Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical Features of Lung Cancer in Japanese Patients Aged Under 50

  • Igata, Fumiyasu (Department of Respiratory Medicine, Fukuoka University School of Medicine and Hospital) ;
  • Uchino, Junji (Department of Respiratory Medicine, Fukuoka University School of Medicine and Hospital) ;
  • Fujita, Masaki (Department of Respiratory Medicine, Fukuoka University School of Medicine and Hospital) ;
  • Iwasaki, Akinori (Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of Medicine and Hospital) ;
  • Watanabe, Kentaro (Department of Respiratory Medicine, Fukuoka University School of Medicine and Hospital)
  • Published : 2016.07.01
⟨ Previous Next ⟩

Abstract

The proportion of lung cancer patients under 50 years old is small at approximately 5-10%, but as with patients older than 50, the number is on the rise. Although lung cancer treatment strategies have undergone extensive transformation in recent years based on the presence or absence of oncogenic driver mutations, there are few reports regarding these mutations in the young or the relationship between clinical setting and prognosis. Therefore, we conducted a study of clinical features in 36 patients under the age of 50 who were diagnosed with primary lung cancer from October 2008 to November 2015. The 22 patients in stages I through III A underwent operations, and all 17 whose lung cancer were detected through screening were candidates for surgery. Gene analysis was conducted for 26 (72.2%); 10 (38.5%) were positive for EGFR gene mutations, and ALK gene translocation was present in 4 (15.4%). In stage IV patients, the median progression free survival (PFS) in the ALK translocation positive and negative patients was 518 days and 130 days, respectively, and the median overall survival (OS) was not reached and 280 days, respectively. A trend toward extended PFS (p=0.203) and OS (p=0.056) was observed in patients positive for ALK translocation. We must strive for early detection by increasing screening rates and evaluate oncogenic driver mutations important for prognosis of lung cancer in the young.

Keywords

References

  1. Andou A, Shimizu N, Maruyama S, et al (1992). Study on cases of resected primary lung cancer in young persons. Kyobu Geka, 45, 379-83 [in Japanese].
  2. Bourke W, Milstein D, Giura R, et al (1992). Lung cancer in young adults. Chest, 102, 1723-9. https://doi.org/10.1378/chest.102.6.1723
  3. Capewell S, Wathen CG, Sankaran R, et al (1992). Lung cancer in young patients. Respir Med, 86, 499-502. https://doi.org/10.1016/S0954-6111(96)80010-2
  4. Enomoto Y, Takada K, Hagiwara E, et al (2013). Distinct features of distant metastasis and lymph node stage in lung adenocarcinoma patients with epidermal growth factor receptor gene mutations. Respir Investig, 51, 153-7. https://doi.org/10.1016/j.resinv.2013.02.004
  5. Icard P, Regnard JF, de Napoli S, et al (1992). Primary lung cancer in young patients: a study of 82 surgically treated patients. Ann Thorac Surg, 54, 99-103. https://doi.org/10.1016/0003-4975(92)91150-8
  6. Inoue M, Okumura M, Sawabata N, et al (2014). Clinicopathological characteristics and surgical results of lung cancer patients aged up to 50 years: the Japanese Lung Cancer Registry Study 2004. Lung Cancer, 83, 246-51. https://doi.org/10.1016/j.lungcan.2013.11.007
  7. Kohno T, Tsuta K, Tsuchihara K, et al (2013). RET fusion gene: translation to personalized lung cancer therapy. Cancer Sci, 104, 1396-400. https://doi.org/10.1111/cas.12275
  8. Lindeman NI, Cagle PT, Beasley MB, et al (2013). Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: guideline from the college of american pathologists, international association for the study of lung cancer, and association for molecular pathology. J Thorac Oncol, 8, 823-59. https://doi.org/10.1097/JTO.0b013e318290868f
  9. Minami H, Yoshimura M, Matsuoka H, et al (2001). Lung cancer treated surgically in patients <50 years of age. Chest, 120, 32-6. https://doi.org/10.1378/chest.120.1.32
  10. Nakanishi Y (2015). Implementation of modern therapy approaches and research for non-small cell lung cancer in Japan. Respirol, 20, 199-208. https://doi.org/10.1111/resp.12460
  11. Sagawa M, Nakayama T, Tsukada H, et al (2003). The efficacy of lung cancer screening conducted in 1990s: four case-control studies in Japan. Lung Cancer, 41, 29-36.
  12. Saika K, Sobue T (2014). Lung cancer: progress in diagnosis and treatments. Topics I. Epidemiology and pathogenesis; 1. Epidemiology, prevention and screening. Nihon Naika Gakkai Zasshi, 103, 1255-60 [in Japanese]. https://doi.org/10.2169/naika.103.1255
  13. Sakairi Y, Nakajima T, Yasufuku K, et al (2010). EML4-ALK fusion gene assessment using metastatic lymph node samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration. Clin Cancer Res, 16, 4938-45. https://doi.org/10.1158/1078-0432.CCR-10-0099
  14. Sawabata N (2014). Prognosis of lung cancer patients in japan according to data from the Japanese joint committee of lung cancer registry. Respir Investig, 52, 317-21. https://doi.org/10.1016/j.resinv.2014.04.002
  15. Takeuchi K, Togashi Y, Kamihara Y, et al (2016). Prospective and clinical validation of ALK immunohistochemistry: results from the phase I/II study of alectinib for ALK-positive lung cancer (AF-001JP study). Ann Oncol, 27, 185-92. https://doi.org/10.1093/annonc/mdv501
  16. Whooley BP, Urschel JD, Antkowiak JG, et al (1999). Bronchogenic carcinoma in young patients. J Surg Oncol, 71, 29-31. https://doi.org/10.1002/(SICI)1096-9098(199905)71:1<29::AID-JSO6>3.0.CO;2-V
  17. Zhang Y, Sun Y, Pan Y, et al (2012). Frequency of driver mutations in lung adenocarcinoma from female neversmokers varies with histologic subtypes and age at diagnosis. Clin Cancer Res, 18, 1947-53. https://doi.org/10.1158/1078-0432.CCR-11-2511