Clinicopathological characteristics and surgical results of lung cancer patients aged up to 50 years: The Japanese Lung Cancer Registry Study 2004

Objective: The clinicopathological characteristics and surgical results of young lung cancer patients were investigated. Materials and methods: Seven hundred and four (6.0%) patients with lung cancer, aged up to 50 years, were enrolled from among the 11,663 patients registered in the Japanese Lung Cancer Registry Study 2004, and their clinical data were compared with those of 10,959 patients older than 50 years. This epidemiological study is based on the single year registration of surgically treated patients in the major institutes in Japan. Results: The 5-year overall survival rate (5Y-OS) and the 5-year lung cancer-related survival rate was 79.2%/69.0% (p<0.001) and 81.3%/76.6%(p = 0.005) in the young/old groups, respectively. In the young/old groups, lobectomy and pneumonectomy was performed in 76.9%/78.0% and 5.7%/3.2%, respectively; adjuvant therapies were given preoperatively in 10.4%/4.7% (p<0.001) and postoperatively in 31.4%/24.5% (p<0.001). The proportions of patients with p-stage IIIA (18.2%) and adenocarcinoma histology (78.7%) were higher in the young group. The 5Y-OS was 94.8%/86.2% for p-stage IA (p<0.001), 87.0%/73.2% for p-stage IB (p = 0.001), 61.0%/61.6% for p-stage IIA (p = 0.595), 71.0%/48.4% for p-stage IIB (p = 0.003), 49.6%/39.4% for p-stage IIIA (p = 0.020), and 80.0%/24.8% for p-stage IIIB (p = 0.012); it was 83.5%/80.7% for females (p = 0.106) and 75.1%/62.3% for males (p < 0.001) in the young/old groups. The postoperative survival was significantly better with all operative procedures in the young group. The 5Y-OS after recurrence was 17.9%/13.4% in the young/old groups (p = 0.016). In the young group, the 5Y-OS was better in females (83.5%) than in males (75.1%, p = 0.002), and for patients with adenocarcinoma (80.3%) than for those with squamous cell carcinoma (68.5%, p = 0.013). Age up to 50 years was identified as an independent better prognostic factor on multivariate analysis. Conclusions: The postoperative survival in lung cancer patients aged up to 50 years was better than that in patients older than 50 years. (C) 2013 Elsevier Ireland Ltd. All rights reserved.