Outcome and prognosis for patients younger than thirty with primary lung cancer

Minerva Chir. 2013 Apr;68(2):175-82.

Abstract

Aim: Aim of the present study was to investigate the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.

Patients: We retrospectively reviewed the clinico-pathological records documenting surgical outcomes and prognostic factors in 68 lung cancer patients aged less than 30 years old enrolled in our hospital between March 1980 and December 2009.

Results: Sixty-eight patients were identified (38 male, 30 female) with a mean age of 22±5 years (range 8 to 29 years). Preoperative clinical manifestations were present in 82.4% (56/68) of the patients and 26.5% (16/68) of patients were initially misdiagnosed. Fifty-two patients had undergone radical surgery, 4 palliative surgery, 9 had exploratory thoracotomies, and 3 had thoracoscopic lung biopsies. Eight patients were classified (TNM) stage Ia, 7 stage Ib, 9 stage IIa, 13 stage IIb, 17 stage IIIa, 10 stage IIIb, and 4 stage IV. Postoperative atelectasis was observed in 4.41% (3/68) of the patients, and 1.47% (1/68) died of respiratory failure 5 days after exploratory thoracotomy. The overall 5-year survival rate in very young people was 31%, while those who underwent radical surgery was slightly higher at 36.7%. Five-year survival rates were correlated with the surgical procedures and pTNM stage (P <0.05). Multivariate analysis indicated that the TNM stage is the only independent prognostic factor (P=0.000).

Conclusion: We conclude that radical surgeries, the predominant comprehensive therapies are the best choice for primary lung cancer patients younger than 30 years of age.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Carcinoma, Small Cell / mortality
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Small Cell / surgery
  • Child
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Neoplasm Staging
  • Palliative Care
  • Pneumonectomy / methods
  • Pneumonectomy / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted / statistics & numerical data
  • Thoracoscopy / methods
  • Thoracoscopy / statistics & numerical data
  • Thoracotomy / methods
  • Thoracotomy / statistics & numerical data
  • Treatment Outcome
  • Young Adult