Non-small cell lung cancer in very young and very old patients

Study objective: A cancer registry was analyzed to determine if the clinico pathologic characteristics, treatment modalities, and prognosis of non-smal l cell lung cancer (NSCLC) patients < 40 years of age at diagnosis differed from patients > 80 years of age at diagnosis. Design: Retrospective review of patients with NSCLC diagnosed between 1987 and 1996, Setting: General teaching hospital in Taiwan. Patients: There were 6,048 cases of NSCLC diagnosed during this period. Amo ng them, 127 patients were < 40 years old and 184 patients were > 80 years old. These patients were selected for our study, Measurements: Data regarding demographics, presentation symptoms, histology , tumor staging, treatment modality, and survival were obtained from all pa tients. Pearson's chi(2) test and the Kaplan-Meier method with a log-rank t est were used for statistical analysis. Results: We found significantly more female patients (p < 0.001) and adenoc arcinoma (p < 0.001) in the younger group, when compared with the older pat ients. Cough was the most frequent presenting symptom in both age groups, f ollowed by dyspnea, chest pain, and hemoptysis. There was no statistical di fference in the severity of the disease in terms of staging between the two age groups. Young patients received surgical intervention more frequently than the aged (p = 0.025). The older patients received only supportive care more frequently (p = 0.011) than the younger patients. Survival was better in young patients, when compared with other patients or aged patients (p < 0.001). Conclusions: The female ses and adenocarcinoma were predominant in young NS CLC patients, when compared with the older patients. Young NSCLC patients t ended to receive more aggressive treatment and had better survival.