Advanced non-small cell lung cancer in patients aged 45 years or younger: outcomes and prognostic factors

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• 作者：Chia-Lin Hsu (1)
  Kuan-Yu Chen (1)
  Jin-Yuan Shih (1)
  Chao-Chi Ho (1)
  Chih-Hsin Yang (2)
  Chong-Jen Yu (1)
  Pan-Chyr Yang (1)
  
• 关键词：Lung cancer ; Prognosis ; Young patients
• 刊名：BMC Cancer
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：12
• 期：1
• 全文大小：257KB
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  49. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/12/241/prepub
  
• 作者单位：Chia-Lin Hsu (1)
  Kuan-Yu Chen (1)
  Jin-Yuan Shih (1)
  Chao-Chi Ho (1)
  Chih-Hsin Yang (2)
  Chong-Jen Yu (1)
  Pan-Chyr Yang (1)
  
  1. Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, and College of Medicine, Taipei, Taiwan
  2. Department of Oncology, National Taiwan University Hospital, and College of Medicine, Taipei, Taiwan
  
• ISSN：1471-2407

文摘

Background Lung cancer in young patients (less or equal to 45?years) is uncommon and has clinical characteristics different from that in older patients. We investigated the outcomes and prognostic factors of young patients with advanced non-small cell lung cancer (NSCLC). Methods From January 2000 to December 2009, we enrolled patients aged ?5?years and diagnosed with stage IIIB or IV NSCLC. Their clinical data, including age, gender, performance status, histologic types, disease stages, laboratory data at diagnosis, treatment modalities, and survival were reviewed and analyzed. A Cox proportional hazard model was used to calculate the hazard ratio (HR) and its 95% confidence interval (CI). Results A total of 144 patients with advanced NSCLC were included. Female patients were more prevalent (n--4, 51.4%). Adenocarcinoma was the most common histologic type (n--19, 82.6%) in both genders (male, n--4, 77.1%; female, n--5, 87.8%). Epidermal growth factor receptor (EGFR) sequences were determined using tumor specimens from 58 patients, and 29 showed an EGFR mutation. No significant difference in median survival was found between patient groups with and without the EGFR mutation (798 vs. 708?days, p--.65). In multivariate analysis, male gender (HR, 1.70; 95% CI: 1.08-2.68), body mass index (BMI) less than 25?kg/m2 (HR, 2.72; 95% CI: 1.39-5.30), stage IV disease (HR, 2.62; 95% CI: 1.50-4.57), and anemia (HR, 2.08; 95% CI: 1.15-3.77) were associated with a short survival time. Conclusions Low BMI, stage IV disease, anemia at diagnosis, and male gender were the negative prognostic factors for young patients with advanced NSCLC.