110928-132

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

Category: 
Lung Cancer - Non-Small Cell Metastatic
Session Type and Session Title: 
General Poster Session, Lung Cancer - Non-small Cell Metastatic
Abstract Number: 

8049

Citation: 

J Clin Oncol 31, 2013 (suppl; abstr 8049)

Author(s): 

Matthew Stephen Lara, Ann Brunson, Ben Kent Tomlinson, Theodore Wun, Lihong Qi, Rosemary Cress, Primo Lara, David R. Gandara, Karen Kelly; Davis Senior HS and UC Davis Comprehensive Cancer Center, Davis, CA; University of California, Davis, Sacramento, CA; UC Davis Comprehensive Cancer Center, Sacramento, CA; University of California, Davis, Davis, CA; University of California, Davis, School of Medicine, Davis, CA; Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, Sacramento, CA; University of California, Davis Comprehensive Cancer Center, Sacramento, CA


Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures

Abstract: 

Background: Lung cancer is often seen in older pts, with a median age at diagnosis of 70 years (yrs). Epidemiology and outcomes are reportedly different among younger NSCLC pts (< 50 yrs). We hypothesized that these pts have longer cause-specific survival (CSS) and that baseline clinical features prognostic for CSS would be identified. Methods: NSCLC pts in the CCR diagnosed between 1/98 through 12/09 were included. The primary outcome was CSS. Hazard ratios (HR) for CSS were calculated using Cox Proportional Hazards (PH) models for all ages & for pts <50 years, adjusted for baseline variables. Results: We identified 132,671 lung cancer pts: 114,451 (86.3%) had NSCLC. 6,389 (5.6%) were < 50 yrs (median, 46 yrs). Demographics: White (3,557, 56%); Histology: AdenoCA (AC) (3,406, 53%), Squamous (781, 12%), BAC (291, 4.6%); Stage IV (3,655, 57%). Fewer pts < 50 yrs were diagnosed in later yrs: from 37% in ‘98-’01 to 29% in ‘06-‘09. Results of Cox PH models for all ages and < 50 years are shown. Conclusions: The relative proportion of pts < 50 yrs has declined by 22% over the past decade. Age < 50 years was an independent predictor of improved CSS (HR 0.83, p<0.001). In younger pts, AC histology was not prognostic for CSS (versus squamous) despite known differences in clinical and biologic behavior between subtypes.Importantly, clinical variables strongly prognostic for CSS were identified in pts < 50 yrs.

Selected clinical variables* All pts
Pts < 50 yrs of age
HR P value HR P value
Female 0.86 <0.001 0.84 <0.001
Age < 50 0.83 <0.001 N/A
Rural 0.99 0.375 1.09 0.166
Stage
II 1.75 <0.001 1.94 <0.001
III 2.24 <0.001 2.49 <0.001
IV 3.51 <0.001 4.37 <0.001
Primary treatment
Surgery 0.22 <0.001 0.23 <0.001
ChemoRT 0.53 <0.001 0.53 <0.001
Year of diagnosis
2002-05 0.91 <0.001 0.89 <0.001
2006-09 0.82 <0.001 0.73 <0.001
Socioeconomic status (SES)
Mid (3) 0.96 <0.001 0.95 0.173
High (4,5) 0.90 <0.001 0.83 <0.001
Histology
AC 0.93 <0.001 0.99 0.788
NOS 1.03 0.0049 1.04 0.497
BAC 0.66 <0.001 0.86 0.112
Large cell 1.1 <0.001 1.09 0.312

* Referent groups: Male, Age >/= 50, Urban, Stage I, No treatment, 1998-2001, Lowest SES (1,2), and Squamous.