Clinicopathological characteristics and treatment strategies for young lung cancer patients

Abstract

Background: The reported age-specific survival rates of lung cancer patients have been largely inconsistent. Management strategies for younger patients and treatment outcomes are not well characterized. Methods: Out of the 4,697 lung cancer patients with treatment history at Tokyo Medical University Hospital between January 2000 and December 2014, 266 patients were <49 years of age. Patient characteristics were investigated, and the association of overall survival (OS) with age, sex, stage, and histological type were investigated. Results: The 1-, 3-, and 5-year survival rates in the ≤49 years age group were 82.9%, 64.6%, and 57.0%. Among surgical cases, the survival rate of patients in the ≤49 years age group was significantly better than that in the 50-69 and ≥70 years age groups (P=0.29 and P<0.0001, respectively). In comparison with the OS rate with clinical stages, I, II, and III (but not with clinical stage IV) in the older than 50 years age group, the rates in the ≤49 years age group were better. The 1-, 3-, and 5-year OS rates of females were higher than those of their males. The 1-, 3-, and 5-year OS rates for lung adenocarcinoma patients were higher than that of lung non-adenocarcinoma patients. Conclusions: Despite the higher proportion of advanced disease, the postoperative survival rate of the younger was higher than that of the older. Aggressive multimodality treatments, including surgery, are more feasible and effective for younger patients as compared with that in older patients.

Epidemiology and prognosis in young lung cancer patients aged under 45 years old in northern China

“…squamous cell carcinoma and SCLC ranked the second and third most common subtype in the younger group 40 – 42 . A relatively high percentage of patients had advanced-stage disease at diagnosis in our study (greater than 50% of all patients), which was consistent with previous studies 12 , 43 .…”

Genomic profiling in non-small-cell lung cancer in young patients. A systematic review

“…We found 45 retrospective studies on AYAs with lung cancer. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 Fourteen were reports from national databases. Our final selection for genomic profiling in AYA with lung cancer included 23 studies 4 , 7 , 8 , 9 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 40 , 41 , 43 , 44 ( Table 1 ).…”

“… 39 In patients with lung cancer, many studies that compare smoking history between young and old patients found significantly less exposure to tobacco in young lung cancer patients. 4 , 7 , 11 , 14 , 15 , 17 , 19 , 21 , 23 , 24 , 28 , 37 , 40 , 43…”

“…NSCLC is still the most common type of lung cancer, but adenocarcinoma is even more common in younger patients. 7 , 11 , 19 , 21 , 23 , 28 , 32 , 35 , 36 , 37 , 38 , 40 , 43 , 45 Rich et al. 36 divided patients with NSCLC extracted from the English National Lung Cancer Audit in six age groups from <39 to >80 years and showed a progressive decrease in the percent of adenocarcinoma from 48% in those aged <39 years to 31% in those aged >80 years.…”

“…Some reports concluded that survival was similar between AYAs and older patients, 8 , 17 , 21 , 23 , 24 , 51 , 75 , 76 , 77 , 78 while others found that young patients performed better. 28 , 34 , 35 , 38 , 40 , 45 , 79 , 80 One of the largest studies that used the National Cancer Database (NCDB) including 173 856 patients from 2003 to 2009 found that 5-year survival was significantly better for younger patients ( P < 0.001), although this difference was more clinically significant in early stages. The absolute difference in 5-year overall survival (OS) at stages I and II (AJCC seventh-edition staging) between both groups was 25%, while at stage IV was only 2%.…”