Lung Cancer In Young Patients Research Articles

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

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. 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. 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). 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.

Genome-wide association study in discordant sibships identifies multiple inherited susceptibility alleles linked to lung cancer

We analyzed a series of young (median age = 52 years) non-smoker lung cancer patients and their unaffected siblings as controls, using a genome-wide 620 901 single-nucleotide polymorphism (SNP) array analysis and a case-control DNA pooling approach. We identified 82 putatively associated SNPs that were retested by individual genotyping followed by use of the sib transmission disequilibrium test, pointing to 36 SNPs associated with lung cancer risk in the discordant sibs series. Analysis of these 36 SNPs in a polygenic model characterized by additive and interchangeable effects of rare alleles revealed a highly statistically significant dosage-dependent association between risk allele carrier status and proportion of cancer cases. Replication of the same 36 SNPs in a population-based series confirmed the association with lung cancer for three SNPs, suggesting that phenocopies and genetic heterogeneity can play a major role in the complex genetics of lung cancer risk in the general population.

Lung cancer in young patients aged from 15 to 44 years: incidence trend, current status and survival analysis from 2002 to 2005.

Objective:To analyze the incidence trend,current status and survival period of young patients with lung cancer aged from 15 to 44 years in Shanghai between 2002 to 2005.Methods:All the data were collected from the database of registration and ma-nagement system of diagnosed cancer cases in Shanghai city organized by Shanghai Municipal Center for Disease Control Prevention.The incidence trend was analyzed by using APC(annual percent change)model.The survival period and median survival time were calculated by using SPSS 12.0 software and life table method.The univariate and multivariate analyses were analyzed by using Kaplan-Meier and COX regression model,respectively.Results:A total of 972 young patients with lung cancer who aged from 15 to 44 years were diagnosed in Shanghai between 2002 and 2005,accounting for 3.09% of the whole lung cancer population.The ratio of male and female patients was 1.63∶1.The percentage of adenocarcinoma in young patients was higher than that in whole lung cancer population at the same period,while the TNM stage was not significantly different between male and female young patients.Multivariate analysis demonstrated that gender,pathological classification and TNM stage were independent prognostic factors for young patients with lung cancer.Conclusion:The lung cancer had different characteristics in young patients compared with that in whole lung cancer population in Shanghai city.It was necessary to further investigate the biologic behavior of lung cancer in young patients.

Bronchogenic carcinoma in patients under 50 years old

Lung cancer in young patients is increasing in frequency. Its clinical course seems to be more aggressive than in the elderly. Our objective is to assess the clinicopathologic characteristics and survival of patients with bronchogenic carcinoma who underwent surgery at our department, comparing people younger than 50 years to older patients. We present a retrospective study of 610 patients diagnosed with non-small-cell lung cancer operated on between 1997 and 2006. They were classified into two groups: under 50 (n=60) and equal to or over 50 (n=550). The proportion of women, smokers and adenocarcinoma were significantly higher in young patients. There were no significant differences in survival rate between the two groups. In our series, despite the differences in sex, smoking history and histology, the behaviour of the disease is similar in both age groups.

Clinical Characteristics and Surgery of Primary Lung Cancer in Younger Patients

Controversy exists regarding the clinical characteristics, pathological findings, and prognosis of patients < 50 years of age with primary lung cancer. The medical records of 4,556 patients diagnosed with primary lung cancer between 1980 and 2004 were reviewed; of these, 305 were < 50 years old. Of 1,335 patients who were surgically treated, 122 were < 50 years old. Females were over-represented in the younger group. Younger patients had a significantly higher incidence of adenocarcinoma and large cell carcinoma, and a lower incidence of squamous cell carcinoma. The resectable rate in younger patients was significantly higher. Overall and among surgically treated patients, the survival rates of younger patients with stage 0-I disease were significantly better than those of older patients. Younger patients with early-stage primary lung cancer had a significantly better prognosis than older patients, although survival in the advanced stages was not significantly different.

The clinical analysis of 469 pulmonary carcinomatous cases diagnosed by bronchoscopy under the age of 40.

In recent years, more and more young patients have been suffering from lung cancer, and these young patients do not always have good prognosis. This article wants to study the relationship between the histopathology with gender, location and the sign of fibrobronchoscopy in lung cancer patients under the age of 40. The article analyzed retrospectively the fibrobronchoscopy data of 469 young lung cancer patients under the age of 40. In the 469 patients, the male/female ratio was 2.42/1. The most common histopathology was squamous cell carcinoma (33.0%), followed by adenocarcinoma (26.%) and small cell carcinoma (20.5%). The ratio of squamous cell carcinoma in male (40.7%) was more than in female (14.6%), and ratio of adenocarcinoma in female (43.1%) was more than in male (19.0%), it is obviously different on the distribution of cancer histopathology between male and female patients (P >0.05). The location of lung carcinoma was more likely in the bilateral upper lobars and in the right lung, 81.4% had direct signs. Lung cancer patients under the age of 40, squamous cell carcinoma is significantly more in male group, but adenocarcinoma is significantly more in female group. This study suggests fibrobrochoscopy is an indispensable approach in the diagnosis of young lung cancer. Paying more attention to the lung cancer of young patients and examining with fibrobronchoscopy will be found much helpful to early diagnosis.

Do genetic factors protect for early onset lung cancer? A case control study before the age of 50 years.

BackgroundEarly onset lung cancer shows some familial aggregation, pointing to a genetic predisposition. This study was set up to investigate the role of candidate genes in the susceptibility to lung cancer patients younger than 51 years at diagnosis.Methods246 patients with a primary, histologically or cytologically confirmed neoplasm, recruited from 2000 to 2003 in major lung clinics across Germany, were matched to 223 unrelated healthy controls. 11 single nucleotide polymorphisms of genes with reported associations to lung cancer have been genotyped.ResultsGenetic associations or gene-smoking interactions was found for GPX1(Pro200Leu) and EPHX1(His113Tyr). Carriers of the Leu-allele of GPX1(Pro200Leu) showed a significant risk reduction of OR = 0.6 (95% CI: 0.4–0.8, p = 0.002) in general and of OR = 0.3 (95% CI:0.1–0.8, p = 0.012) within heavy smokers. We could also find a risk decreasing genetic effect for His-carriers of EPHX1(His113Tyr) for moderate smokers (OR = 0.2, 95% CI:0.1–0.7, p = 0.012). Considered both variants together, a monotone decrease of the OR was found for smokers (OR of 0.20; 95% CI: 0.07–0.60) for each protective allele.ConclusionSmoking is the most important risk factor for young lung cancer patients. However, this study provides some support for the T-Allel of GPX1(Pro200Leu) and the C-Allele of EPHX1(His113Tyr) to play a protective role in early onset lung cancer susceptibility.

Clinical Features of the Lung Cancer Patients Who Were Seen in Kosin University Gospel Hospital from 1994 to 1998

Purpose: Lung cancer is the leading cause of cancer death in the world, including Korea. The aim of this study was to investigate the clinical features of the lung cancer patients who were seen in a University hospital between 1994 to 1998. Materials and Methods: We performed a retrospective review of lung cancer clinical information at Kosin University Gospel Hospital from 1994 to 1998. We analyzed the age, gender, pathologic types, treatment methods and survival. Results: Among 1,547 patients, 1,232 patients (79.6%) were male. The age distribution ranged from 20 to 84 years, and the mean age was 60.2 years old. Squamous cell carcinoma was the most common type of lung cancer (39.7%), followed by adenocarcinoma (23.1%), and small cell carcinoma (16.4%). However, there was an increasing incidence of adenocarcinoma every year. The stages at the diagnosis were I: 6.6%, II: 6%, III: 45.6% and IV: 41.8%. For the small cell carcinoma, 44.6% of the patients were in a limited stage and 55.4% were in an extensive stage. The initial treatments included chemotherapy (46.5%), surgery (15.1%) and radiotherapy (5.1%), but 32.2% of the patients received supportive care only. For the cases receiving surgery, the 5 year survival rate for the stage I patients was 66%, that for the stage II patients was 43.2% and that for the stage III patients was 11.8%. The median survival time (MST) for patients who underwent surgery plus adjuvant chemotherapy was 3.22 year, but the MST of the surgery-treated only patients was 1.51 years. So, adjuvant chemotherapy prolonged survival (p=0.000). On the subgroup analysis, young age and female lung cancer patients who did not receive adjuvant chemotherapy showed poor survival. Conclusion: Squamous cell carcinoma was the most common type of lung cancer. The active treatments were important for the patients’ prognosis. For the patients receiving surgery, adjuvant chemotherapy had a role in improving survival and especially for young age and female lung cancer patients. (J Lung Cancer 2008;7(2):81 �� 85)

Detection of ATM Gene Mutations in Young Lung Cancer Patients: A Population-based Control Study

Ataxia-telangiectasia (A-T) is an autosomal recessive disease characterized by neurological and immunological symptoms, radiosensitivity, and cancer predisposition. Heterozygous carriers of risk mutations in the A-T gene are predisposed to epithelial cancers. We initiated a study to elucidate the frequency and clinical relevance of ATM gene mutations in lung cancer patients of the young (LUCY) and compared the results with population-based control subjects from southwest Germany (KORA=Cooperative Health Research in the Region of Augsburg). In this study, the clinical relevance of ATM gene mutations (S707P; 1066-6T-->G; 2250G-->A, 7630A-->C, E1978X, R2443X, 3801delG, S49C, and D2625E&A2626P, L1420F, P1045R) in 183 young lung cancer patients (<50 years) is evaluated. The control population was comprised of 200 cancer-free subjects from the KORA study. A total of 25 heterozygous carriers of ATM in the LUCY, respectively; 32 heterozygotes in the KORA group were identified. The observed allele frequencies in the LUCY cases were within the range detected for the control subjects (KORA). Multiple analyses of lung cancer patients who carried at least one risk allele of the ATM did not show significantly elevated or reduced risks. In this study, 16% of the German control subjects had ATM variants. ATM variants were detected in about 14% of the lung cancer patients and did not differ significantly from the control subjects. In comparison to young lung cancer patients, ATM gene mutations had no detectable relevant modifying effect on lung cancer risk.

P1-050: Lung cancer in patients under 50 years old

Lung cancer in young patients is increasing in frequency.In 2005 in Institute for Lung Diseases and TB were registered 1471 patients(pts)with lung cancer and 186 pts(12.65%)were under 50 years old.There were significantly more male than female(70.9%:29.3%);mean age 45.8.The majority of them were smokers (76.1%).The diagnosis was established by fiberoptic bronchoscopy in 176(94.6%),percutaneus lung biopsy in 5pts((2,6%)and in 5pts(2,6%) by lymphnode biopsy. In this group of patients the non-small-lung cancer(NSCLC) is found in 75,8%,compared to 24,2% for small cell lung cancer(SCLC).Unfortunately 40,4% from them were with the metastatic disease.Surgical procedure was applied in 67pts (36,02%)chemotherapy was performed in 91(48,9%)pts,radiotherapy in 14(7,5%)pts.In 14pts(7,5%)the only treatment was symptomatic. In the group of patients with lung cancer under 50 years old there were significantly more male,smokers,with advanced stage lung cancer.Squamous cell carcinoma was the most frequent histological type.

P1-035: Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: Washington University experience

NSCLC predominantly affects patients in their sixth and seventh decades of life. It is unclear whether the presentation and outcomes are different in the younger (defined as age ≤ 40 years at the time of diagnosis) when compared with older patients (age > 40). We reviewed the demographic, clinical and pathologic data of all patients diagnosed with NSCLC at Washington University School of Medicine-Siteman Cancer Center from 1990 to 2005. 6118 patients with NSCLC were identified and among them 6010 were > 40 years and 108 were ≤ 40 years of age at the time of diagnosis. The proportion of women in the younger group was 53.7% vs. 43.6% in the older group (p = 0.03). The distribution of stages I, II, III and IV in the younger group was 14%, 7.5%, 34.6% and 43.9% as compared to 28.9%, 7.8%, 29.8% & 33.5% in the older group (p = 0.006). Adenocarcinoma was the most common histology in the younger group compared to the older group (53.7% vs. 38.1%, p<0.001). Squamous cell carcinoma was less common in the younger vs. older group (15.7% vs. 29.9%, p<0.001). The proportion of younger patients diagnosed with brain metastasis at presentation was 18.5% vs. 10% in the older patients (p = 0.004). No significant differences were detected for metastases to the other sites. The 5-year survival was higher in the younger group for each stage, but reached statistical significance only in stage I disease, likely because of the small sample size (see table). TableStage specific 5-year survivalAge ≤ 40Age ≤ 40Age > 40Age > 40p valueN5 yr survival (%)N5 yr survival (%)Stage I15851698450.01Stage II864469310.20Stage III37201789120.13Stage IV479201920.052 Open table in a new tab Lung cancer in younger patients is characterized by higher proportion of women, adenocarcinoma histology, stage IV disease, brain metastases at presentation and better overall survival when compared to older patients.

Distinctive characteristics of non-small cell lung cancer in younger patients: A national cancer database (NCDB) analysis of patients under 40 years old (1998–2003)

18035 Background: Non-small cell lung cancer (NSCLC) is disease of the elderly and is rare in younger adults. NSCLC in younger patients may be biologically different and have a different presentation and natural history. Methods: We identified in the National Cancer Data Base (NCDB), all patients diagnosed with NSCLC from 1998 to 2003. NCDB is a cancer database maintained by the American College of Surgeons. The NCDB data is obtained from the cancer programs participating in the Commission on Cancer NCDB annual call for data. Data on gender, race, stage and histology were obtained from the NCDB. The characteristics of patients with NSCLC from 16–39 years of age were compared to the entire group. Results: In the NCDB, 551248 patients with NSCLC diagnosed from 1998- 2003 were identified. Of these 4093 were in the age group 16–39. We compared the characteristics of NSCLC in younger group to the entire cohort (Table). Younger patients were more likely to be women, 52% vs 42% (p&lt;0.001), and more likely to present with distant disease (stage 3 &amp; 4) 75% vs 61% (p&lt;0.001). Adenocarcinoma was more common in younger patients, 48% respectively, vs. 38%. Squamous cell carcinoma was far less common in younger patients, 12% vs 28% (p&lt;0.001). Conclusions: Patients with NSCLC who are &lt; 40 years old at diagnosis are more likely to be women and have adenocarcinoma histology. Younger patients present with advanced stage more often than those who are older than 40 years at diagnosis. Table: Characteristics of younger patients with NSCLC [Table: see text] No significant financial relationships to disclose.

6 Is one single question a reliable screening tool for depression in elderly cancer patients: a prospective study

pulmonary diseases (20 vs. 5%) accounted for the increased co-morbidity in the older age group. More young lung cancer patients received standard therapy; in stage IIIB chemotherapy + radiotherapy (<65: 63%; 65: 29%) and in stage IV chemotherapy (<65: 75%; 65: 42%). However, more patients in the older age group refused chemotherapy ( 65 y: 29% vs <65 y: 8%). Conclusions: Patients 65 years had worse WHO performance as well as more severe co-morbidity. There was a difference in standard treatment between both age groups in st IIIB and IV lung cancer. However, these differences may be partly due to the patients’ preferences. Regarding the larger number of treatment refusals in the older age group in stage IV disease, it can be hypothesized whether older individuals are probably partly responsible themselves for the differences in treatment.

Hormone Replacement Therapy and Decreased Lung Cancer Survival

Hormone Replacement Therapy and Decreased Lung Cancer Survival

Clinical analysis of 99 young patients with lung cancer in different nationalities in Xinjiang

To study clinicopathological characteristics and national distribution of lung cancer in patients who were younger than 40 years of age in Xinjiang. The records of 99 patients who were younger than 40 years of age with lung cancer who were diagnosed in our hospital from September, 1989 to July, 2001 were reviewed. Analyses as to gender, nationalities, misdiagnosis and pathological types were performed. The female had higher prevalence than the male did, the ratio of male to female was 1.75 to 1. The Han race had higher prevalence than other races did. Most of the patients had clinical manifestations (97.0%). Adenocarcinoma and small cell lung cancer were predominant histologic types, which accounted for about 71.1%. The misdiagnostic rate was 61.6%. In young patients with lung cancer, the diffe-rence of incidence between different genders is smaller than that in senile patients. The prevalence of lung can-cer in young people varies in different races in Xinjiang and Han race has the highest prevalence. The malignancy of lung cancer in young patients is high, and most cases are in advanced stage. The misdiagnostic rate is high.

Polymorphisms in genes involved in xenobiotic metabolism and lung cancer risk under the age of 60 years: A pooled study of lung cancer patients in Denmark and Norway

The genetic susceptibility hypothesis has been used to explain why only a minority of smokers develop lung cancer. Only few studies have studied the role of polymorphisms in phase-I and II metabolizing genes, among young lung cancer patients. We have pooled the individual data of three studies from Denmark and Norway, including 320 patients diagnosed with non-small cell lung cancer at age 59 or below, and 618 age and gender matched controls. A questionnaire was used to determine relevant demographic and lifestyle characteristics, and polymorphisms in following genotypes were determined GSTM1, GSTM3, GSTP1, GSTT1, GPX1, MPO, NQO1 and NAT2. Based on the literature, the alleles of the genotypes were categorised as high- or low-risk alleles. No individual effect of the genotypes was found on the risk of lung cancer. Given a smoking exposure, the presence of high-risk alleles (or phenotypes) was generally found to increase the risk of lung cancer, although the effect modification did not reach statistical significance. A pattern of stronger protective effect was observed in carriers of more than one allele associated with lower risk of lung cancer, and a higher risk of lung cancer in carriers of one or more alleles associated with higher risk of lung cancer, but the results did not reach statistical significance. The effect modification was generally strongest at lower levels of smoking.

Characteristics of patients with lung cancer under the age of 45 years: a case control study.

The aim of this study was to define the clinical and pathological features associated with lung cancer diagnosed in persons under the age of 45 compared with lung cancer in an older population of greater than 45 years. A case control study was undertaken. Cases were defined as patients diagnosed with lung cancer under the age of 45 years. Controls were lung cancer patients over 45 years matched only for the date of diagnosis. Up to four controls were selected for each case. A retrospective review was undertaken of the records of a single tertiary respiratory institution which served a population of 1.2 million. Forty-eight cases of lung cancer (< 45 years of age) were identified and were compared to 123 matched controls with lung cancer (> 45 years of age). Of the cases 67% were female compared with 32% female cases in the control group (P < 0.01). The rate of adenocarcinoma was significantly higher among cases (48% vs 27%, P=0.001), while squamous cell carcinoma was more common in the controls (35% vs 17% P =0.001). Smoking was common in both groups although less so among cases (79% vs 95%, P=0.001)). There was no difference in survival rates between the cases (11 months) compared with controls (8 months) (P=0.1). Young lung cancer patients were predominantly female and adenocarcinoma accounted for a disproportionate number of the histological types. Cigarette smoking appears to be the main aetiological agent but as 21% of the patients under 45 years were non-smokers, other factors (genetic/hormonal) may also contribute. This study has not demonstrated a worse outcome in younger patients.

Lung Cancer Treated Surgically in Patients

Some investigators have suggested that lung cancer in young patients has a more aggressive course and a poorer prognosis than lung cancer in older patients. The aim of this study was to determine if the basal characteristics and survival in younger patients with lung cancer undergoing surgical resection differ from those of older patients. Retrospective clinical study. Of 1,208 consecutive patients who underwent surgery for primary lung cancer between June 1984 and March 2000, we reviewed the medical records of 110 younger patients who were < 50 years of age at the time of surgery and compared them with 1,098 older patients (> or = 50 years of age). All deaths were included. In the younger patient group, asymptomatic disease and adenocarcinoma was significantly more frequent, the rate of smoking was significantly higher, and the amount of smoking (Brinkman index) was significantly larger. For the 94 younger patients with complete resection, the 5-year survival rate was 61.0%, which was not significantly higher than that for the 923 older patients (57.7%). However, the 53 younger patients with stage I disease (5-year survival of 84.3%) had significantly better survival than older patients with the same condition (71.6%). Survival of patients in stage II or stage III disease was not significantly different. The younger patients had significantly better prognoses, and a statistical difference was shown especially in the early stage, while in the advanced stage the malignancy of the lung cancer itself surpassed the difference in survival.

Lung cancer in patients younger than 40 years of age.

We investigated whether the clinicopathologic characteristics and prognosis of lung cancer in younger patients differ from those of older patients. Among 2,763 lung cancer patients treated during the period from April of 1972 to April of 1997, we retrospectively investigated the clinical features and prognosis of 53 patients under 40 years of age (young group) and compared them with the findings of 1,886 patients with 60 years of age or older (elderly group). The proportion of female patients in the younger group was significantly higher than that in the elderly group (39.6% vs. 24.1%). The young group had a significantly higher proportion of adenocarcinoma (75.5% vs. 44.8%) and stage III-IV disease (73.6% vs. 59.2%) and a significantly lower proportion of squamous cell carcinoma (3.8% vs. 32.1%). Regarding the selection of therapy, in the young group, a significantly lower proportion of patients underwent surgical therapy (35.8% vs. 41.5%) and a significantly higher proportion of those (37.7% vs. 16.4%) received chemotherapy. The overall survival between the young and elderly groups was not significantly different. Moreover, the 5-year survival rate of the patients undergoing a surgical resection was 56.1% in the young group and 44.8% in the elderly group (P = 0.0615). This study suggests that the prognosis of young patients with lung cancer is at least equivalent to that of older patients; therefore, they should be managed according to the general therapeutic guidelines.

Lung cancer in patients younger than 40 years in a multiracial Asian country

This study aimed to determine whether the clinicopathological features of lung cancer in patients younger than 40 years differ from that of older patients in an Asian country. We undertook a review of the clinicopathological data of all patients with confirmed primary lung cancer at the Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, from October 1991 to September 1999. Of the 580 patients with lung cancer, 36 (6.2%; 23 males, 13 females) were 21-39 years old at diagnosis. The percentage of people who had never smoked was higher among the younger patients (58.3% vs 19.1%, P < 0.001). Although adenocarcinoma was the most common cell type in both groups, its incidence was higher in the younger patients (24/36 (66.7%) vs 228/544 (41.9%), P = 0.007). The mean World Health Organization performance status at presentation was worse in the younger patients (2.4 vs 2, P = 0.007). In the case of non-small cell lung cancer, all the younger patients presented with either stage IIIb or metastatic disease compared to 77.2% of the older patients (P < 0.001). Younger lung cancer patients were more likely than older patients to have never smoked, to have adenocarcinoma, and to present with poorer performance status and with more advanced-stage non-small cell lung cancer.