Aim was to analyze demographic and tumor characteristics, treatment, and survival of patients with lung cancer younger than 40 years of age (U40) compared to older subgroups (41–70 and >70 years).
Methods:
We analyzed data of young patients diagnosed and treated in 2011–2019 in five pneumo-oncology centers in Czechia. Standard descriptive statistics, chi-squared test, Fisher exact test, and Kaplan-Meier survival analysis were used. p-Values <0.05 were considered significant. These data were compared with two control subgroups (cohort 1: 41–70 years, cohort 2: >70 years).
Results:
We identified 66 patients U40, 61 with non-small cell lung cancer (NSCLC)—50.8% men, mean age 34.6 years, 54.1% nonsmokers, daily good performance status, and 82% in stage IV. Adenocarcinomas dominated, endothelial growth factor receptor (EGFR) positivity was less common than in older groups contrary to anaplastic lymphoma kinase (ALK) mutations. Median progression-free survival was 3.7 months (vs. 4.9 and 6.2 months; p = 0.006) and overall survival reached 11.7 months (vs. 22.3 and 27.3 months; p < 0.001). Young patients in stage IV and never-smokers had shorter survival than older patients.
Conclusion:
Patients with NSCLC U40 had significantly worse prognosis than older patients.
ThomasA, ChenY, YuT. Trends and characteristics of young non-small cell lung cancer patients in the United States. Front Oncol. 2015; 26(6):113.
4.
HsuCL, ChenKY, ShihJY. Advanced non-small cell lung cancer in patients aged 45 years or younger: outcomes and prognostic factors. BMC Cancer. 2012; 13(12):241.
5.
MaruyamaR, YoshinoI, YohenaT. Lung cancer in patients younger than 40 years of age. J Surg Oncol. 2001; 77(3):208–12.
6.
RadzikowskaE, RoszkowskiK, GlazP. Lung cancer in patients under 50 years old. Lung Cancer. 2001; 33(2–3):203–11.
7.
SubramanianJ, MorgenszternD, GoodgameB. Distinctive characteristics of non-small cell lung cancer (NSCLC) in the young: a Surveillance, Epidemiology, and End Results (SEER) analysis. J Thorac Oncol. 2010; 5(1):23–8.
8.
BlancoM, Garcia-FontanE, RivoJE. Bronchogenic carcinoma in patients under 50 years old. Clin Transl Oncol. 2009; 11(5):322–5.
9.
ZhangJ, ChenSF, ZhenY. Multicenter analysis of lung cancer patients younger than 45 years in Shanghai. Cancer. 2010; 116(15):3656–62.
10.
BasumallikN, AgarwalM. Small cell lung cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 JanPMID: 29494065.
11.
BratovaM, KarlinovaB, Skrickova. Non-small cell lung cancer as a chronic disease—a prospective study from the Czech TULUNG Registry. In Vivo. 2020; 34(1):369–79.
12.
Bigay-GaméL, BotaS, GreillierL. Characteristics of lung cancer in patients younger than 40 years: a prospective multicenter analysis in France. Oncology. 2018; 95(6):337–43.
13.
LiF, HeH, QiuB. Clinicopathological characteristics and prognosis of lung cancer in young patients aged 30 years and younger. J Thorac Dis. 2019; 11(10):4282–91.
14.
Galvez-NinoM, RuizR, PintoJA. Lung cancer in the young. Lung. 2020; 198(1):195–200.
15.
MirsadraeeS, OswalD, AlizadehY. The 7th lung cancer TNM classification and staging system: review of the changes and implications. World J Radiol. 2012; 28(4):128–34.
16.
LimW, RidgeCA, NicholsonAG. The 8th lung cancer TNM classification and clinical staging system: review of the changes and clinical implications. Quant Imaging Med Surg. 2018; 8(7):709–18.
17.
EisenhauerEA, TherasseP, BogaertsJ. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009; 45(2):228–47.
LeeY, JeonJH, GohSH. The clinical impact of family history of cancer in female never-smoker lung adenocarcinoma. Lung Cancer. 2019; 136:15–22.
20.
ScarpinoS, Rampioni VinciguerraGL, Di NapoliA. High prevalence of ALK+/ROS1+ cases in pulmonary adenocarcinoma of adoloscents and young adults. Lung Cancer. 2016; 97:95–8.
21.
LiuB, QuanX, XuC. Lung cancer in young adults aged 35 years or younger: a full-scale analysis and review. J Cancer. 2019; 10(15):3553–9.
22.
XiaJ, LiH, JiY, et al.Clinicopathologic characteristics and EGFR mutations in lung cancer patients aged below 45 years. Curr Probl Cancer. 2019; 43(4):363–70.
23.
VavalàT, MonicaV, Lo IaconoM. Precision medicine in age-specific non-small-cell-lung-cancer patients: integrating biomolecular results into clinical practice-A new approach to improve personalized translational research. Lung Cancer. 2017; 107:84–90.
24.
HouH, ZhuH, ZhaoH. Comprehensive molecular characterization of young Chinese patients with lung adenocarcinoma identified a distinctive genetic profile. Oncologist. 2018; 23(9):1008–15.
25.
YeT, PanY, WangR. Analysis of the molecular and clinicopathologic features of surgically resected lung adenocarcinoma in patients under 40 years old. J Thorac Dis. 2014; 6(10):1396–402.
26.
YangS, SongZ, ChengG. Genomic alterations and survival in young patients aged under 40 years with completely resected non-small cell lung cancer. Ann Transl Med. 2019; 7(7):140.
27.
ChenZ, TengX, ZhangJ. Molecular features of lung adenocarcinoma in young patients. BMC Cancer. 2019; 19(11):777.
28.
WangC, LiangH, LinC. Molecular subtyping and prognostic assessment based on tumor mutation burden in patients with lung adenocarcinomas. Int J Mol Sci. 2019; 20(17):4251.
29.
TianP, LiuY, ZengH. Unique molecular features and clinical outcomes in young patients with non-small cell lung cancer harboring ALK fusion genes. J Cancer Res Clin Oncol. 2020; 146(4):935–44.
EarleCC. Outcomes research in lung cancer. J Natl Cancer Inst Monogr. 2004; 33:56–77.
32.
AhrensbergJM, Fenger-GrønM, VedstedP. Primary care use before cancer diagnosis in adolescents and young adults—a nationwide register study. PLoS One. 2016; 11(5):e0155933.
