LUNG-CANCER IN YOUNG PERSONS

Abstract

Lung cancer in patients under 40 yr old is rare. Among 718 patients with lung cancer, 5% or 35 patients were younger than 40. All but 1 were heavy smokers. Twelve young patients who had operations survived 41.7 (SD 46.3) mo.; they included 6 who had resections of Stage 3 disease and who survived 19.2 (SD 16.0) mo. The other 6 young patients treated operatively were free of nodal metastasis (NO); all survived more than 3 yr and 3 of them are apparently cured. The 23 young patients who were not treated operatively survived for 5.6 (SD 3.1) mo. The 5 yr survival rate of these young operated patients was not different from that of 201 operated patients over 40 yr of age. Young nonoperated patients survived for a significantly shorter time (P < 0.0001) than did the older patients who also received only chemotherapy and/or radiation as a treatment. In young patients adenocarcinomas predominated (48.6%), and the incidence of small cell undifferentiated cancers was high (28.6%). These significant differences as compared to the control group did not explain the short survival time of the young patients treated nonsurgically. Lung cancer in young persons is virulent and that diagnosis is frequently delayed. Therapy, in selected patients, should include aggressive resection, sometimes despite advanced local disease. This group of patients justifies innovative, intensive efforts at prompter diagnosis and experimental multimodal therapy.