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Li J, Pan B, Huang Q, Zhan C, Lin T, Qiu Y, Zhang H, Xie X, Lin X, Liu M, Wang L, Zhou C. A Nomogram for Predicting Cancer-Specific Survival in Young Patients With Advanced Lung Cancer Based on Competing Risk Model. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13800. [PMID: 39113289 PMCID: PMC11306286 DOI: 10.1111/crj.13800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 05/09/2024] [Accepted: 06/05/2024] [Indexed: 08/11/2024]
Abstract
BACKGROUND Young lung cancer is a rare subgroup accounting for 5% of lung cancer. The aim of this study was to compare the causes of death (COD) among lung cancer patients of different age groups and construct a nomogram to predict cancer-specific survival (CSS) in young patients with advanced stage. METHODS Lung cancer patients diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and stratified into the young (18-45 years) and old (> 45 years) groups to compare their COD. Young patients diagnosed with advanced stage (IVa and IVb) from 2010 to 2015 were reselected and divided into training and validation cohorts (7:3). Independent prognostic factors were identified through the Fine-Gray's test and further integrated to the competing risk model. The area under the receiver operating characteristic curve (AUC), consistency index (C-index), and calibration curve were applied for validation. RESULTS The proportion of cancer-specific death (CSD) in young patients was higher than that in old patients with early-stage lung cancer (p < 0.001), while there was no difference in the advanced stage (p = 0.999). Through univariate and multivariate analysis, 10 variables were identified as independent prognostic factors for CSS. The AUC of the 1-, 3-, and 5-year prediction of CSS was 0.688, 0.706, and 0.791 in the training cohort and 0.747, 0.752, and 0.719 in the validation cohort. The calibration curves demonstrated great accuracy. The C-index of the competing risk model was 0.692 (95% CI: 0.636-0.747) in the young patient cohort. CONCLUSION Young lung cancer is a distinct entity with a different spectrum of competing risk events. The construction of our nomogram can provide new insights into the management of young patients with lung cancer.
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Affiliation(s)
- Jiaxin Li
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
- Department of Gastroenterology and HepatologyWest China Hospital, Sichuan UniversityChina
| | - Bolin Pan
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
| | - Qiying Huang
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
| | - Chulan Zhan
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
| | - Tong Lin
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
| | - Yangzhi Qiu
- Department of Clinical MedicineGuangzhou Medical UniversityGuangzhouChina
| | | | - Xiaohong Xie
- Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Xinqin Lin
- Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Ming Liu
- Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Liqiang Wang
- College of Life ScienceHenan UniversityKaifengChina
- Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Chengzhi Zhou
- Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina
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Laguna JC, Tagliamento M, Lambertini M, Hiznay J, Mezquita L. Tackling Non-Small Cell Lung Cancer in Young Adults: From Risk Factors and Genetic Susceptibility to Lung Cancer Profile and Outcomes. Am Soc Clin Oncol Educ Book 2024; 44:e432488. [PMID: 38788188 DOI: 10.1200/edbk_432488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Lung cancer has traditionally been associated with advanced age; however, its increasing incidence among young adults raises concerning questions regarding its etiology and unique considerations for this population. In contrast to the older population, the onset of lung cancer at younger age may be attributed to a complex interplay of incompletely understood individual susceptibility and prevalent environmental risk factors beyond tobacco smoke exposure, such as radon gas and air pollution, which are widespread globally. Consequently, this leads to distinct clinical and molecular profiles, requiring a tailored approach. Furthermore, a diagnosis of cancer represents a threatening event during the prime years of a young person's life, prompting concern about career development, social aspects, fertility aspirations, and physical independence. This poses significant additional challenges for health care professionals in a field that remains underexplored. This comprehensive review recognizes lung cancer in young adults as a distinct entity, exploring its clinical and molecular characteristics, diverse predisposing factors, and priorities in terms of quality of life, with the aim of providing practical support to oncologists and enhancing our understanding of this under-researched population.
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Affiliation(s)
- Juan Carlos Laguna
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
- Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
- Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Laura Mezquita
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
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Zhang Z, Huo H, Li F, Miao J, Hu B, Chen S. Surgical outcomes for non-small cell lung cancer in younger adults: A population-based study. Thorac Cancer 2024; 15:1218-1227. [PMID: 38606839 PMCID: PMC11128372 DOI: 10.1111/1759-7714.15300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The surgical outcomes for younger patients with non-small cell lung cancer (NSCLC) remain uncertain. The aim of this study was to investigate the clinical features long-term survival outcomes in younger individuals with NSCLC following surgery. METHODS We queried the Surveillance, Epidemiology, and End Results database from 2010 to 2017, selecting all pathologically confirmed NSCLC cases that underwent cancer-directed surgery. Younger patients were defined as those aged 18-50 years, while older patients were 51-80 years. Propensity score matching (PSM) was implemented to mitigate selection bias. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared using the Kaplan-Meier method. RESULTS Among the 33 586 treated surgically patients, 2223 (6.6%) were young. Compared to the older group, younger patients had a higher frequency of female gender, non-white ethnicity, carcinoid tumors, stage IV disease, pneumonectomy, and postoperative adjuvant therapies. The 5-year OS rates were significantly higher for younger patients (79.3% vs. 62.0%; p < 0.001), as were the 5-year LCSS rates (82.4% vs. 71.8%; p < 0.001). Post-PSM, younger patients consistently demonstrated significantly better OS and LCSS. Further stage-specific analysis revealed significantly improved 5-year OS rates at each stage and superior 5-year LCSS for stages I-II among younger patients. However, there was no statistically significant difference in LCSS for stages III-IV. CONCLUSIONS Overall, younger patients with NSCLC treated surgically exhibit superior OS and LCSS compared to their older counterparts, although no statistically significant difference in LCSS for stages III-IV was observed between the two age groups.
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Affiliation(s)
- Zhirong Zhang
- Department of Thoracic SurgeryBeijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Huandong Huo
- Department of Thoracic SurgeryNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Feng Li
- Department of Pulmonary SurgeryThe Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of SciencesHangzhouChina
| | - Jinbai Miao
- Department of Thoracic SurgeryBeijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Bin Hu
- Department of Thoracic SurgeryBeijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Shuo Chen
- Department of Thoracic SurgeryBeijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
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Mori Y, Seguchi M, Iio Y, Aoyama Y, Tanaka M, Kozai H, Ito M. Factors Influencing Willingness to Undergo Lung Cancer Screening in the Future: A Cross-Sectional Study of Japanese University Students. Healthcare (Basel) 2024; 12:849. [PMID: 38667611 PMCID: PMC11050173 DOI: 10.3390/healthcare12080849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed to elucidate the inclination toward LCS and its determining factors among Japanese university students. This cross-sectional study, involving 10,969 Japanese university students, was conducted in April 2023. A Pearson's chi-square test and a binomial logistic regression analysis were used to analyze factors related to the dependent variable, willingness to undergo LCS in the future. Out of the 6779 participants (61.8%) involved in this study, 6504 (95.9%) provided valid responses, and 4609 (70.9%) expressed a willingness to undergo LCS in the future. Analysis revealed current smoking as a barrier to future willingness to undergo LCS. Other barriers included postponing the age of screening, anxiety about the screening content, and concerns about the possibility of having cancer after screening. Addressing barriers, such as current smoking and anxiety about screening, that prevent young people from undergoing LCS in the future is crucial. Therefore, universities should provide opportunities to educate students about LCS and explore various educational methods.
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Affiliation(s)
- Yukihiro Mori
- Department of Nursing, College of Life and Health Science, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan;
| | - Manato Seguchi
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
| | - Yoko Iio
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Lifelong Sports and Health Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
| | - Yuka Aoyama
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Clinical Engineering, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
| | - Mamoru Tanaka
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.T.); (H.K.)
| | - Hana Kozai
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.T.); (H.K.)
| | - Morihiro Ito
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Lifelong Sports and Health Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
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O’Sullivan DE, Boyne DJ, Ford-Sahibzada C, Inskip JA, Smith CJ, Sripada K, Brenner DR, Cheung WY. Real-World Treatment Patterns, Clinical Outcomes, and Healthcare Resource Utilization in Early-Stage Non-Small-Cell Lung Cancer. Curr Oncol 2024; 31:447-461. [PMID: 38248115 PMCID: PMC10814046 DOI: 10.3390/curroncol31010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
The prognosis of early non-small-cell lung cancer (eNSCLC) remains poor. An understanding of current therapies and outcomes can provide insights into how novel therapies can be integrated into clinics. We conducted a large, retrospective, population-based cohort study of patients with de novo eNSCLC (stages IB, IIA, IIB, and IIIA) diagnosed in Alberta, Canada, between 2010 and 2019. The primary objectives were to describe treatment patterns and survival outcomes among patients with eNSCLC. A total of 5126 patients with eNSCLC were included. A total of 45.3% of patients were referred to a medical oncologist, ranging from 23.7% in stage IB to 58.3% in IIIA. A total of 23.6% of patients initiated systemic therapy (ST), ranging from 3.5% in stage IB to 38.5% in IIIA. For stage IIB and IIIA individuals who received surgery, adjuvant ST was associated with a decreased likelihood of death (hazard ratios (HR) of 0.77 (95% CI: 0.56-1.07) and 0.69 (95% CI: 0.54-0.89), respectively). In a Canadian real-world setting, stage IIB and IIIA patients who received adjuvant ST tended to have better survival than patients who did not, but future studies that provide adjustment of additional confounders are warranted. Examining referral pathways that account for disparities based on age, sex, and comorbidities in the real world would also provide further insights.
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Affiliation(s)
- Dylan E. O’Sullivan
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada; (D.E.O.); (D.R.B.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Devon J. Boyne
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada; (D.E.O.); (D.R.B.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Chelsea Ford-Sahibzada
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | | | | | - Darren R. Brenner
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada; (D.E.O.); (D.R.B.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Winson Y. Cheung
- Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada; (D.E.O.); (D.R.B.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
- Oncology Outcomes Initiative, University of Calgary, Calgary, AB T2N 1N4, Canada
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Dingillo G, Bassiri A, Badrinathan A, Alvarado CE, Sinopoli J, Tapias L, Linden P, Towe CW. Lung Cancer in Young Patients is Associated With More Advanced Disease but Better Overall Survival. J Surg Res 2023; 292:307-316. [PMID: 37683455 DOI: 10.1016/j.jss.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/14/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION It is unclear whether nonsmall cell lung cancer (NSCLC) is associated with more aggressive disease and worse overall survival (OS) among younger patients. The aim of this study is to evaluate outcomes in young patients. We hypothesize that young age is associated with more advanced disease upon presentation, but better OS. METHODS We identified patients with NSCLC from 2004 to 2018 in the National Cancer Database. Patients were categorized in 3 groups: age≤50, 51-84, and ≥85 y. The outcomes were OS, stage IV NSCLC and clinical nodal metastasis. OS was analyzed using multivariate cox and Kaplan-Meier analysis accounting for stage, comorbidities, and other factors. The association of age, presentation with stage IV NSCLC and node positivity was analyzed using multivariate logistic regression. RESULTS In total 1,651,744 patients were identified: 92,506 (5.57%) age ≤50, 1,477,723 (88.90%) age 51-84, and 91,964 (5.53%) age ≥85. Multivariate model showed stage IV NSCLC was associated with age ≤50 (OR 1.17 (1.15-1.20) P < 0.001) and ≥85 (odds ratio (OR) 1.03 (1.02-1.04) P < 0.001). Clinical lymph node positivity was associated with age ≤50 (OR 1.27 (1.23-1.30) P < 0.001). Relative to patients 51-84, the ≤50 group was associated with better survival in Stage I (hazard ratio (HR) 0.61 versus 1.00), stage II (HR 1.12 versus 1.50), stage III (HR 2.12 versus 2.53), and stage IV (HR 6.65 versus 7.53). CONCLUSIONS Patients ≤50-y-old present with more advanced NSCLC, but better OS compared to patients 51-84. These findings suggest the need for increased awareness regarding NSCLC among age groups seen as low risk.
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Affiliation(s)
- Gianna Dingillo
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aria Bassiri
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Avanti Badrinathan
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Christine E Alvarado
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jillian Sinopoli
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Leonidas Tapias
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Philip Linden
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Christopher W Towe
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
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Abdennadher M, Dahmane MH, Zair S, Zribi H, Abdelkbir A, Bouassida I, Mlika M, Sahnoun I, Ben Mansour A, Marghli A. Sex-specificity in Surgical Stages of Lung Cancer in Young Adults. Open Respir Med J 2023; 17:e187430642307140. [PMID: 38660429 PMCID: PMC11041390 DOI: 10.2174/18743064-v17-230818-2022-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 04/26/2024] Open
Abstract
Background Young Patients with lung cancer represent a distinct subset of patients with this neoplasm. Young International studies show increased lung cancer rates in females, while the incidence in males continues to decline. There is evidence to suggest that this trend recurs in younger patients. We studied the effects of gender differences on the incidence of surgical stages of lung cancer in young adults and its mortality rate. Methods This study is a retrospective review (2010-2020) of young adults (aged under 45 years) with surgical-stage of lung cancer. We calculated female-to-male differences in incidence rate ratios, tumor characteristics, surgical management, and survival. Cumulative survival curves were generated by the Kaplan-Meier method. Results We examined 46 men and 24 women, under 45 years. Female patients were diagnosed at earlier stages. The proportion of stage IA disease was significantly higher in women than in men (46% versus 13%, respectively) (p=0.03). Women were more likely never smokers (42% versus 83%, p=0.02). A histologic subtype, females were more likely to have typical carcinoid tumors (13.54% versus 10.21% for males) (p>0.05). The largest histological type in men was adenocarcinoma (25.53% versus 4.16%, p>0.05). All the patients were operated. Three men had neoadjuvant chemotherapy and one was operated on for cerebral oligometastatic before his chest surgery. Adjuvant chemotherapy was given to 7 women and 21 men. Despite the small number of postoperative complications in our study (n= 8, 11.2%), the male sex was significant in predicting this complication (p<0.05). The mortality rate was 1.4%. The 5-year overall survival rates were 84% in men and 87% in women. Conclusion Our study identified sex differences in the incidence and mortality rates for surgical lung cancers in young adults, but the biological and endocrine mechanisms implicated in these disparities have not yet been determined.
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Affiliation(s)
- Mahdi Abdennadher
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Mariem Hadj Dahmane
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Sarra Zair
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Hazem Zribi
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Amina Abdelkbir
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Imen Bouassida
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Mouna Mlika
- Department of Pathology, Tunis El Manar University, Abderrahmen Mami Hospital, Tunisia
| | - Imen Sahnoun
- Department of Pneumology Pavillon D, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Amani Ben Mansour
- Department of Pneumology Pavillon C, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
| | - Adel Marghli
- Department of Thoracic Surgery, Tunis El Manar University, Abderrahmen Mami Hospital Ariana, Tunisia
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Dos Santos PAR, Li Y, Ernani V, D'Cunha J, Aubry MC, Yang P. Clinical outcomes of stage-IV non-small-cell lung cancer in young patients and the impact of tumor markers. Cancer Treat Res Commun 2023; 36:100723. [PMID: 37327571 DOI: 10.1016/j.ctarc.2023.100723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Non-Small Cell Lung Cancer (NSCLC) diagnosed at a younger age have patterns of care, responses to treatment, and outcomes not entirely clear. A particular feature includes more advanced stages at diagnosis. Our objective was to characterize these young patients with advanced disease and evaluate the impact of targeted therapies. METHODS Analyzing our cohort of 18,252 newly diagnosed NSCLC patients, we defined Young-age versus Norm-age based on the age distribution at the time of diagnosis. Stage-IV patients were investigated on their clinical information and outcomes; deaths were considered lung cancer-related. Primary outcome was overall survival (OS). Multivariate Cox models were built to evaluate independent prognostic factors in comparative age groups. RESULTS We found 4,267 patients with stage-IV NSCLC (359 Young-age; 3,908 Norm-age). Young patients had predominance of females (52.6% vs. 43.3%, P = 0.001), never-smokers (43.2% vs. 14.8%, P < 0.001), and adenocarcinoma (73.5% vs. 62.5%, P < 0.001). Mean OS was 21.1 months in the Young and 15.1 months in Norm, respectively (P < 0.001). Young patients were more often treated with surgery (6.7% vs. 5.0%), chemotherapy (53.2% vs. 44.1%), and targeted therapy (10.6% vs. 5.7%). Molecular studies were assessed in patients when the mutation tests became clinically available (93 Young, 875 Norm) and revealed a critical role of targeted therapy in the improved survival of both age groups. DISCUSSION Young patients with stage-IV NSCLC have a specific profile and benefit more when treated with surgery and targeted therapy. Molecular testing is critical in this population, where improved survival was identified. A more aggressive approach to this population needs to be considered.
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Affiliation(s)
| | - Yalun Li
- Department of Pulmonology / Oncology, West China Hospital, China
| | - Vinicius Ernani
- Department of Medical Oncology, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Jonathan D'Cunha
- Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, Arizona, United States of America
| | - Marie-Christine Aubry
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ping Yang
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, United States of America.
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Zhang J, Tang K, Liu L, Guo C, Zhao K, Li S. Management of pulmonary nodules in women with pregnant intention: A review with perspective. Ann Thorac Med 2023; 18:61-69. [PMID: 37323371 PMCID: PMC10263075 DOI: 10.4103/atm.atm_270_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 06/17/2023] Open
Abstract
The process for the management of pulmonary nodules in women with pregnant intention remains a challenge. There was a certain proportion of targeted female patients with high-risk lung cancer, and anxiety for suspicious lung cancer in early stage also exists. A comprehensive review of hereditary of lung cancer, effects of sexual hormone on lung cancer, natural history of pulmonary nodules, and computed tomography imaging with radiation exposure based on PubMed search was completed. The heredity of lung cancer and effects of sexual hormone on lung cancer are not the decisive factors, and the natural history of pulmonary nodules and the radiation exposure of imaging should be the main concerns. The management of incidental pulmonary nodules in young women with pregnant intention is an intricate and indecisive problem we have to encounter. The balance between the natural history of pulmonary nodules and the radiation exposure of imaging should be weighed.
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Affiliation(s)
- Jiaqi Zhang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kun Tang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- Institute of Respiratory Disease of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lei Liu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Guo
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Zhao
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Xia J, Li H, Zhang R, Wang J. Clinicopathological characteristics and prognosis of young patients aged ≤45 years old with non-small cell lung cancer. Open Med (Wars) 2023; 18:20230684. [PMID: 37009049 PMCID: PMC10061572 DOI: 10.1515/med-2023-0684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Lung cancer is rare in young people, but the incidence and mortality are on the rise. We retrospectively analyzed the data of young patients aged ≤45 years diagnosed as lung cancer in our hospital from 2014 to 2021. The purpose was to explore the clinicopathological characteristics of young patients, and the risk factors affecting overall survival (OS) time. The results showed that the young patients were mainly female, had no smoking history, asymptomatic at initial diagnosis, with a high proportion of adenocarcinoma and stage I–II. We divided all patients into two groups according to age and found that the proportion of stage I–II in 18–35 years group was significantly higher than that in 36–45 years group (P = 0.021). The main manifestation of tumor was ground glass opacity (GGO) in 18–35 years group, while most showed non-GGO in 36–45 years group (P = 0.003). The proportion of minimally invasive adenocarcinoma was higher in 18–35 years group, while the invasive adenocarcinoma was higher in 36–45 years group (P = 0.004). Univariate analysis showed that asymptomatic, stage I–II, surgery, women, with few or no metastatic organs had longer OS. Multivariate analysis showed that the independent factors affecting the OS of young patients were tumor stage and more metastatic organs.
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Affiliation(s)
- Jingjing Xia
- Department of Medical Examination, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu 223300, P.R. China
| | - Hong Li
- Department of Medical Examination, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu 223300, P.R. China
| | - Ruirui Zhang
- Department of Pathology, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu 223300, P.R. China
| | - Jipeng Wang
- Department of Respiration, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, No. 1, Huanghexi Road, Huaiyin District, Huai’an, Jiangsu 223300, P.R. China
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11
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周 思, 沈 诚, 车 国. [Research Progress of Treatment for NSCLC in Young Patients]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2022; 25:888-894. [PMID: 36617475 PMCID: PMC9845094 DOI: 10.3779/j.issn.1009-3419.2022.102.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/23/2022] [Accepted: 11/26/2022] [Indexed: 01/10/2023]
Abstract
Non-small cell lung cancer (NSCLC) young patients (≤45 years old), despite their low prevalence, have unique clinical and pathological features. Its morbidity has been on the rise in recent years. With the concept of individualized lung cancer treatment, related researches are gradually gaining attention. In addition, the treatment response and prognosis in NSCLC young patients are different from older patients, so the study of NSCLC young patients is of great clinical significance. This article reviews the clinical manifestations, treatment and prognosis of NSCLC young patients.
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Affiliation(s)
- 思成 周
- 610041 成都,四川大学华西医院胸外科Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 诚 沈
- 610041 成都,四川大学华西医院胸外科Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 国卫 车
- 610041 成都,四川大学华西医院胸外科Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
- 610041 成都,四川大学华西医院肺癌中心Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
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12
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Mamudu L, Salmeron B, Odame EA, Atandoh PH, Reyes JL, Whiteside M, Yang J, Mamudu HM, Williams F. Disparities in localized malignant lung cancer surgical treatment: A
population‐based
cancer registry analysis. Cancer Med 2022; 12:7427-7437. [PMID: 36397278 PMCID: PMC10067046 DOI: 10.1002/cam4.5450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Lung cancer (LC) continues to be the leading cause of cancer deaths in the United States. Surgical treatment has proven to offer a favorable prognosis and a better 5-year relative survival for patients with early or localized tumors. This novel study investigates the factors associated with the odds of receiving surgical treatment for localized malignant LC in Tennessee. METHODS Population-based data of 9679 localized malignant LC patients from the Tennessee Cancer Registry (2005-2015) were utilized to examine the factors associated with receiving surgical treatment for localized malignant LC. Bivariate and multivariate logistic regression analyses, cross-tabulation, and Chi-Square ( χ 2 ) tests were conducted to assess these factors. RESULTS Patients with localized malignant LC who initiated treatment after 2.7 weeks were 46% less likely to receive surgery (adjusted odds ratio [AOR] = 0.54; 95% confidence interval [CI] = 0.50-0.59; p < 0.0001). Females had a greater likelihood (AOR = 1.14; CI = 1.03-1.24) of receiving surgical treatment compared to men. Blacks had lower odds (AOR = 0.76; CI = 0.65-0.98) of receiving surgical treatment compared to Whites. All marital groups had higher odds of receiving surgical treatment compared to those who were single/never married. Patients living in Appalachian county had lower odds of receiving surgical treatment (AOR = 0.65; CI = 0.59-0.71) compared with those in the non-Appalachian county. Patients with private (AOR = 2.09; CI = 1.55-2.820) or public (AOR = 1.42; CI = 1.06-1.91) insurance coverage were more likely to receive surgical treatment compared to self-pay/uninsured patients. Overall, the likelihood of patients receiving surgical treatment for localized malignant LC decreases with age. CONCLUSION Disparities exist in the receipt of surgical treatment among patients with localized malignant LC in Tennessee. Health policies should target reducing these disparities to improve the survival of these patients.
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Affiliation(s)
- Lohuwa Mamudu
- Department of Public Health California State University, Fullerton Fullerton California USA
| | - Bonita Salmeron
- Division of Intramural Research National Institute on Minority Health and Health Disparities, National Institutes of Health Rockville Maryland USA
- Department of Epidemiology Mailman School of Public Health, Columbia University New York New York USA
| | - Emmanuel A. Odame
- Department of Environmental Health Sciences School of Public Health, University of Alabama at Birmingham Birmingham Alabama USA
| | - Paul H. Atandoh
- Department of Statistics Western Michigan University Kalamazoo Michigan USA
| | - Joanne L. Reyes
- Department of Public Health California State University, Fullerton Fullerton California USA
| | | | - Joshua Yang
- Department of Public Health California State University, Fullerton Fullerton California USA
| | - Hadii M. Mamudu
- Department of Health Services Management and Policy College of Public Health, East Tennessee State University Johnson City Tennessee USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University Johnson City Tennessee USA
| | - Faustine Williams
- Division of Intramural Research National Institute on Minority Health and Health Disparities, National Institutes of Health Rockville Maryland USA
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Cai JS, Qiu MT, Yang F, Wang X. Stage IV non-small cell lung cancer among young individuals: Incidence, presentations, and survival outcomes of conventional therapies. Front Oncol 2022; 12:894780. [PMID: 36439488 PMCID: PMC9691661 DOI: 10.3389/fonc.2022.894780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022] Open
Abstract
Background There is a paucity of data published on the clinicopathological features and prognosis of stage IV non-small cell lung cancer (NSCLC) patients aged ≤45 years. Herein, we evaluated a large clinical series in an effort to provide a clearer picture of this population. Methods The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression model was performed to identify prognostic factors for NSCLC among individuals aged ≤45 years. The Kaplan–Meier method with log-rank test was used to compare overall survival (OS) differences between groups. Competing risk analysis with the Fine–Gray test was used to analyze cancer-specific survival (CSS) differences. Propensity score matching (PSM) was used to minimize selection bias. Results Incidence-rate analyses, including 588,680 NSCLC cases (stage IV, 233,881; age ≤ 45 years stage IV, 5,483; and age > 45 years stage IV, 228,398) from 2004 to 2015, showed that the incidence of stage IV NSCLC among young individuals decreased over the years. In comparative analyses of clinical features and survival outcomes, a total of 48,607 eligible stage IV cases (age ≤ 45 years stage IV, 1,390; age > 45 years stage IV, 47,217) were included. The results showed that although patients in the young cohort were more likely to be diagnosed at advanced stages, they were also more likely to receive aggressive treatments. In addition, the survival rates of the young patients were superior to those of the older patients both before and after PSM. Conclusions Stage IV NSCLC patients aged ≤45 years comprise a relatively small but special NSCLC subgroup. Although this population had better survival outcomes than older patients, these patients deserve more attention due to their young age and the significant socioeconomic implications.
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Affiliation(s)
| | | | - Fan Yang
- *Correspondence: Xun Wang, ; Fan Yang,
| | - Xun Wang
- *Correspondence: Xun Wang, ; Fan Yang,
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14
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Treatment patterns for advanced non-small cell lung cancer in the US: A systematic review of observational studies. Cancer Treat Res Commun 2022; 33:100648. [PMID: 36270164 DOI: 10.1016/j.ctarc.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The advent of immunotherapies (I-O) and targeted therapies has transformed the treatment landscape in advanced non-small cell lung cancer (NSCLC). However, adoption of new treatment guidelines and evolving treatment patterns in clinical practice are largely unknown. The aim of this systematic literature review (SLR) was to capture real-world first-line treatment patterns in advanced (staged IIIB-IV) or recurrent NSCLC patients in the US. METHODS Electronic databases were systematically searched for observational studies published 2012-2020 that reported on adult patients receiving first-line therapy for advanced NSCLC. Included studies were reviewed and treatment patterns were summarized descriptively. RESULTS Eighteen studies were included. Platinum-doublet (PD) chemotherapy and unspecified chemotherapy regimens were the most commonly used first-line treatments (up to 71% and 96%, respectively). Chemotherapy as monotherapy was mainly utilized in patients ≥65 years. While chemotherapy use was continuously high, I-O became the preferred front-line treatment in 2018 (32.9%). I-O monotherapy was more prevalent among patients with PD-L1 ≥50%, compared to patients with lower levels. First-line use of tyrosine kinase inhibitors and bevacizumab-based therapies was common in 2010 (33.4% and 21.7%, respectively), but gradually declined to <1% in 2018. CONCLUSION Consistent with the evolving first-line NSCLC treatment landscape in the US, this SLR captures the increasing use of I-O in recent years. While the brief lag in I-O use from the time of authorization may be attributable to an initial resistance to treatment adoption or publication delays, continued use of chemotherapy regimens may reflect an unmet treatment need, which warrants further research.
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15
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Zhou L, Li H, Yang S. Age does matter in adolescents and young adults vs. older adults with lung adenocarcinoma: A retrospective analysis comparing clinical characteristics and outcomes in response to systematic treatments. Oncol Lett 2022; 24:362. [PMID: 36238846 PMCID: PMC9494353 DOI: 10.3892/ol.2022.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Lin Zhou
- Department of Thoracic Surgery, YueBei People's Hospital, Shaoguan, Guangdong 512025, P.R. China
| | - Huiwu Li
- Medical Research Center, YueBei People's Hospital, Shaoguan, Guangdong 512025, P.R. China
| | - Shuhui Yang
- Department of Pathology, YueBei People's Hospital, Shaoguan, Guangdong 512025, P.R. China
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16
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Age-dependent genomic characteristics and their impact on immunotherapy in lung adenocarcinoma. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04195-8. [PMID: 35838838 DOI: 10.1007/s00432-022-04195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence of lung cancer tends to be younger, and adenocarcinoma is the main histological type. Even patients with the same tumor type may have significant differences in clinical features, tumor microenvironment and genomic background at different ages. Immune checkpoint inhibitors (ICIs) have been shown to improve clinical outcomes in patients with lung adenocarcinoma (LUAD). However, differences in ICI efficacy between older and younger patients are unknown. Our study aimed to explore the relationship between age and immunotherapy in LUAD. METHODS In our study, 1313 resected LUAD patients in our hospital were divided into young (age ≤ 50) and old groups (age > 50), and the clinical characteristic differences between them were analyzed. Of these, next-generation sequencing (NGS) was performed on the 311 cases. In addition, immune-related signatures of 508 LUAD patients were analyzed by TCGA RNA expression data. Then, we validated genomic and clinical information of 270 LUAD samples in the MSKCC cohort. RESULTS ERBB2 and EGFR gene mutations were significantly different between the two groups, and the gene mutation number in the old group was significantly higher than that in the young group. In addition, immune-related signatures of LUAD patients were analyzed by TCGA RNA expression data, which indicated that the patients in the old group might have a better immune microenvironment. Then, we validated the MSKCC cohort and found that the TMB of the old group was significantly higher than that of the young group, and the OS of immunotherapy was longer in the old group. CONCLUSION Our study was the first to analyze the differences in the genomic landscape and immune-related biomarkers between the young and old groups of LUAD patients and found that the old group had a better efficacy of immunotherapy, providing a reference for the study design and treatment of patients with LUAD.
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17
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Yang Y, Shen C, Shao J, Wang Y, Wang G, Shen A. Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung Adenocarcinoma. Front Oncol 2022; 12:825598. [PMID: 35847910 PMCID: PMC9282874 DOI: 10.3389/fonc.2022.825598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this study is to predict overall survival (OS) and lung cancer-specific survival (LCSS) in patients with stage IIIA-N2 unresectable lung squamous cell cancer (LUSC), lung adenocarcinoma (LUAD), and large cell neuroendocrine cancer (LCNEC) by constructing nomograms and to compare risk and prognostic factors affecting survival outcomes in different histological subtypes. Methods We included 11,505 unresectable NSCLC patients at stage IIIA-N2 between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Moreover, competition models and nomograms were developed to predict prognostic factors for OS and LCSS. Results Analysis of the SEER database identified 11,505 NSCLC patients, of whom 5,559 (48.3%) have LUAD, 5,842 (50.8%) have LUSC, and 104 (0.9%) have LCNEC. Overall, both OS and LCSS were significantly better in stage IIIA-N2 unresectable LUAD than in LCNEC, while there was no statistically significant difference between LUSC and LCNEC. Age, gender, T stage, chemotherapy, and radiotherapy were significantly associated with OS rates in LUAD and LUSC. However, chemotherapy was the only independent factor for LCNEC (p < 0.01).From competitive risk models, we found that older age, larger tumors, non-chemotherapy and non-radiotherapy were associated with a increased risk of death from LUAD and LUSC. Unlike prognostic factors for OS, our study showed that both chemotherapy and radiotherapy were all LCNEC-specific survival factors for both LCSS and non-LCSS LCNEC. Conclusion Our study reports that unresectable patients with stage IIIA-N2 LCNEC and LUSC have worse LCSS than LUAD. The study’s first prognostic nomogram constructed for patients with unresectable stage IIIA-N2 NSCLC can accurately predict the survival of different histological types, which may provide a practical tool to help clinicians assess prognosis and stratify these prognostic risks to determine which patients should be given an optimized individual treatment strategy based on histology.
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Affiliation(s)
- Ying Yang
- Cancer Research Center Nantong, The Affiliated Tumor Hospital of Nantong University, Nantong University, Nantong, China
| | - Cheng Shen
- Department of Computer Science and Engineering, Tandon School of Engineering, New York University, Brooklyn, NY, United States
| | - Jingjing Shao
- Cancer Research Center Nantong, The Affiliated Tumor Hospital of Nantong University, Nantong University, Nantong, China
| | - Yilang Wang
- Department of Oncology, Nantong Tumor Hospital, Nantong University, Nantong, China
| | - Gaoren Wang
- Department of Radiology, Nantong Tumor Hospital, Nantong University, Nantong, China
| | - Aiguo Shen
- Cancer Research Center Nantong, The Affiliated Tumor Hospital of Nantong University, Nantong University, Nantong, China
- *Correspondence: Aiguo Shen,
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18
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Jones S, Mullett T, Davenport D, Saha S. Lung Cancer in Young Adults: A Single-Center Experience. South Med J 2022; 115:366-370. [PMID: 35649521 DOI: 10.14423/smj.0000000000001404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This single-center retrospective review examines the unique characteristics of young patients (ages 18 to 40 years) who were diagnosed as having non-small-cell lung cancer (NSCLC) at Markey Cancer Center, the only National Cancer Institute-designated cancer center in the state of Kentucky. METHODS This retrospective study examines adult patients with NSCLC who were between ages 18 and 40 at diagnosis. Patients diagnosed between 2012 and 2018 were included. The final cohort consisted of 35 patients. The data collected included patient demographic information, tumor topography, clinical stage, cell type, treatment information/dates, metastasis, and survival data. RESULTS In total, 36 of 3246 total NSCLC cases treated at Markey Cancer Center from 2012 to 2018 were diagnosed in adults aged 18 to 40 (1.11%); 35 of these 36 patients were included in our cohort. The majority (22; 62.86%) presented at an advanced stage of disease (stage III or IV). Furthermore, our cohort consisted of a strong majority of female patients (24; 68.57%). The most common histological type was adenocarcinoma (14; 40.00%). The 5-year survival rate was 47% (standard error 9%). CONCLUSIONS Lung cancer is rare in young patients; when present, often it presents at the advanced stage. Despite many diagnostic tools and treatment modalities available, long-term survival remains poor. Our experience showed a small proportion of patients with NSCLC aged 18 to 40 at diagnosis; among this unique patient population, there is a predominance of smokers, women, adenocarcinoma, and advanced disease.
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Affiliation(s)
| | | | | | - Sibu Saha
- From the University of Kentucky, Lexington
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19
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Hu M, Tan J, Liu Z, Li L, Zhang H, Zhao D, Li B, Gao X, Che N, Zhang T. Comprehensive Comparative Molecular Characterization of Young and Old Lung Cancer Patients. Front Oncol 2022; 11:806845. [PMID: 35096611 PMCID: PMC8789686 DOI: 10.3389/fonc.2021.806845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/13/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Young lung cancer as a small subgroup of lung cancer has not been fully studied. Most of the previous studies focused on the clinicopathological features, but studies of molecular characteristics are still few and limited. Here, we explore the characteristics of prognosis and variation in young lung cancer patients with NSCLC. METHODS A total of 5639 young lung cancer samples (NSCLC, age ≤40) were screened from the SEER and the same number of the old (NSCLC, age ≥60) were screened by propensity score matching to evaluate the prognosis of two groups. 165 treatment-naïve patients diagnosed with NSCLC were enrolled to explore the molecular feature difference between two age-varying groups. CCLE cell line expression data was used to verify the finding from the cohort of 165 patients. RESULTS The overall survival of the young lung cancer group was significantly better than the old. Germline analysis showed a trend that the young group contained a higher incidence of germline alterations. The TMB of the young group was lower. Meanwhile, the heterogeneity and evolutionary degrees of the young lung cancer group were also lower than the old. The mutation spectrums of two groups exhibited variance with LRP1B, SMARCA4, STK11, FAT2, RBM10, FANCM mutations, EGFR L858R more recurrent in the old group and EML4-ALK fusions, BCL2L11 deletion polymorphism, EGFR 19DEL, 20IN more recurrent in the young group. For the base substitution, the young showed a lower fraction of transversion. Further, we performed a pathway analysis and found the EGFR tyrosine kinase inhibitor resistance pathway enriched in the young lung cancer group, which was validated in gene expression data later. CONCLUSIONS There were significantly different molecular features of the young lung cancer group. The young lung cancer group had a more simple alteration structure. Alteration spectrums and base substitution types varied between two groups, implying the different pathogenesis. The young lung cancer group had more potential treatment choices. Although young lung patients had better outcomes, there were still adverse factors of them, suggesting that the young group still needs more caution for treatment choice and monitoring after the treatment to further improve the prognosis.
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Affiliation(s)
- Mingming Hu
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Jinjing Tan
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Zhentian Liu
- Department of Tranlational Medicine, Geneplus-Beijing, Beijing, China
| | - Lifeng Li
- Department of Tranlational Medicine, Geneplus-Beijing, Beijing, China
| | - Hongmei Zhang
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Dan Zhao
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Baolan Li
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Xuan Gao
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,Department of Tranlational Medicine, Geneplus-Shenzhen Clinical Laboratory, Shenzhen, China
| | - Nanying Che
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
| | - Tongmei Zhang
- Beijing Chest Hospital, Capital Medical University & Beijing Tuberculosis and Tumor Research Institute, Beijing, China
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20
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Li P, Yang R, Wang D, Wang L, Wang S, Liu C, Li J, Li L, Liu C, Tong Y, Wang Y. Clinical and genetic characteristics of early-stage multiple primary and independent primary lung adenocarcinoma patients. Asia Pac J Clin Oncol 2022; 18:e420-e426. [PMID: 35098658 DOI: 10.1111/ajco.13743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
AIMS The difference between multiple primary lung cancers (MPLC) and intrapulmonary metastasis (IM) in patients with lung cancer is vital but controversial. Moreover, the genetic and clinical significance difference between MPLC and independent primary lung cancers (IPLC) patients is unknown. METHODS This study retrospectively researched clinical and genetic data of MPLC and IPLC patients from January 2019 to May 2021 at the affiliated hospital of Qingdao University, China. Ninety-four tissue samples from 41 early-stage patients with MPLC, and 94 tissue samples from 94 early-stage patients with IPLC were performed to targeted sequencing. RESULTS A total of 36 patients (88%) showed inconsistent driver mutations, and five MPLC patients (12%) shared single identical EGFR/BRAF/TP53 hotspot mutations in the early stage. In MPLC patients, high-frequency mutations included EGFR (63%), TP53 (12%), BRAF (12%), KRAS (10%), ERBB2 (4%), PIK3CA (3%), and MET (3%). In IPLC patients, high-frequency mutations included EGFR (55%), TP53(26%), KRAS (13%), MAP2K1 (5%), PIK3CA (4%), ERBB2 (4%), NF1 (4%), RET (3%), and BRAF (2%). The higher BRAF and fewer TP53 mutations may be related to the lower malignancy in MPLC patients. CONCLUSIONS The accuracy of pathological diagnosis in patients with early-stage MPLC does not need comprehensive molecular evaluation to supplement histology for differentiating early-stage MPLC and IM. Meanwhile, the molecular difference between MPLC and IPLC may be helpful to study the mechanism of MPLC pathogenesis.
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Affiliation(s)
- Peng Li
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ronghua Yang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dong Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingjie Wang
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Sai Wang
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Chuan Liu
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Jinlong Li
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Ling Li
- Yinfeng Gene Technology Co., Ltd., Jinan, China
| | - Chuang Liu
- Yinfeng Gene Technology Co., Ltd., Jinan, China
| | - Yan Tong
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Yongjie Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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21
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Waser N, Vo L, McKenna M, Penrod JR, Goring S. Real-world treatment patterns in resectable (stages I-III) non-small-cell lung cancer: a systematic literature review. Future Oncol 2022; 18:1519-1530. [PMID: 35073732 DOI: 10.2217/fon-2021-1417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim of this systematic literature review was to describe treatment patterns in non-metastatic non-small-cell lung cancer. Methods: A search was conducted in MEDLINE and EMBASE. Eligible studies were multicentered (>50 patients) and conducted after 2000 in North America, Europe and Asia. Results: Twenty studies met the eligibility criteria. Based on US and Canadian studies in the resectable population, the proportion of patients who received neoadjuvant chemotherapy/chemoradiotherapy and adjuvant chemotherapy/chemoradiotherapy increased with increasing stage (i.e., from <3% in stage I to about 40% in stage III and from 15% in stage I to 30% in stage III, respectively). Within the resectable population, the breakdown between bimodal and trimodal therapy was variable, suggesting that clinical practice is not uniform. Conclusion: Overall, studies were heterogeneous, precluding data extrapolation across regions. Despite heterogeneity and limited evidence, this review suggested an increase in neoadjuvant and adjuvant chemotherapy with increasing stage, generally in line with treatment guidelines.
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Affiliation(s)
| | - Lien Vo
- Bristol Myers Squibb, Lawrenceville, NJ, USA
| | | | - J R Penrod
- Bristol Myers Squibb, Lawrenceville, NJ, USA
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22
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Wan X, Jin X, Wu X, Yang X, Lin D, Li C, Fu Y, Liu Y, Liu X, Lv J, Gontcharov AA, Yang H, Wang Q, Li Y. Structural characterisation and antitumor activity against non-small cell lung cancer of polysaccharides from Sanghuangporus vaninii. Carbohydr Polym 2022; 276:118798. [PMID: 34823804 DOI: 10.1016/j.carbpol.2021.118798] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/03/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022]
Abstract
The medicinal fungus Sanghuangporus vaninii can be cultivated in large scale and has outstanding antitumour activity. In this study, water-soluble S. vaninii polysaccharides (SVPs) were extracted from fruiting bodies. Four polysaccharide sub-fractions (SVP-W, SVP-1, SVP-2 and SVP-3) were isolated, with molecular weights from 90.50 kDa to 261.70 kDa, and all inhibited the proliferation of non-small cell lung cancer cell lines A549, 95-D and NCI-H460, especially the acidic SVP-1. SVP-1 affected cell morphology and colony formation in NCI-H460 cells. It also promoted cell apoptosis following nuclear fluorescence staining and flow cytometry. Methylation and nuclear magnetic resonance analyses revealed that SVP-1 is a heteroglycan with the main chain →4)-β-D-Glcp-(1 → 6)-β-D-Glcp-(1 → 6)-α-D-Galp-(1 → 6)-β-D-Glcp-(1→, and the branched chain α-D-Manp-(1 → 2)-α-D-Manp-(1 → 3)-β-D-Glcp-(1 → 3,6)-β-D-Glcp-(1→. The findings indicate that this natural acidic polysaccharide has potential for non-small cell lung cancer therapy.
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Affiliation(s)
- Xilin Wan
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China; Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Xin Jin
- Key Laboratory of Molecular Epigenetics of the Ministry of Education (MOE), Northeast Normal University, Changchun 130024, China
| | - Xinmin Wu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun 130021, China
| | - Xue Yang
- Cardiovascular Medicine and Cardiac Rehabilitation Center, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun 130021, China
| | - Dongmei Lin
- Electric Diagnosis Department, Jilin Municipal Hospital of Traditional Chinese Medicine, Jilin 132000, China
| | - Changtian Li
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China
| | - Yongping Fu
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China
| | - Yang Liu
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China
| | - Xinze Liu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Jianhua Lv
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China
| | - Andrey A Gontcharov
- Institute of Biology and Soil Science, FEB RAS, 100-letia Vladivostoka Prospect, 159, Vladivostok 690022, Russia
| | - Hongmei Yang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Qi Wang
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China.
| | - Yu Li
- International Cooperation Research Center of China for New Germplasm and Breeding of Edible Mushrooms, Jilin Agricultural University, Changchun 130118, China.
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Cimen F, Düzgün S, Aloglu M, Senturk A, Atikcan S. Molecular properties and survival of lung adenocarcinoma in young patients. Int J Clin Pract 2021; 75:e14646. [PMID: 34310815 DOI: 10.1111/ijcp.14646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/06/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aims to investigate the molecular properties and factors of lung cancer in young patients aged 18-45 years, affecting survival in patients with pulmonary adenocarcinoma. METHODS Patients aged between 18 and 45 years who were diagnosed with lung adenocarcinoma in our hospital between January 2015 and December 2019 and their tumoural mutations were studied and included in this study and then reviewed retrospectively from the hospital records. RESULTS At the time of diagnosis, 71 (3.57%) of 1985 primary lung cancer patients were 45 years old, and 42 (59.2%) male and 29 (40.8%) female patients with a mean age of 39.9 were evaluated. Most of the patients were diagnosed with advanced-stage lung cancer, 55 (77.5%) of them were in stage IV. PET CT showed that the standard intake value (SUV) of 11.1 tended to be high. Multiple organ metastases were detected in 57 patients (80.3%). EGFR (epidermal growth factor receptor) mutation was positive in 13 patients (18.3%), ALK (anaplastic lymphoma kinase) mutation was positive in 13 patients (18.3%) and ROS (c-ros) mutation oncogene was positive in 2 (2.8%) patients. Surgical operation was performed in 21 (29.6%), radiotherapy was given to 29 (40.8%), chemotherapy to 48 (67.6%) and targeted therapy to 22 (31.0%) patients. The mean overall survival of the patients was 16 months. Within 1 year, 41 (57.7%) patients died. CONCLUSION In our study, significant efficacy of age, gender distribution, smoking, metastasis, ALK positivity, presence of chemotherapy, targeted therapy and surgical treatment was observed in young adenocarcinoma patients. The molecular properties of lung adenocarcinoma in young patients differ from those in the general population, and major driver genes are major factors influencing tumour differentiation and prognosis. In our study, we aimed to explain the molecular properties and results of pulmonary adenocarcinoma. In the future, we will provide constructive recommendations for the prevention and treatment of young patients.
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Affiliation(s)
- Filiz Cimen
- Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Sevim Düzgün
- Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Melike Aloglu
- Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Aysegül Senturk
- Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Sükran Atikcan
- Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
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Lung cancer in young patients: natural history, biology and prognosis. Pulmonology 2021; 28:80-81. [PMID: 34625388 DOI: 10.1016/j.pulmoe.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
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25
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Nicolau JS, Lopez RVM, de Moraes Luizaga CT, Ribeiro KB, Roela RA, Maistro S, Katayama MLH, Natalino RJM, de Castro G, Neto JE, Folgueira MAAK. Survival analysis of young adults from a Brazilian cohort of non-small cell lung cancer patients. Ecancermedicalscience 2021; 15:1279. [PMID: 34567264 PMCID: PMC8426012 DOI: 10.3332/ecancer.2021.1279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background The influence of age at diagnosis in non-small cell lung cancer (NSCLC) prognosis is unclear. Objectives To compare in a Brazilian cohort of NSCLC patients of different age groups: 1) The overall survival; 2) Clinical features and treatment options. Methods This is a retrospective cohort study using a hospital-based registry, for NSCLC patients registered in years 2000–2009. Patients were grouped into three age groups: Young adults (YA: < 40 years), middle-aged (MA: 40–64 years) and elderly (E: ≥ 65 years). Kaplan–Meier was used to estimate overall survival and Cox regression for hazard ratios (HRs) and 95% confidence intervals. Results 17,422 NSCLC patients were included: 370 YA (2.1%), 8,697 MA (49.9%) and 8,355 E (48.0%). Compared with older age groups, the YA group had a higher proportion of females, patients diagnosed with adenocarcinoma and metastatic disease (63.2%). Overall survival was longer in YA in the entire cohort and in all clinical stages (CSs) (p < 0.001). For YA, higher education level was a good prognosis factor (compared with illiterate and incomplete elementary); advanced or metastatic disease (compared with early-stage disease) and treatment based in radiotherapy or chemotherapy (CT) (without surgery), compared with treatment combinations with surgery, were poor prognostic factors. Young men (but not women) had lower HR of death compared with older groups; YA had lower HR of death in all CSs compared with patients from older groups. A higher percentage of YA were treated with surgery or CT in early-stage disease compared with older groups. Besides that, YA and MA patients treated with surgery or CT had a better prognosis than elderlies. Conclusions: In this Brazilian cohort of NSCLC patients, most young individuals were diagnosed with metastatic disease. YA presented longer survival than older age groups in all CSs, but mainly in CS I/II and III, where some patients may achieve long remissions or cure.
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Affiliation(s)
- Jéssica Silva Nicolau
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil.,JSN and RVML contributed equally to this work
| | - Rossana Veronica Mendoza Lopez
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil.,JSN and RVML contributed equally to this work
| | | | - Karina Braga Ribeiro
- Faculdade de Ciências Médicas da Santa Casa de Sao Paulo, Sao Paulo, SP, 01238-010, Brazil
| | - Rosimeire Aparecida Roela
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
| | - Simone Maistro
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
| | - Maria Lucia Hirata Katayama
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
| | - Renato José Mendonça Natalino
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
| | - Gilberto de Castro
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
| | - Jose Eluf Neto
- Fundação Oncocentro de Sao Paulo (FOSP), Sao Paulo, SP, 05409-012, Brazil.,Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246 903, Brazil
| | - Maria Aparecida Azevedo Koike Folgueira
- Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 01246-000, Brazil
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Xu L, Su Z, Xie B. Diagnostic value of conventional tumor markers in young patients with pulmonary nodules. J Clin Lab Anal 2021; 35:e23912. [PMID: 34296781 PMCID: PMC8418517 DOI: 10.1002/jcla.23912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 01/25/2023] Open
Abstract
Background Lung cancer is one of the most common malignancies, and there is a trend of increasing incidence in young patients. The preoperative diagnosis of pulmonary nodules is mainly based on the combination of imaging and tumor markers. There is no relevant report on the diagnostic value of tumor markers in young pulmonary nodules. Our study was designed to explore the value of five tumor markers in young patients with pulmonary nodules. Methods We reviewed the medical records of 390 young patients (age ≤45 years) with pulmonary nodules treated at two separate centers from January 1, 2015, to January 1, 2021. Malignant pulmonary nodules were confirmed in 318 patients, and the other 72 patients were diagnosed with benign pulmonary nodules. The gold standard for diagnosis of pulmonary nodules was surgical biopsy. The conventional serum biomarkers included cytokeratin 19 (CYFRA21‐1), pro‐gastrin‐releasing‐peptide (ProGRP), carcinoembryonic antigen (CEA), neuron‐specific enolase (NSE), and squamous cell carcinoma‐associated antigen (SCCA). The diagnostic values of five tumor markers were analyzed by receiver operating characteristic (ROC) curves. Results There were no significant differences in the expression of five tumor markers between the groups (p > 0.05). Single tumor marker (CYFRA21‐1, ProGRP, CEA, NSE, and SCCA) showed a limited value in the diagnosis of malignant pulmonary nodules, with the AUC of 0.506, 0.503 0.532, 0.548, and 0.562, respectively. The AUC of the combined examination was only 0.502~0.596, which did not improve the diagnostic value. Conclusions Five conventional tumor markers had a limited diagnostic value in young patients with pulmonary nodules.
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Affiliation(s)
- Lihuan Xu
- Department of Pulmonary and Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Zhiming Su
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Baosong Xie
- Department of Pulmonary and Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
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Sachs E, Sartipy U, Jackson V. Sex and Survival After Surgery for Lung Cancer: A Swedish Nationwide Cohort. Chest 2021; 159:2029-2039. [PMID: 33217414 PMCID: PMC8129733 DOI: 10.1016/j.chest.2020.11.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/06/2020] [Accepted: 11/07/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Prior reports on a possible female survival advantage in both surgical and nonsurgical cohorts of patients with lung cancer are conflicting. Previously reported differences in survival after lung cancer surgery could be the result of insufficient control for disparities in risk factor profiles in men and women. RESEARCH QUESTION Do women who undergo pulmonary resections for lung cancer have a better prognosis than men when taking a wide range of prognostic factors into account? STUDY DESIGN AND METHODS We performed a nationwide population-based observational cohort study analyzing sex-specific survival after pulmonary resections for lung cancer. We identified 6356 patients from the Swedish National Quality Register for General Thoracic Surgery and performed individual-level record linkage to other national health-data registers to acquire detailed information regarding comorbidity, socioeconomic status, and vital status. Inverse probability of treatment weighting was used to account for differences in baseline characteristics. The association between female sex and all-cause mortality was assessed with Cox regression models, and flexible parametric survival models were used to estimate the absolute survival differences with 95% CIs. We also estimated the difference in restricted mean survival time. RESULTS We observed a lower risk of death in women compared with men (hazard ratio, 0.73; 95% CI, 0.67-0.79). The absolute survival difference at 1, 5, and 10 years was 3.0% (95% CI, 2.2%-3.8%), 10% (95% CI, 7.0%-12%), and 12% (95% CI, 8.5%-15%), respectively. The restricted mean survival time difference at 10 years was 0.84 year (95% CI, 0.61-1.07 years). The findings were consistent across several subgroups. INTERPRETATION Women who underwent pulmonary resections for lung cancer had a significantly better prognosis than men. The survival advantage was evident regardless of age, common comorbidities, socioeconomic status, lifestyle factors, physical performance, type and extent of surgery, tumor characteristics, and stage of disease. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT03567538; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Erik Sachs
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ulrik Sartipy
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Jackson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Vashistha V, Garg A, Iyer H, Jain D, Madan K, Hadda V, Guleria R, Mohan A. A comprehensive comparison between young and older-age non-small cell lung cancer patients at a public referral centre in Delhi, India. Ecancermedicalscience 2021; 15:1223. [PMID: 34158827 PMCID: PMC8183650 DOI: 10.3332/ecancer.2021.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose Given the increasing number of non-small cell lung cancer (NSCLC) patients in India, a comparative analysis between patients under 40 years and those of older age at a major public referral centre would provide insight into the phenotypic patterns of this group. Methods NSCLC patients who were accessioned within the lung cancer clinic database of the Pulmonary Medicine Department at the all India institute of medical sciences – Delhi between 2008 and 2019 were reviewed. Patients 40 years or younger and 60 years or older were selected and categorised as young and older patients, respectively. Baseline clinical characteristics, histologic profiles, treatments administered and survival outcomes were compared between both groups. Results Following the database review, 154 young and 1,058 older patients were selected for inclusion. Clinically, young patients were more often female (26.0% versus 14.5%, p < 0.001), retained a more independent performance status (64.1% versus 45.5%; p < 0.001) and never smoked (63.7 % versus 18.8%, p < 0.001). Regarding disease profiles, young patients were more frequently diagnosed with adenocarcinoma (p < 0.001) and 12 young patients had adenoid cystic carcinoma. Rates of stage IV disease at presentation were higher among young patients (78.0% versus 63.0%, p < 0.001). Regarding treatment, no differences in systemic therapies administered or survival were identified. Conclusion In India, young NSCLC patients are frequently non-smokers and diagnosed with advanced disease. Despite better performance status, young patients do not share better outcomes. Efforts should be directed towards optimising intensive treatment for young patients.
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Affiliation(s)
- Vishal Vashistha
- Raymond G. Murphy New Mexico Veterans Affairs Healthcare System, Section of Haematology and Oncology, 1501 San Pedro Dr SE, Albuquerque, NM 87108, USA.,Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India.,Fulbright-Nehru Fellowship Programme, United States-India Educational Foundation, Fulbright House, 12 Hailey Rd, New Delhi 110002, India
| | - Avneet Garg
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India.,Adesh Institute of Medical Sciences and Research, Department of Pulmonary Medicine, Barnala Bypass, Bathinda 151109, India
| | - Hariharan Iyer
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, Ansari Nagar East, New Delhi 110029, India
| | - Karan Madan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India
| | - Vijay Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India
| | - Randeep Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India
| | - Anant Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi 110608, India
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Cai L, Chen Y, Tong X, Wu X, Bao H, Shao Y, Luo Z, Wang X, Cao Y. The genomic landscape of young and old lung cancer patients highlights age-dependent mutation frequencies and clinical actionability in young patients. Int J Cancer 2021; 149:883-892. [PMID: 33811322 DOI: 10.1002/ijc.33583] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 11/09/2022]
Abstract
The aim of the study was to investigate age-dependent tendency of genomic alterations in lung cancer, and also to examine mutational profiles and its association with clinical treatment outcomes in young adenocarcinoma patients. By studying 7858 lung cancer samples using targeted-gene sequencing, we investigated genomic differences and clinical on-treatment time (OTT) to different therapies between young (≤ 45 years) and old (> 45 years) patients. The age-dependent trend test for genomic alterations in all patients revealed steady increases in tumor mutation burden and alterations in a number of genes with age, including KRAS, MET, CDKN2A, PIK3CA and MDM2, while the frequencies of ALK, ROS1 and RET fusions and ERBB2 mutations were decreasing. The highest rate of EGFR alterations was observed in the 45 ~ 50 years age group. Comparisons of young and old adenocarcinoma patients found that young patients were characterized by a higher prevalence of ALK, ROS1 and RET fusions, and ERBB2 exon-20 insertions and EGFR exon-19 deletions. Actionable mutations were highly prevalent in young adenocarcinoma patients, with 88% of patients harboring at least one actionable genetic alteration. First-line therapies in EGFR-positive patients (n = 979) by EGFR tyrosine kinase inhibitors or chemotherapy resulted in similar OTT between young and old patients. Somatic interaction analyses implied that young EGFR-positive patients were more likely to also have PIK3CA, MET, TP53 and RB1 mutations than old patients. Lung cancer in young patients, and especially those with adenocarcinoma, exhibited different clinical features and genomic attributes compared to old patients, which should be considered for therapeutic decision-making purposes.
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Affiliation(s)
- Lei Cai
- Department of Thoracic Surgery, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Zhejiang, Hangzhou, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Zhejiang, Hangzhou, China
| | - Yong Chen
- Department of Hepatobiliary Surgery, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaoling Tong
- Translational Medicine Research Institute, Geneseeq Technology Inc., Toronto, Ontario, Canada
| | - Xue Wu
- Translational Medicine Research Institute, Geneseeq Technology Inc., Toronto, Ontario, Canada
| | - Hua Bao
- Translational Medicine Research Institute, Geneseeq Technology Inc., Toronto, Ontario, Canada
| | - Yang Shao
- Medical Department, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, China
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhuang Luo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunan, China
| | - Xuming Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunan, China
| | - Yang Cao
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Determining Risk Factors Associated with Depression and Anxiety in Young Lung Cancer Patients: A Novel Optimization Algorithm. ACTA ACUST UNITED AC 2021; 57:medicina57040340. [PMID: 33916080 PMCID: PMC8065798 DOI: 10.3390/medicina57040340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Identifying risk factors associated with psychiatrist-confirmed anxiety and depression among young lung cancer patients is very difficult because the incidence and prevalence rates are obviously lower than in middle-aged or elderly patients. Due to the nature of these rare events, logistic regression may not successfully identify risk factors. Therefore, this study aimed to propose a novel algorithm for solving this problem. Materials and Methods: A total of 1022 young lung cancer patients (aged 20-39 years) were selected from the National Health Insurance Research Database in Taiwan. A novel algorithm that incorporated a k-means clustering method with v-fold cross-validation into multiple correspondence analyses was proposed to optimally determine the risk factors associated with the depression and anxiety of young lung cancer patients. Results: Five clusters were optimally determined by the novel algorithm proposed in this study. Conclusions: The novel Multiple Correspondence Analysis-k-means (MCA-k-means) clustering algorithm in this study successfully identified risk factors associated with anxiety and depression, which are considered rare events in young patients with lung cancer. The clinical implications of this study suggest that psychiatrists need to be involved at the early stage of initial diagnose with lung cancer for young patients and provide adequate prescriptions of antipsychotic medications for young patients with lung cancer.
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Abstract
Lung cancer is the leading cause of global cancer incidence and mortality, accounting for an estimated 2 million diagnoses and 1.8 million deaths. Neoplasms of the lungs are the second most common cancer diagnosis in men and women (after prostate and breast cancer, respectively). With increasing access to tobacco and industrialization in developing nations, lung cancer incidence is rising globally. The average age of diagnosis is 70 years old. Men are twice as likely to be diagnosed with lung cancer, which largely reflects differences in tobacco consumption, although women may be more susceptible due to higher proportions of epidermal growth factor receptor mutations and the effects of oestrogen. African American men in the US are at the highest risk of lung cancer. Family history increases risk by 1.7-fold, with a greater risk among first-degree relatives. Tobacco smoking is the greatest preventable cause of death worldwide, accounting for up to 90% of lung cancer cases, and continued consumption is projected to increase global cancer incidence, particularly in developing nations such as China, Russia, and India. Second-hand smoke among children and spouses has likewise been implicated. Radon from natural underground uranium decay is the second leading cause of lung cancer in the developed world. Occupational hazards such as asbestos and environmental exposures such as air pollution, arsenic, and HIV and Tb infection have all been implicated in lung carcinogenesis, while cannabis smoking, electronic cigarettes, heated tobacco products, and COVID-19 have been hypothesized to increase risk.
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Han X, Ma S. [Current Situation of Clinical Feature and Gene Phenotype of Young Adult Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 23:388-392. [PMID: 32429640 PMCID: PMC7260390 DOI: 10.3779/j.issn.1009-3419.2020.101.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
青年型肺癌的义为发病年龄≤ 40岁且≥ 18岁的的肺癌患者。与传统肺癌相比,青年型肺癌患者起病隐匿,临床症状不典型,在发现时分期通常较晚,多数出现区域淋巴转移或远处转移。目前研究发现,青年型肺癌具有相对独特的基因背景,其肿瘤驱动基因丰度较高,且与其临床表现和预后有着较为密切的关系。青年型肺癌是近年来肿瘤领域关注的热点,本文就青年型肺癌的临床特征,基因表型特点及预后复习文献并综述,旨在为青年型肺癌的诊疗及临床研究提供一些参考与线索。
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Affiliation(s)
- Xuan Han
- Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100083, China
| | - Shaohua Ma
- Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100083, China
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Weinberg FD, Zhao L, Chellappa N, Kalemkerian GP, Ramnath N. Characterization of pneumonia and other factors leading to poorer survival across all age groups in patients with non-small cell lung cancer (NSCLC). J Thorac Dis 2021; 13:986-994. [PMID: 33717571 PMCID: PMC7947482 DOI: 10.21037/jtd-20-2891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Lung cancer death rates and incidence in both men and women have decreased over the past two decades. However, certain subsets of non-small cell lung cancer (NSCLC) have arisen with poor outcomes. Identifying factors which contribute to poorer outcomes as well as those that inform early detection strategies remain unmet needs. We present data from a contemporaneous group of NSCLC patients that received care at a single University teaching hospital to understand clinical and pathological factors influencing outcomes in the past decade. Methods A cohort of 2,289 patients with NSCLC who established care at the Rogel Cancer Center, University of Michigan between January 2011 and April 2019 were identified. Patient characteristics and clinical outcomes were recorded using electronic health records. The Kaplan-Meier method and the Cox proportional model were used to assess relationship between clinic-pathological factors and survival. Results Of the 2,289 patients, 92% were >50 years of age while 8% were <50 years of age. The majority (70%) of older patients were former smokers. The majority (61%) of younger patients were diagnosed as having Stage IV NSCLC. Among younger patients, 87% had histologically confirmed non-squamous histology. Univariate analysis revealed that overall survival was significantly lower in patients diagnosed with pneumonia prior to the diagnosis of NSCLC than in those who were not diagnosed with pneumonia (1.9 vs. 21.8 months; P<0.001). Multivariate analysis revealed that older patients had poorer survival than younger patients (HR 1.57, 95% CI: 1.10–2.06, P=0.01) and that patients diagnosed with pneumonia prior to their lung cancer diagnosis had poorer survival across all age groups, particularly in those with advanced-stage disease. Conclusions Findings from this study merit prospective studies to understand cost-benefit ratio of follow- up cross sectional imaging of all patients diagnosed with unprovoked pneumonia, including in younger non/current smokers.
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Affiliation(s)
- Frank D Weinberg
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, MI, USA.,VA Ann Arbor Health Care System, Ann Arbor, MI, USA
| | - Lili Zhao
- Department of Biostatistics, Ann Arbor, MI, USA
| | - Niranjana Chellappa
- Department of Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI, USA
| | - Gregory P Kalemkerian
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, MI, USA
| | - Nithya Ramnath
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, MI, USA.,VA Ann Arbor Health Care System, Ann Arbor, MI, USA
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Viñal D, Martínez D, Higuera O, de Castro J. Genomic profiling in non-small-cell lung cancer in young patients. A systematic review. ESMO Open 2021; 6:100045. [PMID: 33516149 PMCID: PMC7844571 DOI: 10.1016/j.esmoop.2020.100045] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/19/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Lung cancer in young patients is an uncommon and understudied entity that harbors distinctive epidemiological, clinic-demographic, and genomic features. We carried out a systematic review of genomic profiling in young patients with lung cancer from 2010 to 2020 in the main electronic databases and selected 23 manuscripts. Lung cancer in young patients occurs more frequently in women with adenocarcinoma histology and at more advanced stages. Some studies report higher oncogenic genomic alteration in this population, with higher anaplastic lymphoma kinase rearrangements, a distinct profile of epidermal growth factor receptor mutations, and other novel genomic alterations. Although still uncommon, the implementation of next-generation sequencing (NGS) has shed some light on germline genomic alterations associated with lung cancer in young patients. Although outcomes when compared with the older population are conflicting, the overall prognosis is still poor in this subset of patients and efforts to find targetable genomic alterations should be made to improve survival.
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Affiliation(s)
- D Viñal
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain.
| | - D Martínez
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - O Higuera
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - J de Castro
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain; Experimental Therapies and Novel Biomarkers in Cancer IdiPAZ, Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; CIBERONC, Madrid, Spain
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Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15-39 Years): A Population-Based Study in The Netherlands 1990-2016. Cancers (Basel) 2020; 12:cancers12113421. [PMID: 33218178 PMCID: PMC7698904 DOI: 10.3390/cancers12113421] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Adolescents and young adults (AYAs, aged 15–39 years) with cancer form a distinct patient population within the oncology care setting that is often overlooked in favour of paediatric and older adult patients. As such, specific knowledge on AYAs and their distinct spectrum of cancers is limited. Worldwide, cancer is increasing and it is among the major causes of death among AYAs. Cancer prognosis among AYAs has also been shown to lag behind that of younger and older patients suffering from similar diseases. To address these problems, better understanding of AYA cancers is needed. This study aims to provide an overview of the specific cancer trends among AYAs and the changes that have occurred in the Netherlands since 1990 in terms of incidence, survival, and mortality. This information will provide a solid foundation from which to guide future studies upon, aimed at acquiring more detailed cancer knowledge within the AYA domain. Abstract Adolescent and young adult (AYA) cancer patients, aged 15–39 years at primary cancer diagnosis, form a distinct, understudied, and underserved group in cancer care. This study aimed to assess long-term trends in incidence, survival, and mortality of AYA cancer patients within the Netherlands. Data on all malignant AYA tumours diagnosed between 1990–2016 (n = 95,228) were obtained from the Netherlands Cancer Registry. European age-standardised incidence and mortality rates with average annual percentage change (AAPC) statistics and five-year relative survival rates were calculated. The overall cancer incidence increased from 54.6 to 70.3 per 100,000 person-years (AAPC: +1.37%) between 1990–2016, and increased for both sexes individually and for most cancer types. Five-year relative survival overall improved from 73.7% in 1990–1999 to 86.4% in 2010–2016 and improved for both sexes and most cancer types. Survival remained poor (<60%) for rhabdomyosarcoma, lung, stomach, liver, bladder, and pancreatic carcinomas, among others. Mortality rates among male AYAs overall declined from 10.8 to 6.6 (AAPC: −1.64%) and from 14.4 to 10.1 per 100,000 person-years (AAPC: −1.81%) for female AYAs since 1990. Mortality rates remained unchanged for male AYAs aged 20–24 and 25–29 years. In conclusion, over the past three decades, there has been a considerable increase in cancer incidence among AYAs in the Netherlands. Meanwhile, the survival improved and the mortality overall declined. Survival at five-years now well exceeds above 80%, but did not do so for all cancer types.
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Liu Y, Liu F, Hu X, He J, Jiang Y. Combining Genetic Mutation and Expression Profiles Identifies Novel Prognostic Biomarkers of Lung Adenocarcinoma. Clin Med Insights Oncol 2020; 14:1179554920966260. [PMID: 35153523 PMCID: PMC8826273 DOI: 10.1177/1179554920966260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/17/2020] [Indexed: 11/17/2022] Open
Abstract
Motivation: Although several prognostic signatures for lung adenocarcinoma (LUAD) have
been developed, they are mainly based on a single-omics data set. This
article aims to develop a novel set of prognostic signatures by combining
genetic mutation and expression profiles of LUAD patients. Methods: The genetic mutation and expression profiles, together with the clinical
profiles of a cohort of LUAD patients from The Cancer Genome Atlas (TCGA),
were downloaded. Patients were separated into 2 groups, namely, the
high-risk and low-risk groups, according to their overall survivals. Then,
differential analysis was performed to determine differentially expressed
genes (DEGs) and mutated genes (DMGs) in the expression and mutation
profiles, respectively, between the 2 groups. Finally, a prognostic model
based on the support vector machine (SVM) algorithm was developed by
combining the expression values of the DEGs and the mutation times of the
DMGs. Results: A total of 13 DEGs and 7 DMGs were recognized between the 2 groups. Their
prognostic values were validated using independent cohorts. Compared with
several existing signatures, the proposed prognostic signatures exhibited
better prediction performance in the testing set. In addition, it is found
that 1 of the 7 DMGs, GRIN2B, is mutated much more
frequently in the high-risk group, showing a potential value as a therapy
target. Conclusions: Combining multi-omics data sets is an applicable manner to identify novel
prognostic signatures and to improve the prognostic prediction for LUAD,
which will be heuristic to other types of cancers.
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Affiliation(s)
- Yun Liu
- Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China.,College of Communication Engineering, Jilin University, Changchun, China
| | - Fu Liu
- College of Communication Engineering, Jilin University, Changchun, China
| | - Xintong Hu
- Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Jiaxue He
- Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Yanfang Jiang
- Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
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Garrana SH, Dagogo-Jack I, Cobb R, Kuo AH, Mendoza DP, Zhang EW, Heeger A, Sequist LV, Digumarthy SR. Clinical and Imaging Features of Non-Small-Cell Lung Cancer in Young Patients. Clin Lung Cancer 2020; 22:23-31. [PMID: 33189594 DOI: 10.1016/j.cllc.2020.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Non-small-cell lung cancer (NSCLC) in young adult patients is rare, with scarce data available in patients aged < 40 years and even less in those aged < 35 years. Our goal was to determine the presenting symptoms, clinicopathologic characteristics, and imaging features of young patients with NSCLC at time of diagnosis and compare them to those of older adults. PATIENTS AND METHODS We retrospectively analyzed the medical records and imaging of young patients (≤ 40 years old) with NSCLC treated at our institution between 1998 and 2018. Patients < 35 years old were compared to those between 35 and 40 years old. Characteristics of patients ≤ 40 years old were compared to older patients (> 40 years) from publicly available data sets. RESULTS We identified 166 young patients with NSCLC (median age, 36.6 years; range, 18-40 years). Most presented with nonspecific respiratory symptoms and were diagnosed with pneumonia (84/136, 62%). Compared to patients < 35 years old, patients 35-40 years old were more likely to have malignancy detected incidentally (15% vs. 5%, P = .04). Patients < 35 years old were more likely to have central tumors (55% vs. 33%, P = .02) and to have bone (38% vs. 19%, P = .007) and lung (39% vs. 24%, P = .03) metastases. Compared to older patients (> 40 years), young patients were more likely to be never smokers (65.0% vs. 14.7%, P < .001) and to have advanced disease (88% vs. 66%, P < .001). CONCLUSION Young patients with NSCLC often present with nonspecific symptoms and have advanced disease at diagnosis, often mimicking other pathologies. Awareness of the clinical presentation and imaging features of NSCLC in young patients may help minimize delays in diagnoses.
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Affiliation(s)
- Sherief H Garrana
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Ibiayi Dagogo-Jack
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Rosemary Cobb
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Anderson H Kuo
- Harvard Medical School, Boston, MA; Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Dexter P Mendoza
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Eric W Zhang
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Allen Heeger
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Lecia V Sequist
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Subba R Digumarthy
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA.
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Suidan AM, Roisman L, Belilovski Rozenblum A, Ilouze M, Dudnik E, Zer A, Peled N. Lung Cancer in Young Patients: Higher Rate of Driver Mutations and Brain Involvement, but Better Survival. J Glob Oncol 2020; 5:1-8. [PMID: 31067141 PMCID: PMC6550091 DOI: 10.1200/jgo.18.00216] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Anna May Suidan
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Laila Roisman
- Soroka University Medical Center, Be'er-Sheva, Israel
| | | | | | | | - Alona Zer
- Rabin Medical Center, Petah Tikva, Israel
| | - Nir Peled
- Soroka University Medical Center, Be'er-Sheva, Israel
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Chen X, Xu B, Li Q, Xu X, Li X, You X, Yu Z. Genetic profile of non-small cell lung cancer (NSCLC): A hospital-based survey in Jinhua. Mol Genet Genomic Med 2020; 8:e1398. [PMID: 32657049 PMCID: PMC7507563 DOI: 10.1002/mgg3.1398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/18/2020] [Accepted: 06/15/2020] [Indexed: 01/06/2023] Open
Abstract
Background We describe the clinical features, genetic profile, and their correlation in NSCLC patients. Methods A total of 256 Chinese patients with NSCLC were enrolled in this study. NGS‐based genomic profiling of major lung cancer‐related genes was performed on formalin‐fixed paraffin‐embedded tumor samples. Results Of 256 patients with NSCLC, 219 were adenocarcinoma and most of them were in the early stage. Among patients, 63.3% patients have more than two gene mutations. By analyzing variant allele frequency (VAF), we found that the median VAF has significant differences between squamous cell carcinoma and adenocarcinoma, as well as early stage and advanced stage. The frequency of mutations in EGFR, MET, and RET were significantly higher in nonsmokers than in smokers. Besides, Pearson correlation analysis found that ALK, BRAF, and MET mutations had a strong correlation with age. Notably, higher frequencies of ALK and BRAF alterations were associated with younger age, while more frequent MET mutations appear in the patients at age 55 or older. Conclusion More unique features of cancer driver genes in Chinese NSCLC were identified by next‐generation sequencing. These findings highlighted that it is necessary to carry out targeted detection according to different clinical features for NSCLC.
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Affiliation(s)
- Xianguo Chen
- Department of Thoracic SurgeryJinhua Municipal Central HospitalJinhua Hospital of Zhejiang UniversityJinhuaChina
| | - Bo Xu
- Department of Thoracic SurgeryJinhua Municipal Central HospitalJinhua Hospital of Zhejiang UniversityJinhuaChina
| | - Qiang Li
- Hangzhou D.A. Medical LaboratoryHangzhouChina
| | - Xiaoyi Xu
- Department of Thoracic SurgeryJinhua Municipal Central HospitalJinhua Hospital of Zhejiang UniversityJinhuaChina
| | - Xianshuai Li
- Department of Thoracic SurgeryJinhua Municipal Central HospitalJinhua Hospital of Zhejiang UniversityJinhuaChina
| | - Xia You
- Hangzhou D.A. Medical LaboratoryHangzhouChina
| | - Zhaonan Yu
- Hangzhou D.A. Medical LaboratoryHangzhouChina
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He CH, Shih JF, Lai SL, Chen YM. Non-small cell lung cancer in the very young: Higher EGFR/ALK mutation proportion than the elder. J Chin Med Assoc 2020; 83:461-465. [PMID: 32221155 DOI: 10.1097/jcma.0000000000000311] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND This study aimed to analyze pathologic characteristics, treatment, prognosis, and tumor epidermal growth factor receptor/anaplastic large-cell lymphoma kinase (EGFR/ALK) mutation proportion of non-small cell lung cancer (NSCLC) patients aged <40 years at diagnosis. METHODS We retrospectively reviewed data of NSCLC patients diagnosed at Taipei Veterans General Hospital between June 2007 and December 2014, aged <90 years at the time of the diagnosis. RESULTS We found 5051 cases of NSCLC, including 168 patients who were <40 years (younger group) and 4883 patients aged 40 to 89 years (older group). We found that the younger group had a significantly higher proportion of the EGFR mutation (22.6% vs 16.2%, p = 0.026) and the ALK mutation (4.2% vs 0.5%, p < 0.001) than the older group. Although the younger group included more stage IV patients (60.1% vs 49.6%, p = 0.002), it had a better overall survival (OS) rate (1 year: 73.7% vs 66.2%, p = 0.043; 5 years: 44.4% vs 33.7%, p = 0.004) (median survival time: 55 vs 26 months, p = 0.002). About the histologic subtype of NSCLC, the younger group presented less frequent cases of squamous cell carcinoma (4.2% vs 16.1%, p < 0.001), whereas the adenocarcinoma subtype was similarly frequent in the two groups (76.8% vs 76.5%, p = 0.924). CONCLUSION The OS rate in younger NSCLC patients was higher than that in the older NSCLC patients, despite the higher rate of stage IV NSCLC patients in the younger group. This survival benefit is most likely due to the higher proportion of the EGFR and ALK mutations and the corresponding tyrosine kinase inhibitor treatment.
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Affiliation(s)
- Chien-Hui He
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, China Medical University, Taichung, Taiwan, ROC
| | - Jen-Fu Shih
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Shinn-Liang Lai
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Liang Y, Hou H, Jiang M, Zhang C, Liu D, Zhang X. [Genetic Profile of Young Chinese Patients with Lung Adenocarcinoma]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:239-246. [PMID: 32316711 PMCID: PMC7210088 DOI: 10.3779/j.issn.1009-3419.2020.101.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
背景与目的 全球肺癌的发病率正呈逐年上升趋势,其中腺癌所占的百分比日益升高。据统计,全球的肺癌平均初诊年龄在70岁左右,虽然肺癌仍以老年患者居多,但发病年龄的年轻化趋势愈加明显。结合现有研究数据,我们已知在非小细胞肺癌中,年轻患者疾病的发生有其独特的生物学特点。但年轻肺腺癌患者的基因组学特性和临床特征仍有待确定。本研究采用高通量测序(next-generation sequencing technology, NGS)技术对中国年轻肺腺癌患者的基因突变状态进行了研究。 方法 共收集了89例年龄≤45岁的肺腺癌患者组织标本,所有患者均知情同意。使用NGS检测用于确定癌组织中驱动基因突变。此外,对同期行NGS检测的95例 > 45岁肺腺癌患者的基因组和临床病理特征进行回顾性分析。 结果 根据年龄分类对184例肺腺癌患者的驱动基因突变频率进行了分析,揭示了年龄≤45岁的年轻组患者的独特基因特征。其中间变淋巴瘤激酶(anaplastic lymphoma kinase, ALK)融合基因和人表皮生长因子受体-2(human epidermal growth factor receptor 2, HER2)基因的突变频率较高。而鼠类肉瘤病毒癌基因(kirsten rat sarcoma viral oncogene, KRAS)、丝氨酸/苏氨酸蛋白激酶11(serine/threonine kinase 11, STK11)和表皮生长因子受体(epidermal growth factor receptor, EGFR)20外显子突变的趋势则相反,这些突变在年龄 > 45岁的老年组中更为常见。此外,年轻组EGFR基因突变同时伴有肿瘤蛋白p53(tumor protein p53, TP53)基因突变较老年组更为普遍(81.6% vs 44.9%),这可能使其应用EGFR酪氨酸激酶抑制剂(EGFR-tyrosine kinase inhibitor, EGFR-TKI)后疗效较差。 结论 NGS分析显示年轻腺癌患者具有独特的基因突变特点。在年轻患者中发现EGFR/TP53共突变的频率较高,这些独特的基因组学特征对临床治疗有重要的指导意义。
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Affiliation(s)
- Yu Liang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Helei Hou
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Man Jiang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Chuantao Zhang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Dong Liu
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Xiaochun Zhang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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Reply to: Lung Cancer in Young Patients: The Importance of Assessing Driver Mutations and Treatment Strategies. Lung 2020; 198:427-428. [DOI: 10.1007/s00408-020-00338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dai D, Wang Y, Hu X, Jin H, Wang X. Prognostic analysis of very early onset pancreatic cancer: a population-based analysis. PeerJ 2020; 8:e8412. [PMID: 32095324 PMCID: PMC7017800 DOI: 10.7717/peerj.8412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to use competing risk model to assess whether very early onset pancreatic cancer (VEOPC ) (<45 years) had a worse prognosis than older pancreatic cancer (PC) patients, and to build a competing risk nomogram for predicting the risk of death of VEOPC. METHODS We selected pancreatic adenocarcinoma (PDAC) patients as our cohort from the Surveillance, Epidemiology, and End Results (SEER) database. The impact of cancer specific death was estimated by competing risk analysis. Multivariate Fine-Gray regression for proportional hazards modeling of the subdistribution hazard (SH) model based nomogram was constructed, which was internally validated by discrimination and calibration with 1,000 bootstraps. RESULTS Our cohort included 1,386 VEOPC patients and 53,940 older patients. We observed that in unresectablePDAC patients, VEOPC had better cancer specific survival (CSS) than each older group (45-59 years, 60-69 years, 70-79 years and >79 years). There was no significant prognostic difference between VEOPC and each older group in resectablePDAC. Our competing nomogram showed well discrimination and calibration by internal validation. CONCLUSION For unresectable PDAC patients, VEOPC had better CSS than older patients. Our competing risk nomogram might be an easy-to-use tool for the specific death prediction of VEOPC patients with PDAC.
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Affiliation(s)
- Dongjun Dai
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yanmei Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinyang Hu
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongchuan Jin
- Laboratory of Cancer Biology, Key Lab of Biotherapy, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xian Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Zhejiang University, Hangzhou, Zhejiang, China
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Liu J, Zhou H, Zhang Y, Fang W, Yang Y, Hong S, Chen G, Zhao S, Chen X, Zhang Z, Xian W, Shen J, Huang Y, Zhao H, Zhang L. Impact of prior cancer history on the overall survival of younger patients with lung cancer. ESMO Open 2020; 5:e000608. [PMID: 32054633 PMCID: PMC7046373 DOI: 10.1136/esmoopen-2019-000608] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with a history of prior cancer are frequently excluded from cancer trials. Previous studies indicated that prior cancer does not adversely impact clinical outcomes for patients with lung cancer older than 65 years. However, it remains unknown whether these results are applicable to patients with lung cancer aged younger than 65 years old. The study aimed to investigate the impact of prior cancer history on younger patients with lung cancer. METHODS We identified younger patients with lung cancer (<65 years) diagnosed between 2004 and 2009 in the Surveillance, Epidemiology, and End Results database. Propensity score matching was performed to balance differences in baseline characteristics between groups. Kaplan-Meier method and the Cox proportional hazards model were used to evaluate the impact of prior cancer on overall survival (OS). RESULTS Among 103 370 eligible patients with lung cancer, 15.18% had a history of prior cancer. Lung and bronchus (25.83%), breast (14.13%), prostate (8.85%) and cervix uteri (4.74%) were the most common prior cancer types. Of prior cancers, 61.56% are localised and regional stages. More than 67.98% of prior cancers were diagnosed within 5 years of the index lung cancer diagnosis. The median times of diagnosis for prior cancers were 38 months. Patients with prior cancer had the same/non-inferior OS as that of patients without a prior cancer diagnosis (propensity score-adjusted HR=1.01, 95% CI=0.99 to 1.04, p=0.324). Subgroup analyses stratified by timing of prior cancer displayed almost the same tendency (p>0.05). Interestingly, early-stage patients with a history of prior cancer had adverse survival curves (p<0.05). Advanced-stage patients with prior cancer had non-inferior survival (p>0.05). CONCLUSIONS A prior cancer diagnosis has a heterogeneous effect on the survival of patients with lung cancer aged <65 years across different stages, but further prospective studies are still warranted.
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Affiliation(s)
- Jiaqing Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Huaqiang Zhou
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yaxiong Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wenfeng Fang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yunpeng Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shaodong Hong
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Gang Chen
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shen Zhao
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xi Chen
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhonghan Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wei Xian
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jiayi Shen
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yan Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hongyun Zhao
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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Abstract
INTRODUCTION Median age at diagnosis of lung cancer is 70 years. Its presentation in patients 40 or younger is uncommon and it has been proposed that maybe it is a different disease due to its clinical characteristics and genetic makeup. There are a limited number of studies in this population and they report different clinic-pathological characteristics in comparison with older patients. METHODS We described the incidence of lung cancer patients diagnosed at age 40 or younger at the Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima-Peru; from 2009 to 2017 and evaluated the characteristic of NSCLC. Epidemiologic and clinic-pathological data was collected from clinical files. Analysis was carried out using SPSSvs19 software. RESULTS We identified 3823 patients with lung cancer seen at INEN during the study period. Among these, 166 (4.3%) patients were 40 years or younger, and 137/166 (82.5%) were NSCLC. Median age at diagnosis was 36 years (range 14-40 years) and 59.1% of patients were female. A smoking history was present in 14.4% of patients. Frequent symptoms at diagnosis were cough (62.0%), chest pain (51.8%) and dyspnea (40.9%). Adenocarcinoma was the most common histological type (63.3%). Most patients had advanced disease at diagnosis (84.7%). The median overall survival was 8.2 months. CONCLUSIONS The proportion of young patients with lung cancer in our population is higher than that reported in the most recent literature. Lung cancer in the young is mostly sporadic, more frequent in women, usually adenocarcinoma type and it presents with advanced disease, resulting in a very poor survival.
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Affiliation(s)
- Julia Kastner
- University of Maryland School of Medicine, Baltimore, MD
| | - Rydhwana Hossain
- University of Maryland School of Medicine, Cardiothoracic Imaging, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, MD
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Hou H, Zhang C, Qi X, Zhou L, Liu D, Lv H, Li T, Sun D, Zhang X. Distinctive targetable genotypes of younger patients with lung adenocarcinoma: a cBioPortal for cancer genomics data base analysis. Cancer Biol Ther 2019; 21:26-33. [PMID: 31594446 DOI: 10.1080/15384047.2019.1665392] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is still limited comprehensive genotyping data about young patients with lung adenocarcinoma. Herein, next generation sequencing (NGS) data of lung adenocarcinoma patients was retrospectively analyzed to evaluate the relationship between young age at diagnosis and the comprehensive molecular characteristics. The cBioPortal for Cancer Genomics database was queried for cancer genomic studies of lung adenocarcinoma and a cohort of 773 patients with complete cancer genomics data was selected from 2 of 11 studies. The relationship between age at diagnosis and frequency of targetable genotypes was analyzed and verified in another cohort composed of 177 Chinese lung adenocarcinoma patients undergoing NGS assay. Of the 773 eligible lung adenocarcinoma patients, younger age was associated with an increased likelihood of a targetable genotype (P < .001). Specifically, a higher prevalence of EGFR mutations (P = .005), ALK arrangements, ROS1 arrangements (P = .035) and RET arrangements (P < .001) were identified in younger patients. The frequency of KRAS mutations (P < .001) was significantly associated with older age at diagnosis and a similar trend existed for MET (P = .057) but not BRAF-V600E (P = .686) and ERBB2 (P = .083). Additionally, an age at diagnosis of 45 years was found to be a feasible cutoff point to differentiate the younger from the older patients by comprehensive molecular characteristics. These results indicated that younger patients with lung adenocarcinoma were associated with an increased likelihood of harboring a targetable genotype. Distinctive molecular characteristics were identified in patients younger than 45 years with lung adenocarcinoma, which highlights the importance of the NGS assay and personalized therapy in this subpopulation.
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Affiliation(s)
- Helei Hou
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chuantao Zhang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaogai Qi
- Department of Radiotherapy, Qingdao Central Hospital, The Second Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lei Zhou
- Department of Pathology, The Municipal Hospital of Qingdao, Qingdao, China
| | - Dong Liu
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hongying Lv
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tianjun Li
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dantong Sun
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaochun Zhang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Li F, He H, Qiu B, Ji Y, Sun K, Xue Q, Guo W, Wang D, Zhao J, Mao Y, Mu J, Gao S. Clinicopathological characteristics and prognosis of lung cancer in young patients aged 30 years and younger. J Thorac Dis 2019; 11:4282-4291. [PMID: 31737313 DOI: 10.21037/jtd.2019.09.60] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Lung cancer is one of the most common malignant tumors in the world and mainly occurs in elderly patients, but rarely in young patients. The purpose of this retrospective study was to examine the clinicopathological features and prognosis of lung cancer patients aged 30 years and younger. Methods Patients aged 30 years and younger with lung cancer admitted to our center from November 2013 to October 2018 were retrospectively identified. Data included sex, age, smoking history, family history of cancer, high resolution computed tomography results, size and location of tumors, histology of tumors, lymph node status, stage of tumors, treatment methods and prognosis of patients. Results The patient group included more females (56.3%) than males (43.7%) among lung cancer patients aged 30 and younger. Some patients had a history of tobacco inhalation and family cancer (17.5% and 22.3%, respectively). The most common tumors were in the left lower lobe (27.2%). Nearly half (49.5%) of the patients had pathological adenocarcinomas and 59.3% of the patients were showed early clinical stage and had no lymph node metastasis. All patients received surgical treatment; 47.1% received lobectomy and only 17.9% received adjuvant therapy such as radiotherapy, chemotherapy or targeted therapy after operation. Only seven (7.4%) of the successful follow-up patients died. Local recurrence occurred in two cases and distant metastasis in six cases. Conclusions The main clinicopathological type of lung cancer in young lung cancer patients aged 30 years and younger is adenocarcinoma, and most cases were at the early stage. Surgical treatment based on lobectomy is still the main treatment method and the prognosis of these patients is very good. Early screening of lung cancer should be actively promoted for young people.
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Affiliation(s)
- Fang Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Huayu He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Bin Qiu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ying Ji
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kelin Sun
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wei Guo
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Dali Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jun Zhao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Zhou X, Shou J, Sheng J, Xu C, Ren S, Cai X, Chu Q, Wang W, Zhen Q, Zhou Y, Li W, Pan H, Li H, Sun T, Cheng H, Wang H, Lou F, Rao C, Cao S, Pan H, Fang Y. Molecular and clinical analysis of Chinese patients with anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer. Cancer Sci 2019; 110:3382-3390. [PMID: 31444835 PMCID: PMC6778633 DOI: 10.1111/cas.14177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/08/2019] [Accepted: 08/15/2019] [Indexed: 12/17/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK) fusions have been recognized as a therapeutic target in non‐small cell lung cancer (NSCLC). However, molecular signatures and clinical characteristics of the Chinese population with ALK‐rearranged NSCLC are not well elucidated. In the present study, we carried out targeted next‐generation sequencing on tissue and plasma ctDNA samples in 1688 patients with NSCLC. Overall, ALK fusions were detected in 70 patients (4.1%), and the frequencies of ALK fusions detected in tissue and plasma samples were 5.1% and 3.3%, respectively. Additionally, the prevalence of breakpoint locations for EML4‐ALK fusions in ctDNA was significantly correlated with that in tumor tissues (R2 = .91, P = .045). According to age, the incidence rates of ALK fusions among young (age <45 years), middle‐aged (between 45 and 70 years) and elderly (>70 years) patients were significantly different (P < .001). In 70 ALK‐rearranged cases, coexistence of epidermal growth factor receptor (EGFR) alterations and ALK fusions was detected in 12 cases (17.1%) and EGFR mutations tended to coexist with non‐EML4‐ALK rearrangements. Notably, novel ALK fusion partners, including TRIM66,SWAP70,WNK3,ERC1,TCF12 and FBN1 were identified in the present study. Among EML4‐ALK fusion variants, patients with variant V1 were younger than patients with variant V3 (P = .023), and TP53 mutations were more frequently concurrent with variant V3 compared with variant V1 (P = .009). In conclusion, these findings provide new insights into the molecular‐clinical profiles of patients with ALK‐rearranged NSCLC that may improve the treatment strategy of this population.
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Affiliation(s)
- Xiaoyun Zhou
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Jiawei Shou
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Jin Sheng
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Chunwei Xu
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University, Fuzhou, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuyu Cai
- Sun Yet-Sen University Cancer Center, Guangzhou, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenxian Wang
- Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qinhong Zhen
- Department of Medical Oncology, Quzhou People's Hospital, Quzhou, China
| | - Yuefen Zhou
- Department of Medical Oncology, Lishui Municipal Central Hospital, Lishui, China
| | - Wenfeng Li
- Department of Medical Oncology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Hongsen Li
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Tao Sun
- Department of Surgery, University of Chicago, Chicago, USA
| | | | - Huina Wang
- Acornmed Biotechnology Co., Ltd., Beijing, China
| | - Feng Lou
- Acornmed Biotechnology Co., Ltd., Beijing, China
| | - Chuangzhou Rao
- Department of Radiation and Chemotherapy, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Shanbo Cao
- Acornmed Biotechnology Co., Ltd., Beijing, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Yong Fang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
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Chen T, Zhou F, Jiang W, Mao R, Zheng H, Qin L, Chen C. Age at diagnosis is a heterogeneous factor for non-small cell lung cancer patients. J Thorac Dis 2019; 11:2251-2266. [PMID: 31372262 DOI: 10.21037/jtd.2019.06.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The incidence of lung cancer is reported as age dependent. However, the link between survival and age at diagnosis remains controversial. To date, few studies have examined the relationship between age and the clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC). Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, we included in our analysis 151,919 patients diagnosed with NSCLC between 2004 and 2013. Logistic regression was used to evaluate the associations between age and clinicopathological characteristics. N and M stages were separately assessed in each T stage. Results Of the patients enrolled, 60,271 patients were diagnosed at the M1 stage, 147,263 patients had lymph node metastasis, and 49,862 patients underwent surgery. Younger age was inversely associated with high N stage and M stage (P<0.001, respectively). For each T stage, the inverse associations with M1 stage and lymph node metastasis were also presented (P<0.001, respectively). Age was an independent risk predictor for NSCLC patients by using univariate and multivariate analyses. Conclusions Age at diagnosis is a heterogeneous factor for NSCLC patients: younger patients have an increased risk of lymph node and distant metastases, yet have a better prognosis.
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Affiliation(s)
- Tao Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Fangyu Zhou
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Weili Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.,Key Laboratory of Public Health Safety (Ministry of Education), Shanghai 200032, China
| | - Rui Mao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Hui Zheng
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Linlin Qin
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Chang Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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