Advanced non-small cell lung cancer in patients aged 45 years or younger: outcomes and prognostic factors.
BACKGROUND
Lung cancer in young patients (less or equal to 45 years) is uncommon and has clinical characteristics different from that in older patients. We investigated the outcomes and prognostic factors of young patients with advanced non-small cell lung cancer (NSCLC).


METHODS
From January 2000 to December 2009, we enrolled patients aged ≤45 years and diagnosed with stage IIIB or IV NSCLC. Their clinical data, including age, gender, performance status, histologic types, disease stages, laboratory data at diagnosis, treatment modalities, and survival were reviewed and analyzed. A Cox proportional hazard model was used to calculate the hazard ratio (HR) and its 95% confidence interval (CI).


RESULTS
A total of 144 patients with advanced NSCLC were included. Female patients were more prevalent (n = 74, 51.4%). Adenocarcinoma was the most common histologic type (n = 119, 82.6%) in both genders (male, n = 54, 77.1%; female, n = 65, 87.8%). Epidermal growth factor receptor (EGFR) sequences were determined using tumor specimens from 58 patients, and 29 showed an EGFR mutation. No significant difference in median survival was found between patient groups with and without the EGFR mutation (798 vs. 708 days, p = 0.65). In multivariate analysis, male gender (HR, 1.70; 95% CI: 1.08-2.68), body mass index (BMI) less than 25 kg/m(2) (HR, 2.72; 95% CI: 1.39-5.30), stage IV disease (HR, 2.62; 95% CI: 1.50-4.57), and anemia (HR, 2.08; 95% CI: 1.15-3.77) were associated with a short survival time.


CONCLUSIONS
Low BMI, stage IV disease, anemia at diagnosis, and male gender were the negative prognostic factors for young patients with advanced NSCLC.
Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, and College of Medicine, Taipei, Taiwan.
Chia-Lin
CL
Hsu
Kuan-Yu
KY
Chen
Jin-Yuan
JY
Shih
Chao-Chi
CC
Ho
Chih-Hsin
CH
Yang
Chong-Jen
CJ
Yu
Pan-Chyr
PC
Yang
D000328:Adult; D000367:Age Factors; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
D066246:ErbB Receptors