Surgical Treatment of Primary Lung Cancer in Young Patients

Objective: Our aim was to investigate the correlation of clinical features and prognosis of surgical treatment for lung cancer in young patients. Methods: Ninety two young patients(≤40 years old) with primary lung carcinoma underwent surgical treatment from Jan 1978 to Dec 1996. We statistically analyzed the sex distribution, age, symptoms, diagnosis, treatment, and prognosis. Results: The ratio of men to women patients was 3.38∶1. Among them there were 34 cases of squamous carcinoma (37%), 30 cases of adenocarcinoma (33%), 26 cases of small cell lung cancer (28%), and 2 cases of large cell carcinoma (2%). According to TNM staging method , 30 cases were at stage I, 30 at stage II, 32 at stage III. Fifty four patients received lobectomy (59%),36 received pneumonectomy (39%),and 2 received wedge shaped resection(29%).The overall postoperative 5 year survival rate was 46%(42/92). The 5 year survival rate in patients older than 40 during the same period was 34%,with a very significant difference (P0.01). The 5 year survival rates in squamous carcinoma , adenocarcinoma, small cell lung cancer and large cell lung cancer were 68%,30%,38%, and 0, respectively. The 5 year survival rate in squamous carcinoma was higher than that in adenocarcinoma(P0.01) and small cell lung cancer(P0.05). No significant difference of the 5 year survival rate was found between adenocarcinoma and small cell lung cancer. The 5 year survival rates were 63% in TNM stage I, 53% in stage II , 22% in stage III. No statistical difference existed between stage I and II, but very significant difference existed between stage I and III (P0.01), and significant difference between stage II and III (P0.05). Conclusion: The number of man in patients was obviously higher than women. Squamous carcinoma accounted for the most part in this study, with no significant difference when comparing with adenocarcinoma and small cell lung cancer. The postoperative 5 year survival rates in the young patients was 46%, which was higher than that in patients older than 40 during the same period. The patients with squamous carcinoma had good prognosis, while the prognosis of patients with cancers in stage III are not so good.