Comparison of prognosis between epidermal growth factor mutation positive and negative groups in lung adenocarcinoma patients with brain metastases

Abstract Introduction Brain metastasis (BM) in non-small cell lung cancer (NSCLC) is still an important reason for morbidity and mortality despite the advances in cancer treatment. Using tyrosine kinase inhibitors against epidermal growth factor receptors (EGFR) mutations revolutionized NSCLC treatment. We investigated whether the presence of EGFR mutation influences survival in patients with lung adenocarcinoma with BM. Material and methods The data of the patients with pathological diagnoses of NSCLC and BM at tertiary hospitals were analyzed retrospectively in terms of survival. A total of 2554 patients diagnosed with NSCLC pathologically between 01 January 2010 and 01 January 2021 were identified. After the exclusion of patients with a lack of data, unknown EGFR mutation status, no brain metastasis, and additional malignancy 336 patients were included in the study. Results It was found that EGFR ( +) patients were more female dominant (48.6% vs 13.3% p < 0.0001) and were have less history of smoking (47.2% vs 87.1%, p < 0.0001) and were better survival (79.2% vs 92.8%). We found negativity of EGFR increased death risk by 1.700 times (95% CI 1.323–2.183, p < 0.0001) in univariate analysis and by 1.724 times (95% CI 1.251–2.377, p = 0.0001) in multivariate analysis. When overall survivals were compared estimated overall survival time of EGFR ( −) patients was 10.088 (95% CI 8.571–11.606) months and of EGFR ( +) patients was 11.829 months (95% CI 10.336–13.323) (p < 0.001). Conclusion EGFR positivity was associated with survival. Also, survival was significantly longer in EGFR-positive patients with brain metastases diagnosed with NSCLC.