Surgery for Non-small Cell Lung Cancer in Younger Patients: What are the Differences?

• DOI: 10.1016/j.hlc.2014.07.054
• Publication Date: 2014-07-14T16:33:22Z
• Authors: Andrea Dell’Amore; Marco Monteverde; Nicola Martucci; Fabio Davoli; Guido Caroli; Emanuela Pipitone; Alessandro Bini; Franco Stella; Davide Dell’Amore; Caterina Casadio; Gaetano Rocco
• Keywords: Adult; Male; Lung Neoplasms; Databases, Factual; Sex Factor; Disease-Free Survival; Databases; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; Retrospective Studie; Carcinoma, Non-Small-Cell Lung; 616; 80 and over; 617; Humans; Age Factor; Lung surgery; Non-Small-Cell Lung; Factual; Aged; Retrospective Studies; Lung cancer prognosi; Aged, 80 and over; Carcinoma; Age Factors; Younger patient; Middle Aged; 3. Good health; Lung Neoplasm; Lung cancer; Lung cancer prognosis; Lung surgery; Thoracic surgery; Younger patients; Adult; Age Factors; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Databases, Factual; Disease-Free Survival; Female; Humans; Lung Neoplasms; Male; Middle Aged; Retrospective Studies; Sex Factors; Survival Rate; Cardiology and Cardiovascular Medicine; Pulmonary and Respiratory Medicine; Medicine (all); Survival Rate; Thoracic surgery; Female; Lung cancer; Human

Non-small cell lung cancer (NSCLC) in young adults is uncommon. The objective of this study was to evaluate the clinicopathological characteristics, outcomes and prognosis of people younger than 50 years old treated surgically for NSCLC.A retrospective study was conducted using the institutional database of four thoracic surgery units to collect patients with NSCLC younger than 50 years who had undergone surgery. These patients were compared with older patients (>75-years) operated in the same institutions and in the same period.We identified 113 young patients and 347 older patients. Younger patients were more likely to be female, non-smokers, with fewer comorbidities. Younger patients were more likely to be symptomatic at the time of diagnosis. Risk factors for poor prognosis in younger patients were T-stage, and disease-free-interval less than 548 days. Kaplan-Meier analysis showed a lower five-year survival in older patients compared with the younger ones (66% vs 38%, p=0.001).In conclusion NSCLC in younger patients has some distinct clinicopathological characteristics. The overall-survival of young patients is better than in older patients. Young patients receive more complete and aggressive treatment that could explain better survival. Further prospective studies with larger patient populations are required, to clarify the biological and genetic variance of NSCLC in younger patients.