Ciência e terapia do câncer

Metastatic Non-Small Cell Lung Cancer in the Young: A Retrospective Comparative Analysis

Abstract

Zineb Benbrahim, Lamiae Amaadour, Lamiae Boudahna, Naima Abda, Chakib Nejjari, Samia Arifi, Nawfel Mellas and Omar El Mesbahi

Background: Non-small cell lung cancer (NSCLC) in young patients is uncommon and is thought to constitute a distinct oncological entity with characteristic clinicopathological patterns. The objective of our work is to analyze presentation, management and outcome data of NSCLC patients aged less than 45 years and compare them with those of patients over 45 years old.

Materials and methods: We retrospectively reviewed all patients treated for metastatic NSCLC over the period of 5 years (2007–2012) at the Medical Oncology Department of Hassan II University Hospital. The clinicopathological characteristics of patients aged less than and over 45 years old were compared and evaluated for prognostic significance regarding outcome.

Results: The data for NSCLC patients (116), of whom 15 were aged <45, were retrieved. In comparative analysis, there was a trend for an increased proportion of females with lung cancer among the younger individuals (56% in the younger vs 23 % in the older age group, p=0.008). History of smoking was less frequently retrieved in younger patients (40%) than patients aged over 45 (81.2%) (p=0.005).No differences were found for hemoptysis, performance status, histology or number of metastatic sites. More patients in the young group (86.7%) received biotherapy with platinum based regimen than in older patients (50.5%); (p= 0.008).The mean number of cycles was 2.6 per patient. The Progression free survival (PFS) and overall survival (OS) were not significantly different (median PFS: 6.0 vs 5.0 months; p=0.9 and median OS 7.0 vs. 5.0 months, p=0.14).

Conclusion: This retrospective study failed to present strong evidence that NSCLC among young individuals constitutes a distinct clinicopathological entity. The limited number of younger patients treated here, suggests designing other studies to shed light on this controversial subject.