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Background: Young patients with lung cancer represent a distinct subset of patients with this disease. Studies show that younger patients are more likely to be women and non-smokers. They are diagnosed at a later stage; the histologic type is more likely to be adenocarcinoma and more driver mutations such as in the EGFR gene are found. Prognosis and survival of the younger patients has mostly been shown to be better in the younger population.Methods: Retrospective data was collected in a single tertiary hospital between 1/2010 and 12/2015. Patients were divided into 2 age groups: patients who were diagnosed aged younger than 50 years and patients aged older than 60 years. We analyzed demographic characteristics, disease course and survival. Results: The younger cohort included 77 patients, with a median age of 45 years. The older group included 107 patients, median age of 68 years. Both groups had similar female to male ratio and had similar ratio of smokers, although the younger had significantly lower median pack years (40 vs. 60, P<0.001). Adenocarcinoma was the most common histopathology in both age groups (64% vs. 71%) and a larger proportion of small cell lung cancer histology was found in the younger cohort (12% vs. 3%, P<0.001). EGFR mutations were more common in the young cohort (18% vs. 13%, P¼0.06), as well as ALK translocations (9% vs. 1%, P<0.001) and accordingly, they were treated by more targeted therapies (25% vs. 16%, P¼0.015). Although young patients had more brain metastasis (38% vs. 21%, P¼0.002), their median survival was not significantly different than the older cohort (24.8 vs.18.2 months p¼0.5). yet after performing sub-stratification it was found that patients under 40 years had better median survival (70.8 months P¼0.05). Among patients with a driver mutation, median survival was better for younger patients (31.9 vs. 17.0 months, P¼0.003). Conclusion: Young patients with lung cancer have better median survival; their tumors harbor a higher rate of driver mutations and they have a higher percentage of brain involvement.

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