title: Multicenter analysis of lung cancer patients younger than 45 years in Shanghai.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oncology, Shanghai Medical College, and Department of Thoracic Surgery, Shanghai Cancer Hospital, Fudan University, Shanghai, China. zhangjie2289@hotmail.com
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Su-feng
authors.initials: SF
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhen
authors.forename: Jiaqing
authors.initials: J
authors.lastname: Xiang
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Wu
authors.forename: Pingping
authors.initials: P
authors.lastname: Bao
authors.forename: James
authors.initials: J
authors.lastname: Luketich
authors.forename: Hong
authors.initials: H
authors.lastname: Hu
authors.forename: Xian
authors.initials: X
authors.lastname: Zhou
authors.forename: Junhua
authors.initials: J
authors.lastname: Zhang
authors.forename: Shihua
authors.initials: S
authors.lastname: Yao
authors.forename: Hai-Quan
authors.initials: HQ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002681:China; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis