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  P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

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    P3.16-31 - Younger Patients Operated for Lung Cancer Have Better Overall Survival (ID 13891)

    12:00 - 13:30  |  Author(s): Danush Davoodi
    • Abstract
    • Slides

    Background
    

    Median age of patients diagnosed with lung cancer is 63 years. Incidence of lung cancer in population of patients younger than 50 years of age is relatively low. The aim of this study was to compare the clinical outcomes of patients with early lung cancer onset (ELCO, onset before the age of 50) and late lung cancer onset (LLCO, onset after the age of 50).

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We have retrospectively analyzed the prospectively collected data of 1517 patients with Lung cancer treated in a Thoracic Surgery Department in the years 2007-2015. Patients were divided into two groups, group I - 78 patients with ELCO and group II - 1439 patients with LLCO. We have compared overall survival in unmatched and matched population. In order to reduce potential selection bias being a result of different histology and different rate of concomitant diseases we performed a propensity-score matched analysis (based on exact matching – by sex, pTNM, type of operation, pathological diagnosis and Charlson Comorbidity Index). The latter analysis was performed in 65 ELCO patients with 453 LLCO patients.

    4c3880bb027f159e801041b1021e88e8 Result
    

    In the unmatched population we found no differences in gender, pTNM and type of surgery performed. Younger patients were also more likely to have typical carcinoid (23.1% vs 2.6%, p<0.05, OR 11.06 95%CI 5.695-21.360) and mucoepidermoid tumours (2.6% vs 0.3%, p<0.05, OR 7.547 95%CI 0.997-44.708), whereas the older patients were more likely to have squamous cell lung carcinoma (39.7% vs 23.1%, p<0.05, OR 0.455 95%CI 0.256-0.799). Older patients were more likely to be smokers (82% vs 59%, p<0.05 OR 0.316, 95%CI 0.192-0.519). Median Charlson Comorbidity Index in younger population was 0 and in the older population was 1 (p<0.05). Five-year survival in EOLC group was 71.9% vs. 58.7% in LLCO (p=0.008).

    The propensity score-matched analysis with exact method, comparing sex, pTNM, type of operation, pathological diagnosis and Charlson Comorbidity Index, showed that younger patients had better survival rates compared to older patients (p<0.001 HR=0.559, 95%CI 0.360-0.865). Five-year survival in patients with ELCO was 77.6% comparing to 61.5% in LLCO patients (p=0.011).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Patients with early lung cancer onset have higher five-year survival after surgical treatment compared to patients with late lung cancer onset irrespectively of histology.

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