Abstract
Purpose
To compare clinicopathologic factors including tumor-node-metastasis (TNM) stage between young and elderly patients with non-small cell lung cancer (NSCLC).
Methods
This retrospective study compared the following characteristics between 52 young patients with NSCLC (<50 years of age) and 67 elderly patients with NSCLC (>60 years): duration of symptoms before medical consultation, smoking index, family history of cancer, Ki-67 index, and pTNM stage. A binary logistic regression analysis was used to identify factors predictive of greater stage NSCLC (stage III/IV compared to stage I/II) within each age group.
Results
The incidence of adenocarcinoma was higher in the young than in the elderly (P=0.006). Smoking index (P=0.002) and Ki-67 index (P<0.001) were lower in the young than in the elderly. In young patients with NSCLC, delayed treatment (greater duration from symptoms to medical consultation, P=0.050) and active tumor proliferation (higher Ki-67 index, P=0.003) were predictive of more advanced cancer stage (III/IV), with only symptom duration being predictive of stage III/IV NSCLC among elderly patients. Among young patients, cough (P=0.021) and chest congestion (P=0.040) were the most significant warning symptoms of advanced-stage NSCLC.
Conclusion
High tumor proliferation and delayed treatment are predictive of advanced NSCLC on presentation among young individuals. Early diagnosis by imaging, such as with the use of low dose computed tomography (LDCT), for young individuals with coughing and chest congestion over 1 month might be effectiveto improve prognosis and outcomes.
Disclosure
Xin Jin and Yi Zhang report grants from Beijing Hospitals Authority, outside the submitted work. The authors declare that they have no other potential conflicts of interests for this work.