Bronchogenic carcinoma in patients age 30 and younger.

BACKGROUND: Lung cancer is rare in patients 30 years of age or younger. There is very little published data on lung cancer in this group of patients. METHODS: A retrospective review of patients 30 years of age and younger with bronchogenic carcinoma treated at Roswell Park Cancer Institute between 1973 and 1994 was done. RESULTS: There were 20 patients (11 female and 9 male). Mean age was 27 years (range, 19-30). The predominant histologic types were adenocarcinoma in 11 patients (55%), and undifferentiated large-cell carcinoma in 5 patients (25%). All patients presented with either stage III (8 patients) or IV disease (12 patients). Eight patients (40%) underwent surgical resection (2 lobectomies, 6 pneumonectomies). Other treatments included chemotherapy in 15 patients (75%) and radiation therapy in 7 (35%). Median survival was only 5.5 months, and there were no 5-year survivors. Univariate analysis identified stage (p = 0.05), resection (p = 0.0005), and treatment with chemotherapy (p = 0.001) as predictors of survival. On multivariate analysis, resection (p = 0.0001) and chemotherapy (p = 0.001) remained as independent predictors of survival. CONCLUSIONS: Young patients with lung cancer present with advanced-stage disease and their cancers appear to be biologically aggressive. Although curative treatment is rarely possible, aggressive multimodality therapy is warranted.