Lung Cancer in Patients under Age 40

四十歲以下之肺癌

張比嵩(Bee-Song Chang) ； 葛魯蘋(Luo-Ping Ger) ； 陳政隆(Cheng-Lung Chen) ； 李世俊(Shih-Chun Lee)

《Journal of Medical Sciences》 14卷5期 (1994/04) Pp. 325-340

摘要

三軍總醫院由民國72年5月至82年12月共有51例年齡小於40歲之肺癌患者。所有患者發現時皆有症狀。其中27例為女性，24例為男性，最年輕之患者年齡為21歲，中間年齡為34歲。所有抽煙患者皆為男性。組織分類上有36例患者為腺癌，6例為鱗狀細胞癌，4例為小細胞癌，3例為大細胞癌及2例為分化不良癌。肺癌分期上2例患者為第1期，1例第2期，4例為3a期，44例為第3b期或第4期。只有6例患者接受了完全切除手術。全部患者由1年至5年之累計存活率分別為31.4％，13.8％，9.81％，6.54％，3.27％，但接受完全切除手術之患者5年存活率為60％。單變相分析存活之預後因子發現在不同之年齡、性別、組織分類，疾病分期及治療方式與存活率之間存在有統計學上有意義之差異。在不含變相手術治療之多變相預後因子分析中發現年齡小於30歲，男性，疾病分類較早期及有接受化學治療在統計學上皆為有意義之較好預後因子。在不含變相疾病分期之多變相預後因子分析中發現接受根除切除手術及化學治療在統計學上為有意義之較好預後因子。由本文可以得到一個結論，年齡小於40歲之肺癌為一種快速致死疾病；患者年齡若小於30歲則預後較大於30歲者差，男性患者較女性患者佳，患者有接受化學治療較未接受化學治療者佳。但患者若是在疾病分期上較早或患者有接受根除切除手術治療則仍可以得到相當好之存活率。

關鍵字

肺癌 ； 40歲以下

並列摘要

Fifty-one patients less than 40 years of age were evaluated in Tri-Service General Hospital between May 1983 and December 1992. All the patients were symptomatic. Twenty-seven patients were female, 24 patients were male. The youngest patient was 21 years old. Median age was 34 years old. All 11 smokers were male. Thirty-six patients (70.6%) had adenocarcinoma, 6 had squamous cell carcinoma, 4 had small cell carcinoma, 3 had large cell carcinoma, and 2 had poor differentiated carcinoma. Two patients had Stage I, one had Stage II, four had Stage IIIa and 44 patients had Stage IIIb or Stage IV disease at the time of initial examination. Only 6 patients had complete resection of the tumors. Overall cumulative 1-year, 2-year, 3-year, 4-year, 5-year survival rate were 31.4%, 13.8%, 9.81%, 6.54% and 3.27% respectively. Median survival was 6.79 months. The cumulative 5-year survival rate of patients who had curative resection was 60%. Univariate analysis of prognostic factors for survival found there were significant differences between age, sex, tumor histology, stage, and treatment. Multivariate analysis of prognostic factors for model 1 (operation was not included) found age over 30, male, earlier stage, and chemotherapy were significant better prognostic factors associated with survival; for model 2 (stage was not included) found curative resection and chemotherapy were the prognostic factors associated with survival. In conclusion, lung cancer in patients' age under 40 was a rapid fatal disease. Patients with age under 30 years old had worse prognosis than patients with age over 30 years old. Male patients had better prognosis than female patients. Patients who had chemotherapy had better prognosis than patients who had no chemotherapy. However, patients who were in the earlier stages or who had curative resection still could have good survival.

並列關鍵字

Lung cancer ； age under 40