Objective: To study the survival of patient with advanced non-small cell lung carcinoma [NSCLC] treated at Chonburi Cancer Hospital, in addition to focus on an epidermal growth factor receptor [EGFR] mutation testing, including an epidermal growth factor receptor-tyrosine kinase inhibitor [EGFR-TKI] therapy and to find a prognostic factor for survival.

Materials and Methods: The present retrospective cohort study was conducted by review medical records of stage IIIB-IV NSCLC patients treated at Chemotherapy unit, Chonburi Cancer Hospital, Thailand, between July 1, 2013 and June 30, 2016.

Results: There were 148 patients with median follow-up time 7.90 months. Median age was 60.5 years old (range 25 to 91). There were male 64%, non-smokers 37%, and stage IIIB/IV 17/83%. The Eastern cooperative oncology group [ECOG] performance status 0 to 1, 2 to 4, and no record were found 35%, 36%, and 29%, respectively. The most common systemic first-line and second-line systemic therapies were platinum-based doublet and docetaxel, respectively. The median survival time of all patients was 8.04 months. Median survival times of patients receiving and not receiving systemic therapies were 10.60 months and 3.00 months, respectively (p<0.001). Less than a quarter of the patients (27/148, 18.2%) were tested for EGFR mutations. Fifty five percent (15/27) of the patients tested for EGFR status were sensitive mutations. Unfortunately, only some of them could access to an EGFR-TKI therapy and mostly received it as a late-line therapy. Multivariate analysis showed that ECOG performance status 2 to 4 (p<0.001), no record for ECOG performance status (p = 0.001), no lung metastasis (p = 0.012), and unknown of EGFR mutation status (p = 0.001) were significantly unfavorable prognostic factors for the survival.

Conclusion: The survival time of advanced NSCLC patients at Chonburi Cancer Hospital was comparable to other pivotal studies. In real-life clinical practice, EGFR testing was quite low because of limitation to access to EGFR-TKI. The poor ECOG performance status, no record for ECOG performance status, no lung metastasis and unknown EGFR mutation were poor prognostic factors for the overall survival.

Keywords: Non-small cell lung cancer, Survival, EGFR mutation, Prognostic factor