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Year : 2020  |  Volume : 47  |  Issue : 1  |  Page : 17-22

How does age affect clinicopathology and survival in non-small-cell lung cancer? An institutional retrospective analysis from North-East India

1 Department of Medical Oncology, Kilpauk Medical College, Chennai, Tamil Nadu, India
2 Department of Radiation Oncology, RIMS, Imphal, Manipur, India

Correspondence Address:
Dr. Yumkhaibam Sobita Devi
Department of Radiation Oncology, RIMS, Lamphelpat, Imphal - 795 004, Manipur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jss.JSS_47_19

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Context: Worldwide, lung cancer is the most common type of cancer and the most frequent cause of cancer-related mortality. There are limited numbers of studies on the prognostic impact of age on non-small cell lung cancer (NSCLC) in developing countries such as India. Aims: The aim was to compare the clinicopathology and survival between younger and older age NSCLC. Subjects and Methods: A retrospective review was carried out on 780 diagnosed cases of NSCLC, treated between 2007 and 2015. The patients were divided into two age groups, younger (<50 years) and older (≥50 years) age groups. Results: Younger NSCLC patients constituted 6.2% of the total study population and were found to have greater proportion of female patients (P = 0.000), lesser prevalence of smokers (P = 0.000), higher rate of positive family history of lung cancer (P = 0.000), metastatic disease at presentation (P = 0.009), adenocarcinoma as the most common histopathology (P = 0.000), greater proportion of patients received combined modality treatment (P = 0.001), and had better overall survival (P = 0.04), whereas older age NSCLC patients were diagnosed more frequently with poor performance status (Eastern Cooperative Oncology Group 3 or 4) (P = 0.000), more likely to be smokers (P = 0.000), higher prevalence of comorbidities, i.e., diabetes mellitus (P = 0.012), hypertension (P = 0.067), bronchial asthma or chronic obstructive pulmonary disease (P = 0.018), squamous cell carcinoma as the most common histopathological subtype, and greater proportion of patients received either single modality treatment or no treatment (P = 0.000). Multivariate analysis revealed age to be an independent prognostic factor (P = 0.019). Conclusions: Younger NSCLC patients, in spite of aggressive disease at diagnosis, are good candidates for combined modality treatment and have better survival.

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