free survival and overall survival using Cox proportional hazards models.
Included a total of 48 patients who underwent curative-intent resection between 2010 and 2017.
54.2% of patients experienced recurrence during follow-up.
Independent predictors of recurrence identified include ECOG performance status ≥1 (HR 4.55, 95% CI 1.226–16.899; P=0.024) and stage III vs. I (HR 5.07, 95% CI 1.181–21.771; P=0.029).
EGFR subtype was not significantly associated with recurrence (P=0.428).

Abstract

8038 Background: This study aimed to identify clinicopathologic factors associated with recurrence in patients with surgically resected lung adenocarcinoma harboring uncommon EGFR mutations. Methods: We conducted a multicenter retrospective cohort study. The study included patients with stage I–III lung adenocarcinoma harboring uncommon EGFR mutations (G719X, S768I, or L861Q) who underwent curative-intent resection between 2010 and 2017 in South Korea. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox proportional hazards models. Results: A total of 48 patients were analyzed (stage I: n=33, stage II: n=6, stage III: n=9). The median age was 65 years; 56.3% were female and 66.7% were never-smokers. Mutation distribution was G719X (72.9%), S768I (16.7%), and L861Q (10.4%). Visceral pleural invasion (VPI) and lymphovascular invasion (LVI) were present in 37.5% and 16.7% of cases, respectively. During follow-up, 26 patients (54.2%) experienced recurrence and 21 (43.8%) died. Multivariable analysis identified ECOG performance status ≥1 (HR 4.55, 95% CI 1.226–16.899; P=0.024), stage III vs. I (HR 5.07, 1.181–21.771; P=0.029), and VPI (HR 3.67, 1.030–13.058; P=0.045) as independent predictors of recurrence. EGFR subtype (non-G719X vs. G719X) was not significantly associated with recurrence (P=0.428). Conclusions: Patients with surgically resected lung adenocarcinoma harboring uncommon EGFR mutations face a substantial risk of postoperative recurrence. Conventional clinicopathologic factors—particularly ECOG status, advanced stage, and VPI—outperform EGFR subtype as prognostic indicators. These findings support the need for risk-adapted surveillance and prospective evaluation of adjuvant strategies in these high-risk subsets. Univariate and multivariate Cox regression analysis for the risk factors associated with recurrence. Variables Recurrence rate* Univariate analysis,HR (95% CI) P -value Multivariate analysis,HR (95% CI) P -value ECOG 0 50.0 (19/38) - - 1≤ 70.0 (7/10) 1.64 (0.678-3.955) 0.273 4.55 (1.226-16.899) 0.024 EGFR mutation G719X 54.3 (19/35) - - Non-G719X 53.8 (7/13) 0.91 (0.377–2.210) 0.840 0.58 (0.155–2.207) 0.428 Tumor size † < 2.0 cm 38.5 (5/13) - - ≥ 2.0 cm 60.0 (21/35) 1.59 (0.599–4.214) 0.353 1.75 (0.434–7.068) 0.431 Clinical stage I 48.5 (16/33) - - II <jat

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