Bronchogenic carcinoma in patients under age 40

Eighty-nine patients aged 19 to 39 years were treated for bronchogenic carcinoma at Roswell Park Memorial Institute between 1973 and 1983. The male to female ratio was 1.6:1. The vast majority of patients were habitual cigarette smokers. Forty-four patients (49%) had adenocarcinoma or bronchoalveolar cell carcinoma. Twenty-seven (30%) had large cell undifferentiated carcinoma. Nine (10%) had small cell carcinoma and 6 (7%), squamous cell carcinoma. At the time of diagnosis, 2 patients (2%) had stage I disease, 3 (3%) had stage II disease, 30 (34%) had stage IIIA disease, 28 (32%) had stage IIIB disease, and 26 (29%) had stage IV disease. Only 3 patients survive. Median survival of all patients was 7.5 months. Median survival of patients whose tumor was surgically resected was 17.5 months. Advanced stage of disease at the time of diagnosis characterized this group of young patients with primary cancer of the lung. The brief duration of symptoms and the poor survival suggest this is a more aggressive tumor in younger patients than in older patients.