Background: The prognostic value of EGFR  and KRAS  mutations in resected non-small cell lung cancer (NSCLC) has been reported. However, conflicting results were reported in these studies. The effect of mutations in these two genes in resected NSCLC remains controversial.
Methods: We searched Internet databases for studies reporting disease-free survival (DFS) and overall survival (OS) in resected NSCLC patients with EGFR  or KRAS  mutations. A meta-analysis calculating the pooled hazard ratio (HR) for DFS and OS was used to measure the association of EGFR  or KRAS  mutations with the prognosis of patients after surgery.
Results: A total of 9,635 patients from 32 studies were included in this analysis. The combined HR for EGFR  mutations on DFS was 0.77 (95% CI 0.66–0.90, p =0.001) and on OS was 0.72 (95% CI 0.66–0.80, p <0.00001). In addition, the combined HR for KRAS  mutations on DFS was 1.5 (95% CI 1.15–1.96, p =0.002) and on OS was 1.49 (95% CI 1.28–1.73, p <0.00001). Sensitivity analysis, subgroup analysis, and bias analysis proved the stability of the results.
Conclusion: The analysis showed that EGFR  mutations were significantly associated with DFS and OS. These findings indicated that surgically treated NSCLC patients with EGFR  mutations were inclined to exhibit a prolonged DFS and OS. In addition, the results indicated that KRAS  mutations predicted worse DFS and OS in patients with resected NSCLC.
Keywords: EGFR  mutations, KRAS  mutations, meta-analysis, non-small cell lung cancer, prognosis, resected