211249 Surgical results and prognosis of patients with primary bronchogenic carcinoma aged less than 30 years

/Duan Liang(段亮，Dept Thorac Surg，Tongji Univ Affil Shanghai Pulmon Hosp，Shanghai 200433)…∥Chin J Thorac Cardiovasc Surg.-2011，27(4).-208 ～211

ObjectiveTo investigate and analyze the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.MethodsA retrospective review is presented of patients less than 30 years with surgical treatment of bronchogenic carcinoma between 1969 and 2008.There were 59 patients(36 male and 23 female).Mean age was 23 years(range 8-29).The ratio of men to women patients was 1.7∶1.Forty-nine cases(83.0%)were symptomatic at presentation and 18 cases(30.5%)were misdiagnosed as other diseases.Surgical procedures included radical resection in 46 cases，palliative resection in 3 cases，thoracotomy only for unresectable disease in 7 cases and VATS biopsy in 3 cases.The histological types were 18 adenocarcinomas，13 carcinoids，9 mucoepidermoid carcinoma，5 squamous cell carcimomas，4 small cell lung cancer，3 adenosquamous carcinoma and 4 others.On TNM staging，8 cases in stageⅠa，3 cases in stageⅠb，9 cases in stageⅡa，12 cases in stageⅡb，15 cases in stageⅢa，8 cases in stageⅢb，4 cases in stageⅣ.ResultsThere were no operative death in radical group.Post-operative atelectasis in 3 cases.One case died from postoperative respiratory failure in explorative group，the postoperative five year survival rate was 27.0%.radical resection group 5-year survival was 35%.Univariate analysis identified TNM stage and surgical procedures as predictors of survival(P ＜0.05).factors that had no significant effect on overall survival included gender，histologic sbutype and postoperative chemotherapy(P ＞ 0.05).The 5 year survival in stageⅠ，Ⅱ，Ⅲa，Ⅲb+ Ⅳ were 75.0%，33.3%，14.3%and 0，respectively.The 5 year survival in lobectomy，pneumonectomy and explorative were 43.0%，18.2%and O，respectively.On multivariate analysis，TNM stage of disease was the only independent predictor of survival(P=0.000).ConclusionWe should pay attention to adolescent lung cancer and improve the diagnosis rate avoiding of delaying surgical treatment.The five year survival rate of radical resection for adolescent lung cancer was good.They should be treated with aggressive multimodality therapy and surgical resection is the first-line treatment for them.13 refs，1 fig，1 tab.