Lung Cancer vs. "Young Cancer" - Is There a Difference?

Introduction: Lung cancer is the leading cause of death among all cancer diseases worldwide. Most of patients were in the age group of 65-69 years, however we also experience young patients with lung cancer. This subgroup is rather small, but it deserves major attention. Aims: Our study focused on patients aged under 40 years with lung cancer diagnosed between 2011-18 in five pneumo-oncology centers in Czechia. Our aim was to analyze demographic and tumor characteristics, treatment and survival outcomes contraty to the older patients (cohort 2). Methods: Basic characteristics were described by standard descriptive statistics. Chi-squared test and Fisher exact test were used for comparison of variables between cohorts. Kaplan-Meier survival analysis was used to estimate PFS and OS. As a level of statistical significance, p value <0.05 was used. Results: We found 66 patients under 40ty with lung cancer – 61 patients with NSCLC and 5 patients with SCLC, only NSCLC patients were underwent to a further analysis (cohort 1). This cohort counts 50, 8% of men, mean age 34,6 years, 54,1% of non-smokers (vs 79,7% in cohort 2, p <0.001), mainly in a good performance status. About 82% were in IV stage (vs 67,7%, p<0.001). Adenocarcinomas dominated (75,4%), 16,3% were EGFR positive (vs 21,6% in cohort 2), 25,6% ALK positive (vs 8,5% in cohort 2). Median PFS of young lung cancer patients was 3,7 months (vs 4,9 months, p = 0,006), OS reached 11,7 months (vs 22,3 months, p <0.001). Conclusions: Patients under 40ty have much worse prognosis than older patients with lung cancer. The investigation of a different etiopathogenesis of their disease is needed as well as a new approach both in diagnosis and treatment.