Comparison Of Clinical Features,Prognosis,and Causes Between Young And Non Young Lung Cancer

Purpose of the study:Lung cancer is an age-related tumor,which mainly occurs in middle-aged and elderly patients who smoke.However,in recent years,more and more studies have found that lung cancer has a younger trend.Seer is a tumor database based on a large number of people.By comparing the clinical characteristics,prognosis and causes of death of young lung cancer and non young cancer in SEER database,it can provide guidance for the prevention and treatment of young lung cancer.Research methods:This study is a retrospective study based on SEER database.The first part summarizes the population characteristics of young and elderly lung cancer,and explores the changes of the number ratio,sex ratio and tumor characteristics of the two groups in different years.The second part analyzes the survival of the two groups and compares the survival differences between the two groups;Univariate and multivariate analysis were performed on all patients to determine the independent prognostic factors,and the tendency matching score was further performed on the two groups to further explore the impact of age on prognosis;The characteristics of the causes of death of the two groups were summarized and compared.Part Ⅰ results:The proportion of young women with lung cancer was higher,while the proportion of men in the non young group was higher(P < 0.01).The tumor grade of stage I patients in the young group was significantly lower than that in the non young group(P < 0.01).The tumors in the two groups were mostly found in the right lung and located in the upper lobe.The proportion of right lung and upper lobe in the young group was higher than that in the non young group(P < 0.01).The young group was mainly adenocarcinoma and higher than the non young group.There were significant differences in TNM stage and metastasis between the two groups(P <0.01).The proportion of chemotherapy,radiotherapy and surgery in the young group is higher than that in the non young group,and may be treated in a variety of ways.From 2004 to 2013,in terms of the number of cases,the total number of cases in the elderly group showed a gradual increasing trend,while the young group showed a downward trend.From 2004 to 2013,the proportion of stage IV lung cancer in the non young group gradually increased,the proportion of stage I and II patients was stable,and the proportion of stage III patients decreased year by year;In the young lung cancer group,the proportion fluctuated greatly,but in general,the proportion of advanced lung cancer in the young lung cancer group was higher than that in the non young group(P < 0.01).Part Ⅱ results:The results of survival analysis showed that in the comparison of overall population survival,the prognosis of young lung cancer treated with relevant treatment was significantly better than that of the non young group.The median overall survival events were 23 months vs 13 months respectively.Multivariate analysis showed that the other variables were independent prognostic factors for lung cancer,except that there was no significant statistical difference in tumor laterality(left side and unknown location).Among other factors,the young group with lung cancer was an independent prognostic factor,suggesting that the prognosis of the young group was better.It is worth noting that targeted therapy and chemotherapy in treatment are risk factors for the prognosis of lung cancer in single factor,which is obviously inconsistent with the clinical reality,but they become independent protective factors of lung cancer after multi factor adjustment.After PSM matching,there was no significant difference between the two groups in gender,race,tumor differentiation,primary location,laterality,pathological type,stage,chemotherapy,radiotherapy and surgery.The survival analysis of the two groups again showed that the prognosis of the young group was better than that of the non young group.Subgroup analysis of the population after PSM by age showed that the prognosis of the middle-aged and non young groups was worse.Especially in subgroups such as tumor pathological grade and TNM stage,the lower the grade is,the lower the degree of malignancy is,and the older the age is,the worse the prognosis is.The distribution of causes of death was significantly different between the two groups from 2004 to 2013.Among them,the mortality rate of the non young group was 82.3%.In the proportion of causes of death,non lung cancer patients accounted for 18.2%.The top three causes of death from lung cancer were heart related diseases(21.7%),COPD(15.4%)and other malignant tumors(12.4%)..The mortality rate of the youth group was 65.5%.Among the causes of death,the proportion of patients with non lung cancer death accounted for 12.4%,which was lower than that of the non youth group;The top three causes of death from lung cancer were other malignant tumors(27.5%),heart disease(10.4%),accidents and adverse reactions(6.4%).Research conclusion:Compared with the non young group,there are differences in the clinical characteristics of the young group.Young lung cancer patients are more common in females,adenocarcinoma,and have a higher degree of malignancy;Age is an independent prognostic factor for lung cancer patients,and the prognosis of young patients is better than that of non young patients.The non-lung cancer causes of death in the young patients were significantly different from those in the non young group,and other malignancies were the main non-lung cancer causes of death in the young lung cancer patients.