Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): A California Cancer Registry analysis

Matthew S. Lara, Ann Brunson, Theodore Wun, Ben Tomlinson, Lihong Qi, Rosemary D Cress, David R Gandara, Karen Kelly

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Non-small cell lung cancer (NSCLC) is uncommonly diagnosed in patients younger than 50 years of age. We analyzed the California Cancer Registry (CCR) to describe epidemiologic characteristics and outcomes in this patient subset and to identify factors prognostic for cause-specific survival (CSS). Methods: Patients diagnosed with NSCLC between 1/1/98 through 12/31/09 and reported to the (CCR) as of October 2011 were included. The primary outcome measure was CSS. Cox regression models were used to evaluate predictors of CSS in young patients with NSCLC, adjusted for potential confounders. Interaction analysis was performed between age groups (<50 vs. ≥50) and specific demographic and tumor covariates. Results: We identified 132,671 lung cancer cases, of which 114,451 (86.3%) had NSCLC. Of these, 6389 (5.6%) were < 50 years of age (median, 46 years). The most common histology was adenocarcinoma (3697, 57.9%). Most patients had stage III (1522, 23.8%) or IV (3655, 57.2%) disease. Fewer young patients were diagnosed in recent years (n, % of total NSCLC population of that era): 1998-2001 (2355, 6.0), 2002-2005 (2182, 5.7), and 2006-2009 (1852, 5.0), P< 0.001. Multivariate analysis showed that age <50 years was an independent predictor of improved CSS (HR 0.827, P< 0.001). Significant predictors of better CSS in patients <50 years included female sex, Asian or Hispanic ethnicity, lower stage, later year of diagnosis, and higher socioeconomic status, among others. Adenocarcinoma histology was not associated with improved CSS in this patient subset (HR 0.987, P= 0.78). Interaction analysis revealed that Hispanic race and bronchioloalveolar histology had differential CSS outcomes dependent on age group. Conclusions: This large registry study found that age <50 years is an independent predictor of improved CSS. Variables prognostic for CSS differed somewhat from those in older patients.

Original languageEnglish (US)
Pages (from-to)264-269
Number of pages6
JournalLung Cancer
Volume85
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Non-Small Cell Lung Carcinoma
Registries
Survival
Neoplasms
Histology
Hispanic Americans
Adenocarcinoma
Age Groups
Delayed Diagnosis
Proportional Hazards Models
Social Class
Lung Neoplasms
Multivariate Analysis
Demography
Outcome Assessment (Health Care)
Population

Keywords

  • Cause specific survival
  • Epidemiology
  • Non-small cell lung cancer
  • Prognosis
  • Registry analysis
  • Young patients

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

@article{01818d676bdd4845810b9a483aaf2628,
title = "Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC): A California Cancer Registry analysis",
abstract = "Background: Non-small cell lung cancer (NSCLC) is uncommonly diagnosed in patients younger than 50 years of age. We analyzed the California Cancer Registry (CCR) to describe epidemiologic characteristics and outcomes in this patient subset and to identify factors prognostic for cause-specific survival (CSS). Methods: Patients diagnosed with NSCLC between 1/1/98 through 12/31/09 and reported to the (CCR) as of October 2011 were included. The primary outcome measure was CSS. Cox regression models were used to evaluate predictors of CSS in young patients with NSCLC, adjusted for potential confounders. Interaction analysis was performed between age groups (<50 vs. ≥50) and specific demographic and tumor covariates. Results: We identified 132,671 lung cancer cases, of which 114,451 (86.3{\%}) had NSCLC. Of these, 6389 (5.6{\%}) were < 50 years of age (median, 46 years). The most common histology was adenocarcinoma (3697, 57.9{\%}). Most patients had stage III (1522, 23.8{\%}) or IV (3655, 57.2{\%}) disease. Fewer young patients were diagnosed in recent years (n, {\%} of total NSCLC population of that era): 1998-2001 (2355, 6.0), 2002-2005 (2182, 5.7), and 2006-2009 (1852, 5.0), P< 0.001. Multivariate analysis showed that age <50 years was an independent predictor of improved CSS (HR 0.827, P< 0.001). Significant predictors of better CSS in patients <50 years included female sex, Asian or Hispanic ethnicity, lower stage, later year of diagnosis, and higher socioeconomic status, among others. Adenocarcinoma histology was not associated with improved CSS in this patient subset (HR 0.987, P= 0.78). Interaction analysis revealed that Hispanic race and bronchioloalveolar histology had differential CSS outcomes dependent on age group. Conclusions: This large registry study found that age <50 years is an independent predictor of improved CSS. Variables prognostic for CSS differed somewhat from those in older patients.",
keywords = "Cause specific survival, Epidemiology, Non-small cell lung cancer, Prognosis, Registry analysis, Young patients",
author = "Lara, {Matthew S.} and Ann Brunson and Theodore Wun and Ben Tomlinson and Lihong Qi and Cress, {Rosemary D} and Gandara, {David R} and Karen Kelly",
year = "2014",
doi = "10.1016/j.lungcan.2014.04.007",
language = "English (US)",
volume = "85",
pages = "264--269",
journal = "Lung Cancer",
issn = "0169-5002",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Predictors of survival for younger patients less than 50 years of age with non-small cell lung cancer (NSCLC)

T2 - A California Cancer Registry analysis

AU - Lara, Matthew S.

AU - Brunson, Ann

AU - Wun, Theodore

AU - Tomlinson, Ben

AU - Qi, Lihong

AU - Cress, Rosemary D

AU - Gandara, David R

AU - Kelly, Karen

PY - 2014

Y1 - 2014

N2 - Background: Non-small cell lung cancer (NSCLC) is uncommonly diagnosed in patients younger than 50 years of age. We analyzed the California Cancer Registry (CCR) to describe epidemiologic characteristics and outcomes in this patient subset and to identify factors prognostic for cause-specific survival (CSS). Methods: Patients diagnosed with NSCLC between 1/1/98 through 12/31/09 and reported to the (CCR) as of October 2011 were included. The primary outcome measure was CSS. Cox regression models were used to evaluate predictors of CSS in young patients with NSCLC, adjusted for potential confounders. Interaction analysis was performed between age groups (<50 vs. ≥50) and specific demographic and tumor covariates. Results: We identified 132,671 lung cancer cases, of which 114,451 (86.3%) had NSCLC. Of these, 6389 (5.6%) were < 50 years of age (median, 46 years). The most common histology was adenocarcinoma (3697, 57.9%). Most patients had stage III (1522, 23.8%) or IV (3655, 57.2%) disease. Fewer young patients were diagnosed in recent years (n, % of total NSCLC population of that era): 1998-2001 (2355, 6.0), 2002-2005 (2182, 5.7), and 2006-2009 (1852, 5.0), P< 0.001. Multivariate analysis showed that age <50 years was an independent predictor of improved CSS (HR 0.827, P< 0.001). Significant predictors of better CSS in patients <50 years included female sex, Asian or Hispanic ethnicity, lower stage, later year of diagnosis, and higher socioeconomic status, among others. Adenocarcinoma histology was not associated with improved CSS in this patient subset (HR 0.987, P= 0.78). Interaction analysis revealed that Hispanic race and bronchioloalveolar histology had differential CSS outcomes dependent on age group. Conclusions: This large registry study found that age <50 years is an independent predictor of improved CSS. Variables prognostic for CSS differed somewhat from those in older patients.

AB - Background: Non-small cell lung cancer (NSCLC) is uncommonly diagnosed in patients younger than 50 years of age. We analyzed the California Cancer Registry (CCR) to describe epidemiologic characteristics and outcomes in this patient subset and to identify factors prognostic for cause-specific survival (CSS). Methods: Patients diagnosed with NSCLC between 1/1/98 through 12/31/09 and reported to the (CCR) as of October 2011 were included. The primary outcome measure was CSS. Cox regression models were used to evaluate predictors of CSS in young patients with NSCLC, adjusted for potential confounders. Interaction analysis was performed between age groups (<50 vs. ≥50) and specific demographic and tumor covariates. Results: We identified 132,671 lung cancer cases, of which 114,451 (86.3%) had NSCLC. Of these, 6389 (5.6%) were < 50 years of age (median, 46 years). The most common histology was adenocarcinoma (3697, 57.9%). Most patients had stage III (1522, 23.8%) or IV (3655, 57.2%) disease. Fewer young patients were diagnosed in recent years (n, % of total NSCLC population of that era): 1998-2001 (2355, 6.0), 2002-2005 (2182, 5.7), and 2006-2009 (1852, 5.0), P< 0.001. Multivariate analysis showed that age <50 years was an independent predictor of improved CSS (HR 0.827, P< 0.001). Significant predictors of better CSS in patients <50 years included female sex, Asian or Hispanic ethnicity, lower stage, later year of diagnosis, and higher socioeconomic status, among others. Adenocarcinoma histology was not associated with improved CSS in this patient subset (HR 0.987, P= 0.78). Interaction analysis revealed that Hispanic race and bronchioloalveolar histology had differential CSS outcomes dependent on age group. Conclusions: This large registry study found that age <50 years is an independent predictor of improved CSS. Variables prognostic for CSS differed somewhat from those in older patients.

KW - Cause specific survival

KW - Epidemiology

KW - Non-small cell lung cancer

KW - Prognosis

KW - Registry analysis

KW - Young patients

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