P3.16-31 Younger Patients Operated for Lung Cancer Have Better Overall Survival

Abstract

Median age of patients diagnosed with lung cancer is 63 years. Incidence of lung cancer in population of patients younger than 50 years of age is relatively low. The aim of this study was to compare the clinical outcomes of patients with early lung cancer onset (ELCO, onset before the age of 50) and late lung cancer onset (LLCO, onset after the age of 50). We have retrospectively analyzed the prospectively collected data of 1517 patients with Lung cancer treated in a Thoracic Surgery Department in the years 2007-2015. Patients were divided into two groups, group I - 78 patients with ELCO and group II - 1439 patients with LLCO. We have compared overall survival in unmatched and matched population. In order to reduce potential selection bias being a result of different histology and different rate of concomitant diseases we performed a propensity-score matched analysis (based on exact matching – by sex, pTNM, type of operation, pathological diagnosis and Charlson Comorbidity Index). The latter analysis was performed in 65 ELCO patients with 453 LLCO patients. In the unmatched population we found no differences in gender, pTNM and type of surgery performed. Younger patients were also more likely to have typical carcinoid (23.1% vs 2.6%, p<0.05, OR 11.06 95%CI 5.695-21.360) and mucoepidermoid tumours (2.6% vs 0.3%, p<0.05, OR 7.547 95%CI 0.997-44.708), whereas the older patients were more likely to have squamous cell lung carcinoma (39.7% vs 23.1%, p<0.05, OR 0.455 95%CI 0.256-0.799). Older patients were more likely to be smokers (82% vs 59%, p<0.05 OR 0.316, 95%CI 0.192-0.519). Median Charlson Comorbidity Index in younger population was 0 and in the older population was 1 (p<0.05). Five-year survival in EOLC group was 71.9% vs. 58.7% in LLCO (p=0.008). The propensity score-matched analysis with exact method, comparing sex, pTNM, type of operation, pathological diagnosis and Charlson Comorbidity Index, showed that younger patients had better survival rates compared to older patients (p<0.001 HR=0.559, 95%CI 0.360-0.865). Five-year survival in patients with ELCO was 77.6% comparing to 61.5% in LLCO patients (p=0.011). Patients with early lung cancer onset have higher five-year survival after surgical treatment compared to patients with late lung cancer onset irrespectively of histology.