Trojnar Anna, Domagała-Kulawik Joanna, Sienkiewicz-Ulita Anna, Zbytniewski Marcin, Gryszko Grzegorz M, Cackowski Marcin M, Dziedzic Michał, Woźnica Katarzyna, Orłowski Tadeusz M, Dziedzic Dariusz A
Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Institute of Clinical Sciences, Maria Curie-Skłodowska Medical Academy, Warsaw, Poland.
Transl Lung Cancer Res. 2022 Dec;11(12):2382-2394. doi: 10.21037/tlcr-22-443.
Non-small cell lung cancer diagnosed in young patients is rare. Younger patients with lung cancer are mostly female and have a more advanced stage at initial diagnosis. To our knowledge, no studies have compared single-surgical treatment in different age groups among women. Our study aimed to elucidate the clinicopathological characteristics and the best strategies for surgically treating young women with non-small-cell lung cancer.
The data were collected retrospectively from the Polish Lung Cancer Study Group database. Women who were surgically treated for non-small-cell lung cancer between 2007 and 2020 were included in the study. The participants (n=11,460) were divided into two subgroups: aged ≤55 and >55 years.
Statistically significant differences were found for grades IB, IIA, IIIA, and IIIB (22.8% 24.5%, 5.3% 7.5%, 19.3% 15.8%, 5.8% 3.2%, for younger and older women, respectively, all P<0.001). The univariate analysis showed a higher percentage of 5-year survival in the group of younger women than in older women (0.67 0.64, P=0.00076). Regarding the stage of advancement, statistically significant differences in survival were found for stages IA1, IA2, and IIIA (0.95 0.86, P=0.047; 0.88 0.79, P=0.003; 0.5 0.42, for younger and older women, respectively, all P=0.01). Postoperative complications were more common in older than younger women (27.6% 23.1%, P<0.001). However, there were no statistically significant differences in the number of hospitalization days since surgery and postoperative 30-day mortality.
Younger women treated surgically were characterized by a lower percentage of comorbidities, were treated in a more advanced stage of the disease and had a lower percentage of postoperative complications, which, however, did not affect the hospitalization time. Despite the more advanced stage of the disease, survival in selected stages was much better than in the group of older women.
年轻患者中诊断出的非小细胞肺癌较为罕见。年轻肺癌患者大多为女性,且初诊时病情分期更晚。据我们所知,尚无研究比较不同年龄组女性的单手术治疗情况。我们的研究旨在阐明年轻女性非小细胞肺癌的临床病理特征及手术治疗的最佳策略。
数据回顾性收集自波兰肺癌研究组数据库。纳入2007年至2020年间接受非小细胞肺癌手术治疗的女性。参与者(n = 11460)分为两个亚组:年龄≤55岁和>55岁。
在IB、IIA、IIIA和IIIB期发现了统计学显著差异(年轻女性和老年女性分别为22.8%对24.5%、5.3%对7.5%、19.3%对15.8%、5.8%对3.2%,所有P<0.001)。单因素分析显示年轻女性组的5年生存率高于老年女性(0.67对0.64,P = 0.00076)。关于疾病进展阶段,在IA1、IA2和IIIA期发现了生存方面的统计学显著差异(年轻女性和老年女性分别为0.95对0.86,P = 0.047;0.88对0.79,P = 0.003;0.5对0.42,所有P = 0.01)。术后并发症在老年女性中比年轻女性更常见(27.6%对23.1%,P<0.001)。然而,术后住院天数和术后30天死亡率没有统计学显著差异。
接受手术治疗的年轻女性的特点是合并症比例较低,在疾病更晚期接受治疗,术后并发症比例较低,不过这并未影响住院时间。尽管疾病分期更晚,但特定阶段的生存率比老年女性组要好得多。