Multicenter analysis of lung cancer patients younger than 45 years in Shanghai

Abstract

BACKGROUND:The treatment, prognosis, and outcomes of young lung cancer patients have not been fully explored. In addition, there is a pressing need to characterize this subgroup of patients, because there is a trend of increasing incidence in younger patients from Europe and Japan. METHODS: Consecutive, nonselected young patients (<45 years old) with pathologically diagnosed lung cancer treated at 175 qualified hospitals in the greater Shanghai area were included in this analysis. Incidence, prognostic factors, and treatment outcome of lung cancer patients from 2002 to 2006 were documented. A comparison with lung cancer patients of any age was also made. RESULTS: A total of 12,380 patients with nonsmall cell lung cancer were registered. Among them, 652 patients were between 15 and 45 years old. One-year, 3-year, and 5-year survival rates of lung cancer patients younger than 45 years were 49.87%, 26.68%, and 23.12%, respectively. TNM stage, treatment hospital (tertiary vs community hospital), sex, and cancer histology were confirmed as independent prognostic factors. Compared with lung cancer patients of any age in Shanghai, the percentage of adenocarcinoma in the young male subgroup was significantly higher (63.77% vs 43.19%, P < .001). Interestingly, median survival time of young lung cancer patients was similar with that of lung cancer patients of any age, but was significantly shorter than the median survival of middle-aged patients (45-60 years old). CONCLUSIONS: Median survival of the middle-aged group (45-60 years) was significantly longer than the young group (<45 years) and the old group (>60 years). Therefore, aggressive treatment modalities should be strongly considered for young lung cancer patients. Cancer 2010;116;3656-62.

Characteristics of Lung Cancer in Patients Younger than 40 Years: A Prospective Multicenter Analysis in France

“…It is rare in young patients. Many studies suggested that the disease may represent a specific entity in these young subjects or, at least, is associated with specific characteristics: female over-representation [7][8][9][10][11][12][13][14][15][16], predominance of adenocarcinoma [7,[9][10][11][12][13][14][16][17][18][19] and advanced stage at diagnosis [8, 9, 11-13, 15, 16, 20].…”

“…Some studies concluded that young patients had a longer survival [10,12,13,[15][16][17][18], although the authors sometimes acknowledged that they received more aggressive treatment, others found a shorter survival [19], and many studies did not find any survival difference between young and older patients [9,14,[21][22][23][24]. However, these results cannot be compared because the cut-off used to define young patients varies from 40 to 50 years, and the populations included in these studies are heterogeneous, sometimes limited to non-small cell lung cancer (NSCLC) or adenocarcinoma or restricted to patients who underwent surgery.…”

Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): A California Cancer Registry analysis

“…There have been numerous papers focused on young NSCLC patients, each with varying definitions of "young" [5][6][7][8]. Some of these studies attempted to compare outcomes between younger and older NSCLC patients.…”

Lung Squamous Cell Carcinoma in a Young Female Never Smoker: A Case Report

“…[1][2][3] Reports also show that adenocarcinomas are more frequent than squamous cell carcinomas and comprise the majority of tumors among young patients, never smokers, and female patients with lung cancer, respectively. [3][4][5] Cigarette smoking is the major risk factor for lung cancer in young people. The smoking rate among young patients with lung cancer is 45% to 97% in western countries.…”