Objective: To determine if the clinicopathologic
features and survival of lung cancer patients < 50 years of age
differ from those of older patients.
Retrospective review of patients with primary bronchogenic carcinoma
diagnosed at a single, multidisciplinary cancer center.
Setting: A National Cancer Institute-designated
comprehensive cancer center in urban Detroit, MI.
Patients: All patients with primary bronchogenic carcinoma
evaluated in the Multidisciplinary Lung Cancer Clinic at the Barbara
Ann Karmanos Cancer Institute between 1990 and 1993.
Results: Of 1,012 patients with lung cancer, 126 (12.5%)
were < 50 years old at diagnosis, with a median age of 44 years. The
median age of the 886 patients ≥ 50 years of age was 65 years. The
gender (p = 0.08) and racial (p = 0.12) characteristics of the
younger and older patient groups were not significantly different. More
than 90% of patients in both groups were smokers. The incidence of
adenocarcinoma was significantly higher in younger patients (48.4% vs
36.0%, p < 0.001), and early-stage disease was less frequently
diagnosed in younger patients (4.8% vs 19.7%, p < 0.001). Younger
patients were more likely than older patients to undergo treatment,
including surgery and combined-modality therapy (p < 0.001). Median
survival was 13 months in younger and 9 months in older patients, while
overall survival was similar in younger and older patients
(p = 0.13).
Conclusions: Although younger patients
with lung cancer present with more advanced-stage disease, their
overall survival is similar to that of older patients, suggesting that
lung cancer is not an inherently more aggressive disease in patients< 50 years of age.
SEER = Surveillance, Epidemiology, and End Results