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(Chest. 2002;121:309-310.)
© 2002 American College of Chest Physicians

Non-small Cell Lung Cancer in Very Young and Very Old Malaysian Patients

Chong-Kin Liam, MBBS, FCCP; Kim-Hatt Lim, MBBS and Catherine Mee-Ming Wong, MBBS

University of Malaya Kuala Lumpur, Malaysia

Correspondence to: Chong-Kin Liam, MBBS, FCCP, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; e-mail: liamck{at}medicine.med.um.edu.my

To the Editor:

We read with great interest the article by Kuo et al (February 2000)1 on non-small cell lung cancer (NSCLC) in very young and very old patients. This, together with the paucity of information on lung cancer in very young and very old Asian patients,2 3 4 has prompted us to share our data on these patients. We reviewed the clinicopathologic data of patients with histologically and/or cytologically confirmed primary lung cancer diagnosed at our medical center, a tertiary teaching hospital, from October 1991 to September 1999. Of 510 patients with NSCLC diagnosed during this period, 32 patients (6.3%) were < 40 years old (the young group) and 14 patients (2.7%) were > 80 years old (the elderly group; Table 1 ). There was no difference in the male-to-female ratio between the young, middle-aged (40 to 80 years), and elderly groups. A significantly smaller proportion of young patients smoked compared to the other two groups. Compared with the elderly group alone, the proportion of smokers in the young group was also smaller. However, this was not statistically significant (two-tailed Fisher’s Exact Test, p = 0.054). Adenocarcinoma was the most common cell type in all three age groups, but it was significantly more common in the young group. There was, however, no significant difference in the proportion of adenocarcinoma between the young and the elderly groups. Metastatic (stage IV) disease at presentation was significantly more frequent in the young patients. When compared with the elderly patients, a higher proportion of young patients presented with stage IV disease (two-tailed Fisher’s Exact Test, p = 0.010). Of the three groups, a significantly higher proportion of young patients had poorer performance status at presentation. However, there was no significant difference in the level of performance status at presentation between the young and elderly patients.


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  		Table 1.. Clinicopathologic Features of NSCLC in Different Age Groups*

 
Therefore, unlike the report by Kuo et al,1 we did not find significantly more female patients or more instances of adenocarcinoma in very young patients when compared with very old patients. Also, unlike the report by Kuo et al,1 we found our very young patients to have more advanced disease at presentation.

References

  1. Kuo, CW, Chen, YM, Chao, JY, et al (2000) Non-small cell lung cancer in very young and very old patients. Chest 117,354-357[Abstract/Free Full Text]
  2. Sekine, I, Nishiwaki, Y, Yokose, T, et al (1999) Young lung cancer patients in Japan: different characteristics between the sexes. Ann Thorac Surg 67,1451-1455[Abstract/Free Full Text]
  3. Shimono, T, Hayashi, T, Kimura, M, et al (1994) Surgical treatment of primary lung cancer in patients less than 40 years of age. J Clin Oncol 12,981-985[Abstract/Free Full Text]
  4. Sugio, K, Ishida, T, Kaneko, S, et al (1992) Surgically resected lung cancer in young adults. Ann Thorac Surg 53,127-131[Abstract]




This Article
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