Adjuvant therapy in pStage IA1–IIA lung adenocarcinoma (pN0): A multicenter study focusing on EGFR mutations and recurrence patterns (CReGYT-01 EGFR study)
Bibliographic record
Abstract
BACKGROUND: Adjuvant treatment strategies based on EGFR mutation status remain unestablished in stage I-II lung adenocarcinoma. Although UFT is an established adjuvant therapy in Japan for resected pathological N0 (pN0) lung adenocarcinoma, its clinical utility according to EGFR mutation status remains unclear. This study aimed to evaluate the efficacy of UFT and recurrence patterns in pStage IA1-IIA disease, with a primary focus on pStage IA3-IIA and the influence of EGFR mutation status. METHODS: This multicenter retrospective study included 2,462 patients with pStage IA1-IIA lung adenocarcinoma (TNM 8th edition) who underwent complete resection at 21 institutions in Japan (2015-2018). Propensity score matching was employed to adjust for baseline differences between treatment groups. We evaluated the survival benefit of UFT by EGFR mutation status and analyzed recurrence patterns based on EGFR status and other clinicopathological variables. RESULTS: In the post-PSM cohort (N = 600), UFT significantly improved overall survival (OS) (p = 0.007, HR = 0.546), particularly in EGFR wild-type patients (p < 0.001, HR = 0.403). UFT also prolonged recurrence-free survival (RFS) in EGFR wild-type cases (p = 0.004, HR = 0.604). No OS or RFS benefit was observed in EGFR mutation-positive patients. Subgroup analysis showed that UFT provided significant OS benefit in patients with high-malignancy histological subtypes such as solid/micropapillary (HR = 0.32, 95 % CI: 0.13-0.80). EGFR mutation and lymphovascular invasion were independent predictors of recurrence, with EGFR mutations associated specifically with distant and CNS recurrence. CONCLUSIONS: Adjuvant UFT improves OS and RFS in EGFR wild-type pStage IA3-IIA lung adenocarcinoma, particularly in patients with high-risk pathological features. In contrast, UFT is ineffective in EGFR mutation-positive cases, highlighting the need for refined adjuvant treatment strategies tailored to EGFR status and tumor biology in early-stage lung adenocarcinoma with pathological N0 (pN0).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".