Outcome and prognosis for patients younger than thirty with primary lung cancer

Aim of the present study was to investigate the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.

We retrospectively reviewed the clinico-pathological records documenting surgical outcomes and prognostic factors in 68 lung cancer patients aged less than 30 years old enrolled in our hospital between March 1980 and December 2009.

Sixty-eight patients were identified (38 male, 30 female) with a mean age of 22±5 years (range 8 to 29 years). Preoperative clinical manifestations were present in 82.4% (56/68) of the patients and 26.5% (16/68) of patients were initially misdiagnosed. Fifty-two patients had undergone radical surgery, 4 palliative surgery, 9 had exploratory thoracotomies, and 3 had thoracoscopic lung biopsies. Eight patients were classified (TNM) stage Ia, 7 stage Ib, 9 stage IIa, 13 stage IIb, 17 stage IIIa, 10 stage IIIb, and 4 stage IV. Postoperative atelectasis was observed in 4.41% (3/68) of the patients, and 1.47% (1/68) died of respiratory failure 5 days after exploratory thoracotomy. The overall 5-year survival rate in very young people was 31%, while those who underwent radical surgery was slightly higher at 36.7%. Five-year survival rates were correlated with the surgical procedures and pTNM stage (P <0.05). Multivariate analysis indicated that the TNM stage is the only independent prognostic factor (P=0.000).

We conclude that radical surgeries, the predominant comprehensive therapies are the best choice for primary lung cancer patients younger than 30 years of age.