Affiliation:
1. Department of Thoracic Surgery Beijing Institute of Respiratory Medicine and Beijing Chao‐Yang Hospital, Capital Medical University Beijing China
2. 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 China
3. Department of Pulmonary Surgery The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences Hangzhou China
Abstract
AbstractBackgroundThe 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.MethodsWe 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.ResultsAmong 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.ConclusionsOverall, 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.