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Lung Resections for Primary Malignancies in Patients Younger Than 40 Years: A Review of Cases in a Fifteen Year Period FREE TO VIEW

Daniel Valdivia, MD; Lucas Hoyos, MD; Lidia Macias, MD; David Gomez, PhD; Andres Varela, PhD
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Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain

Chest. 2014;145(3_MeetingAbstracts):329A. doi:10.1378/chest.1824013
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SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Review the characteristics and outcomes of patients in our series

METHODS: Retrospective analysis of patients younger than 40 years undergoing lung resection for primary malignant tumors in our department between 1997-2012.

RESULTS: N = 24. 16 (67.7%) men. Average age: 32.7 years (range 13-40 years). 12 (50%) patients were smokers. The most common comorbidity was hypertension 17%. The histologic types were: Adenocarcinoma 8 (33.3%), Typical Carcinoid 8 (33.3%), Mucoepidermoid 3 (12.5%), Squamous Cell Carcinoma 2 (8.3%), Neuroendocrine 1 (4.2%), Large Cell Carcinoma 1 (4.2%) and Germ Cell Carcinoma of Pulmonary Origin 1 (4.2%). Procedures performed: 16 lobectomies (15 by open approach and one by VATS) and of these three were made with bronchoplasty, one with chest wall resection and one with diaphragm resection. 2 segmentectomies, one atypical and one typical (lingulectomy), 3 pneumonectomies and 2 sleeve resections without associated lobectomy. In 1 case a bilobectomy was performed. The median stay was 6.5 days (range 4-28). The incidence of postoperative complications was 35% (pleural effusion 3 cases (15%), fever 2 cases (10%), oxygen therapy, atelectasis and vocal cord paralysis one case each (5%)). The survival for each stage at 1, 3 and 5 years respectively was: IA: 100% in the 3 evaluation periods, IB: 100, 100, and 80%, II A: 100, 75 and 75%, II B: 100, 100 and 50%, III A 100, 0 and 0%. A patient with stage IV died 4 years after surgery. Patient with Germ Cell Carcinoma of Pulmonary Origin had a completed pathological response after induction chemotherapy. No patient died during hospitalization or in the first year after surgery.

CONCLUSIONS: Adenocarcinoma and Typical Carcinoid are the most common histological types in our series. Early diagnosis and complete resection helps to improve survival in these patients.

CLINICAL IMPLICATIONS: Provide data on a group of patients where the lung cancer remains rare

DISCLOSURE: The following authors have nothing to disclose: Daniel Valdivia, Lucas Hoyos, Lidia Macias, David Gomez, Andres Varela

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