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

ABSTRACT

AIM: Aim of the present study was to investigate the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients. 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. RESULTS: 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). CONCLUSION: We conclude that radical surgeries, the predominant comprehensive therapies are the best choice for primary lung cancer patients younger than 30 years of age.