title: Surgery for non-small cell lung cancer in younger patients: what are the differences?
abstract: BACKGROUND
  Non-small cell lung cancer (NSCLC) in young adults is uncommon. The objective of this study was to evaluate the clinicopathological characteristics, outcomes and prognosis of people younger than 50 years old treated surgically for NSCLC.
  
  
  METHODS
  A retrospective study was conducted using the institutional database of four thoracic surgery units to collect patients with NSCLC younger than 50 years who had undergone surgery. These patients were compared with older patients (>75-years) operated in the same institutions and in the same period.
  
  
  RESULTS
  We identified 113 young patients and 347 older patients. Younger patients were more likely to be female, non-smokers, with fewer comorbidities. Younger patients were more likely to be symptomatic at the time of diagnosis. Risk factors for poor prognosis in younger patients were T-stage, and disease-free-interval less than 548 days. Kaplan-Meier analysis showed a lower five-year survival in older patients compared with the younger ones (66% vs 38%, p=0.001).
  
  
  CONCLUSIONS
  In conclusion NSCLC in younger patients has some distinct clinicopathological characteristics. The overall-survival of young patients is better than in older patients. Young patients receive more complete and aggressive treatment that could explain better survival. Further prospective studies with larger patient populations are required, to clarify the biological and genetic variance of NSCLC in younger patients.
authors.affiliation: Division of Thoracic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy. Electronic address: dellamore76@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dell'Amore
authors.affiliation: Division of Thoracic Surgery, Morgagni Pierantoni Hospital, Forlì, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Monteverde
authors.affiliation: Division of Thoracic Surgery, Istituto Nazionale dei Tumori, IRCCS Fondazione Pascale, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Martucci
authors.affiliation: Division of Thoracic Surgery, University Eastern Piedmont, Novara, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Davoli
authors.affiliation: Division of Thoracic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Caroli
authors.affiliation: Department of Formative Science, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pipitone
authors.affiliation: Division of Thoracic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bini
authors.affiliation: Division of Thoracic Surgery, S.Orsola Malpighi University Hospital, Bologna, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Stella
authors.affiliation: Division of Thoracic Surgery, Morgagni Pierantoni Hospital, Forlì, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Dell'Amore
authors.affiliation: Division of Thoracic Surgery, University Eastern Piedmont, Novara, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Casadio
authors.affiliation: Division of Thoracic Surgery, Istituto Nazionale dei Tumori, IRCCS Fondazione Pascale, Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Rocco
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000601:surgery*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
keywords: Lung cancer; Lung cancer prognosis; Lung surgery; Thoracic surgery; Younger patients