青年人与老年人肺癌的比较

目的 对青年人肺癌（年龄≤40岁）和老年人肺癌（年龄≥70岁）的病理类型、临床表现、性别比例、临床分期及对治疗的选择进行比较。方法 回顾性收集6年来在我院经病理学证实青年人组70例及老年人组135例肺癌患者的年龄、性别、组织学分类、起始症状、临床分期及治疗经过进行比较。结果 （1）青年人组中女性患者比例较老年人组明显增高（P＜0.01)。青年人组腺癌的比例亦较老年组高。（2）青年组中出现胸痛症状的比例明显高于老年人组（P＜0.01)。（3）青年人组中中晚、期比例略高于老年人组，但统计学上无显著性差异。（4）青年人组中手术治疗及放化疗的比例要明显高于老年人组（P＜0.01)，老年人组中更倾向于保守治疗。结论 青年人肺癌与老年人肺癌相比，女性患者比例明显增高，腺癌比例增高，疾病进展迅速，恶性度高，且易误诊。早期诊断，积极治疗能提高肺癌的生存期。     

40岁以下青年人肺癌的临床病理特征和预后

目的　探讨 <4 0岁青年人肺癌的临床病理特征及预后 ,并与≥ 4 0岁的中老年人肺癌进行比较。方法　对 12 9例青年人肺癌 (青年组 )以及随机选择的 14 0例中老年人肺癌 (中老年组 )进行回顾性分析 ,比较两组临床病理特征和生存期。结果　青年组与中老年组相比 ,青年组女性患者比例高 (P =0 .0 37) ,平均症状持续时间长 (4 .7个月 ,P <0 .0 0 1) ,误诊率高 (6 5 .1% ,P <0 .0 0 1) ,平均误诊时间长 (5 .6个月 ,P <0 .0 0 1) ,以腺癌为主要病理类型 (5 4 .3% ,P <0 .0 0 1) ,癌细胞分化差 (6 9.5 % ,P <0 .0 0 1) ,诊断时晚期多 (74 .4 % ,P <0 .0 0 1) ,接受综合治疗的比例高 (94 .6 % ,P <0 .0 0 1) ,因远处转移而致治疗失败者的比例高 (6 4 .7% ,P =0 .0 2 )。两组总的中位生存期和 5年生存率差异无显著性 (P =0 .2 889) ,但Ⅰ期和Ⅱ期中 ,青年组中位生存期及 5年生存率优于中老年组 (P =0 .0 4 95 )。两组肿瘤家族史及吸烟史差异无显著性。结论　青年人肺癌的临床病理特征明显不同于中老年人肺癌 ,但生存期相似。将青年人肺癌定义为“青年型肺癌”有临床实际意义。     

Comparison between young and old patients with bronchogenic carcinoma

The aim of this study was to compare the clinical characteristics, histological type, stage at diagnosis, treatment and survival of young (< or = 45 years) and older patients with bronchogenic carcinoma. The study was designed as a retrospective review of all lung cancer patients referred to the Kuwait Cancer Control Center over a 10-year period from 1985 to 1994. The study comprised 590 patients with primary bronchogenic carcinoma, of whom 72 (12%) were < or = 45 years of age at the time of diagnosis. Median (range) duration of symptoms, percentage of smokers and male to female ratios for the younger and older patients were 8 (2-48) weeks vs. 8 (1-52) weeks (p = 0.9), 74% vs. 83% (p = 0.06) and 5.5 vs. 5.3, respectively. The majority of patients had advanced stage disease at presentation; 91% of the younger patients had stage III or IV compared with 88% of the older patients (p = 0.1). The histological types for the younger and older patients were 32% vs. 20% for adenocarcinoma (p = 0.01) and 33% vs. 45% for squamous cell carcinoma (p = 0.1). There were more patients in the younger group who had surgery (21% vs. 7.5%) than in the older group (p = 0.001). Follow-up data were available for 177 patients out of 190 Kuwaiti national patients (93%). The median (range) survival rates for young and old patients were 8 (3-62) months and 7 (1-174) months, respectively (p = 0.09). Only 6 patients survived for more than 5 years, one (7.6%) from the younger group and 5 (3%) from the older group. Our study shows a relatively high percentage of young patients in our population of lung cancer patients. Apart from the higher incidence of adenocarcinoma in the young group and the fact that these patients had more surgery than the older group, there were no other significant differences between the two groups.     

Unique Features of Gastric Cancer in Young Patients: Experience from a General Hospital in Nepal

Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.     

Lung cancer in patients younger than 40 years of age.

BACKGROUND AND OBJECTIVES: We investigated whether the clinicopathologic characteristics and prognosis of lung cancer in younger patients differ from those of older patients. METHODS: Among 2,763 lung cancer patients treated during the period from April of 1972 to April of 1997, we retrospectively investigated the clinical features and prognosis of 53 patients under 40 years of age (young group) and compared them with the findings of 1,886 patients with 60 years of age or older (elderly group). RESULTS: The proportion of female patients in the younger group was significantly higher than that in the elderly group (39.6% vs. 24.1%). The young group had a significantly higher proportion of adenocarcinoma (75.5% vs. 44.8%) and stage III-IV disease (73.6% vs. 59.2%) and a significantly lower proportion of squamous cell carcinoma (3.8% vs. 32.1%). Regarding the selection of therapy, in the young group, a significantly lower proportion of patients underwent surgical therapy (35.8% vs. 41.5%) and a significantly higher proportion of those (37.7% vs. 16.4%) received chemotherapy. The overall survival between the young and elderly groups was not significantly different. Moreover, the 5-year survival rate of the patients undergoing a surgical resection was 56.1% in the young group and 44.8% in the elderly group (P = 0.0615). CONCLUSIONS: This study suggests that the prognosis of young patients with lung cancer is at least equivalent to that of older patients; therefore, they should be managed according to the general therapeutic guidelines.     

Lung Cancer in Patients under 50 Years Old

A long-term retrospective study was carried out on 790 cases of lung cancer to determine if the clinicopathologic characteristics and survival rates of lung cancer patients under the age of 50 differ from those of patients 50 years of age or older at diagnosis by analyzing data on patients registered at Tochigi Cancer Center Hospital. Of the 790 patients, 77 (9.7%) were under the age of 50 at diagnosis. The percentage of women in the younger patient group was significantly higher than that in the older patient group (39.0% vs. 27.5%; P =0.034). Tumor histology revealed a significant preponderance of adenocarcinomas (60 patients, 77.9%) and a paucity of squamous cell carcinomas (8 patients, 10.4%) in the younger age group ( P <0.001). The preponderance of adenocarcinoma was significant in both males and females (male: P =0.004, female: P =0.004). Smoking rates and rate of detection by cancer screening did not differ between the two age groups. Because of the paucity of smokers among the younger female patients, causes of lung cancer other than smoking should be sought in younger patients. No difference was found in the stage of the disease at presentation, treatment methods and survival rates between the two age groups. It is suggested that the prognosis for patients with lung cancer under the age of 50 is not significantly worse than for those aged 50 years or older, as has been shown by several investigators.     

Lung cancer in patients under 50 years old.

A long-term retrospective study was carried out on 790 cases of lung cancer to determine if the clinicopathologic characteristics and survival rates of lung cancer patients under the age of 50 differ from those of patients 50 years of age or older at diagnosis by analyzing data on patients registered at Tochigi Cancer Center Hospital. Of the 790 patients, 77 (9.7%) were under the age of 50 at diagnosis. The percentage of women in the younger patient group was significantly higher than that in the older patient group (39.0% vs. 27.5%; P = 0.034). Tumor histology revealed a significant preponderance of adenocarcinomas (60 patients, 77.9%) and a paucity of squamous cell carcinomas (8 patients, 10.4%) in the younger age group (P<0.001). The preponderance of adenocarcinoma was significant in both males and females (male: P = 0.004, female: P = 0.004). Smoking rates and rate of detection by cancer screening did not differ between the two age groups. Because of the paucity of smokers among the younger female patients, causes of lung cancer other than smoking should be sought in younger patients. No difference was found in the stage of the disease at presentation, treatment methods and survival rates between the two age groups. It is suggested that the prognosis for patients with lung cancer under the age of 50 is not significantly worse than for those aged 50 years or older, as has been shown by several investigators.     

年轻肺癌患者的临床特征和分子特征的回顾性研究

目的:探究年轻肺癌患者（≤40岁）的临床特征、分子特征和预后。方法:此回顾性研究纳入了我院2010年至2020年间279例临床资料完整的年轻肺癌患者分析其临床特征。此研究纳入我院2010年至2020年间419例进行下一代测序检测（next-generation sequencing,NGS）的年老肺癌患者（>40岁）来比较年轻组和年老组肺癌患者分子特征的差异,探讨了年龄依赖性突变频率。单变量和多变量分析用于发现晚期年轻患者的预后因素。结果:腺癌是年轻肺癌患者的主要病理亚型;大多数我国年轻患者被诊断为早期肺癌,且TNM分期与体检显著相关（P＜0.001）。年轻组的EGFR突变频率明显低于年老组（P=0.047）。年轻组ALK（P＜0.001）、ROS1（P＜0.001）和ERBB2（P=0.001）的变异率显著高于年老组。单变量和多变量分析显示女性（HR,0.541;95%CI:0.308~0.950）（P=0.032）、吸烟史（HR,2.829;95%CI:1.083~7.389）（P=0.034）、单纯化疗（HR,3.242;95%CI:1.390~7.565）（P=0.007）和单纯分子靶向治疗（HR,2.227;95%CI:1.077~4.607）（P=0.031）是影响晚期年轻肺癌患者PFS的独立因素。结论:我国年轻肺癌患者以腺癌和早期肺癌为主。具有独特的分子特征,因此检测其分子特征并积极治疗更为有益。     

Breast Cancer in Young Women from a Low Risk Population in Nepal

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low comparedto Western countries. However, the incidence of breast cancer among young women is relatively high. Breastcancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features.The aim of this study was to investigate clinico-pathological and biological characteristics in younger breastcancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Ninehundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery,Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, wereretrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. Themean age was 34.6±5.0 years among younger patients compared to 54.1±9.9 for those ≥40 years. The mean age atmenarche was also significantly lower (13.5±1.5 vs 14.2±1.5 years p=0.001) while the mean duration of symptomswas significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of theyoung women versus 0.3% in the older one. Mammography was performed less frequently in younger patients(59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women (5.0±2.5 vs4.5±2.4cm, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients.In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, p≤0.05). Theproportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportionof younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type wasductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients(55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2%vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion oftriple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in youngNepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advancedstage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young womenis worth special attention for earlier detection.     

Decisions for extent of gastric surgery in gastric cancer patients: younger patients require more attention than the elderly

BACKGROUND AND OBJECTIVES: There is a prevailing belief that young patients with gastric adenocarcinomas have a more aggressive disease. METHODS: We reviewed the prospectively collected database of 753 gastric adenocarcinomas patients who had undergone curative gastrectomy. Clinicopathological factors and the survival rates for each pathological TNM stage were compared between patients younger than 40 years of age and the others. RESULTS: Fifty-four (9.8%) patients were younger than 40 years of age. The overall accuracy of the intra-operative stage was 62.5%; 54.0% in the young patients and 63.5% in older patients (P = 0.006). Intraoperative under-staging was more commonly seen in the younger patients when compared to the older patients. These trends were more prominent in patients with surgical stage I disease. Age proved to be an independent risk factor influencing the accuracy of intraoperative staging using a logistic regression analysis. There was no difference in overall 3-year survival rate between the two age groups for each pathological TNM stage. CONCLUSIONS: The present study showed that intra-operative under-staging was more common in young patients with gastric cancer, especially with stage I disease. This finding raises the concern for inaccurate diagnosis and surgical under treatment in younger patients with stage I gastric cancer.     

Adenocarcinoma of the lung in young patients: the M. D. Anderson experience

BACKGROUND: Surveillance, Epidemiology, and End Results (SEER) data for the years 1973-1992 documented that patients age < 50 years presented with more advanced disease. Because of the increase in the incidence rate of lung adenocarcinoma in the past few decades and the presentation of more advanced disease in young patients, this study was performed to determine whether differences in survival exist between younger and older patients with this disease. METHODS: The authors reviewed the experience of the University of Texas M. D. Anderson Cancer Center between 1985-1994, encompassing 157 patients age < 40 years of 4097 patients registered with adenocarcinoma of the lung. For comparison, 157 patients age > 50 years with lung adenocarcinoma were selected; these patients were matched for gender, stage of disease at presentation, and definitive therapy modality to assess survival differences more accurately. Data regarding exposure to second-hand smoke were not collected secondary to lack of documentation in the charts reviewed. RESULTS: There were no significant differences between the 2 groups with regard to the overall survival rate (P = 0.34) or time to progression (P = 0.43). Smoking status (current vs. former vs. never-smoker) was not found to be predictive of survival in either the younger group (P = 0.51) or the older group (P = 0.92). CONCLUSIONS: The data from the current study indicate that overall survival and disease free survival rates were not significantly different in these two groups. Thus, the younger patient population should be treated similarly to the older patient population. However, a surprisingly high percentage of younger patients were female (45%) and had never smoked (27%), suggesting that risk factors other than active smoking may be involved in lung carcinogenesis in these patients.     

High-dose radiation therapy for elderly patients with inoperable or unresectable non-small cell lung cancer

PURPOSE: To evaluate definitive radiation therapy delivering doses in excess of 60 Gy for elderly patients aged 75 years or over with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: The treatment results for 97 patients aged 75 years or older (mean age 78 years; elderly group) with inoperable or unresectable NSCLC were retrospectively analyzed and compared with those for 206 patients younger than 75 year old (mean age 64 years; younger group). The elderly patients were classified into two groups; 67 patients aged 75-79 years (the elderly A) and 30 patients aged 80 years or older (the elderly B). Most of all patients were treated with a total dose of 60 Gy or more in 2 Gy daily standard fractionation. RESULTS: The overall 2 and 5 year survival rates were 32 and 13% for the elderly A group, and 28 and 4% for the elderly B group, respectively, compared with 36 and 12% for the younger group. There was not a statistically significant difference in survival rates among three groups. In stage I-II NSCLC patients there was also no significant difference in survival curves among the three groups. In patients with stage III disease, however, the survival curve of the elderly B was inferior to those of the younger group and the elderly A group, although the difference was not statistically significant. After the treatment the deterioration rate of the performance status was only 5% in the younger group and 8% in the elderly group. Only three younger and two elderly patients died of late pulmonary insufficiency associated with high-dose irradiation to the proximal bronchus. No other treatment-related event was observed except for mild acceptable acute complications in the elderly groups. CONCLUSIONS: Definitive radiation therapy is recommended to the elderly aged 75 years or older with inoperable or unresectable NSCLC, especially early stage disease, as an acceptable choice of treatment.     

Endometrial adenocarcinoma in young thai women

Objective: To evaluate the clinicopathological characteristics and survival analysis in endometrial adenocarcinoma women younger than the age of 40 years compare to older women. Methods: Medical records of 423 endometrial adenocarcinoma patients who received primary surgical treatment at King Chulalongkorn Memorial Hospital during 1996-2005 were reviewed. The patients were divided into two groups; 40 years of age or younger (group A, 42 patients) and older than 40 years (group B, 381 patients). Results: Up to 10% (42/423) of endometrial adenocarcinoma patients were younger than the age of 40 years. The higher incidence of nulliparous and obesity (BMI > 30 kg/m2) was significantly demonstrated in group A (81%/34.1% and 52.4%/25.2%, respectively). However, obesity was an only independent factor in multivariate analysis. No significant difference in surgical stage distribution and the other pathologic characteristics was demonstrated between both groups. However, poor histologic grade (grade 3) and deep myometrial invasion (myometrial invasion more than 50%) tended to be found more frequent in the patients older than the age of 40 years, although there was no statistical significance (16% versus 4.7% and 31% versus 14.3%, respectively). Moreover, synchronous ovarian cancer seemed to be higher in young patients (7.1% and 2.9%, p> 0.05). Median time to follow was 63 months (range-145 months). Five years disease free survival and 5 years overall survival were 87.3% and 92.4% in group A versus 83.8% and 88.0% in group B without statistical significance between both groups. Conclusions: Obesity was the only independent factor associated with endometrial adenocarcinoma in young patients. Distribution of the surgical stage and the other pathologic characteristics were similar between both groups without survival benefit in young patients.     

小于30岁低龄肺癌患者的临床分析

背景与目的青年肺癌患者肿瘤恶性程度高,侵袭性强,预后差,已成为多数共识。既往对青年肺癌患者的研究多以40岁或45岁为界,而<30岁的低龄肺癌患者临床资料少见报道。本文回顾分析了解放军总医院从1993年至今17年来诊疗过的<30岁的低龄肺癌患者的病史、分期、治疗及病理特点,为这一年龄段肺癌患者的诊疗提供参考。方法检索解放军总医院收治的1993年以来所有<30岁的肺癌患者,共计53例。其中非小细胞癌患者34例,小细胞癌患者19例。男女比例1.5:1。非小细胞肺癌患者中,腺癌27例,鳞癌6例,腺鳞癌1例,无大细胞癌患者。其中12例接受手术治疗,38例化放疗,3例放弃治疗。结果全组无住院死亡病例,12例手术患者中,手术根治性切除8例,姑息性切除4例。结论低龄肺癌患者腺癌,小细胞癌比例大,多数出现症状就诊时处于晚期,预后差。改善预后应重视常规体检,早期诊断。     

Poorer survival of elderly patients with ovarian cancer: a population-based study

OBJECTIVE: To compare ovarian cancer survival in elderly and young patients. MATERIAL AND METHODS: Using the Geneva Cancer Registry, we identify women diagnosed with primary ovarian cancer between 1980 and 1998. We compared tumors characteristics, treatment patterns of young patients (70 years) by logistic regression. To evaluate the effect of age on prognosis, we compared disease specific survival by Cox proportional hazard analysis, taking into account other prognostic factors. RESULTS: This study included 285 patient aged 70 years and 451相似文献   

Stage and treatment variation with age in postmenopausal women with breast cancer: compliance with guidelines

Breast cancer-specific mortality is static in older women despite having fallen in younger age groups, possibly due to lack of screening and differences in treatment. This study compared stage and treatment between two cohorts of postmenopausal women (55-69 vs >70 years) in a single cancer network over 6 months. A total of 378 patients were studied (>70: N=167, 55-69 years: N=210). Older women presented with more advanced disease (>70: metastatic/locally advanced 12%, 55-69 years: 3%, P<0.01). Those with operable cancer had a worse prognosis (Nottingham Prognostic Index (NPI) >70: median NPI 4.4, 55-69 years: 4.25, P<0.03). These stage differences were partially explained by higher screening rates in the younger cohort. Primary endocrine therapy was used in 42% of older patients compared with 3% in the younger group (P<0.001). Older women with cancers suitable for breast conservation were more likely to choose mastectomy (>70: 57.5% mastectomy rate vs 55-69 years: 20.6%, P<0.01). Nodal surgery was less frequent in older patients (>70: 6.7% no nodal surgery, 55-69 years: 0.5%, P<0.01) and was more likely to be inadequate (>70: 10.7% <4 nodes excised, 55-69 years: 3.4%, P<0.02). In summary, older women presented with more advanced breast cancer, than younger postmenopausal women and were treated less comprehensively.     

青年胃癌患者的临床病理特征及预后分析

目的:研究青年(≤35岁)胃癌患者的临床病理特征和预后的影响因素。方法:回顾性收集湖南省肿瘤医院2010年10月至2017年12月行根治性切除的2029例Ⅰ-Ⅲ期胃癌患者的临床病理资料,根据患者首次确诊时年龄大小分为青年组(n=75)和对照组(n=1954)。对比两组患者的一般状况、病理结果和长期生存等,采用χ²或t检验分别对比分析分类变量和连续变量,Kaplan-Meier法、Log-rank检验及Cox回归多因素分析预后影响因素。结果:青年组胃癌患者的平均年龄为30.13岁(19~35)岁,其中53.3%为女性。与对照组相比,青年组患者中女性患者的比例更高,术前白蛋白水平更高,全身合并症的发生率及术后并发症的发生率更低,术后住院时间更短,而接受新辅助化疗和辅助化疗的比例更高(均P<0.05)。青年组和对照组术后1、3和5年生存率没有统计学差异(94.6%、60.1%、54.2%vs 89.3%、67.7%、58.1%,P=0.601)。进一步Cox回归多因素分析显示,肿瘤病理分期是影响青年胃癌患者术后生存的主要因素。结论:青年胃癌患者以女性更为常见,早期发现,行根治性切除以后,接受辅助化疗等治疗,其预后与中老年患者相当。     

Very young women (<35 years) with operable breast cancer: features of disease at presentation.

BACKGROUND: Breast cancer rarely occurs in young women. Our knowledge about disease presentation, prognosis and treatment effects are largely dependent upon older series. MATERIALS AND METHODS: We evaluated biological features and stage at presentation for 1427 consecutive premenopausal patients aged < or = 50 years with first diagnosis of invasive breast cancer referred to surgery at the European Institute of Oncology from April 1997 to August 2000. A total of 185 patients (13%) were aged < 35 years ('very young') and 1242 (87%) were aged 35-50 years ('less young'). The expression of estrogen receptors (ER), progesterone receptors (PgR), presence of vascular invasion (VI), grading (G), expression of Ki-67, HER2/neu overexpression, pathological stage according to TNM staging system (pTNM), pathological tumor size and number of axillary lymph node involvement were evaluated. RESULTS: Compared with less young patients, the very young patient group had a higher percentage of tumors classified as ER negative (P < 0.001), PgR negative (P = 0.001), higher expression of Ki-67 > or = 20% of cells stained; 62.2% versus 53%, (P < 0.001), vascular or lymphatic invasion (48.6% versus 37.3%, P = 0.006), and pathological grade 3 (P < 0.0001). There was no difference between the two groups for pT, pathological tumor size (pN) and number of positive lymph nodes. CONCLUSIONS: We conclude that compared with less young premenopausal patients, very young women have a greater chance of having an endocrine-unresponsive tumor, and are more likely to present with a higher grade, more extensively proliferating and vessel invading disease. Pathological tumor size, nodal status and number of positive axillary lymph-nodes have a similar distribution among the younger and the older cohorts, thus not supporting previous data indicating more advanced disease in younger patients at diagnosis of operable disease.     

老年肺癌患者预后相关因素分析

目的分析>70岁的老年肺癌患者临床特征及其预后相关因素。方法收集2003年1月至2012年1月期间住院的110例肺癌患者的资料,分成>70岁(老年组,50例)与≤70岁(非老年组,60例)两组,比较两组的生存率及影响预后的因素。结果老年组和非老年组的1、2、3、4年生存率分别为74.0%、53.8%、11.6%、5.8%和81.4%、61%、41.9%、22.8%,差异无统计学意义(P>0.05)。单因素分析显示,分期、KPS评分、有无体重减轻是影响老年组肺癌患者预后的因素。多因素分析显示,分期、有无体重减轻是影响老年组预后的相关因素。结论分期、有无体重减轻是影响老年肺癌的独立预后因素,正确的分期结合功能状态评分,对老年肺癌的治疗具有指导意义。     

Ovarian cancer in younger vs older women: a population-based analysis

To compare the clinico-pathologic prognostic factors and survival of younger vs older women diagnosed with epithelial ovarian cancer. Demographic, clinico-pathologic, treatment, and surgery information were obtained from patients with ovarian cancer from the Surveillance, Epidemiology, and End Results Program from 1988 to 2001 and analysed using Kaplan-Meier estimates. Of 28 165 patients, 400 were <30 years (very young), 11 601 were 30-60 (young), and 16 164 were >60 (older) years of age. Of the very young, young, and older patients, 261 (65.3%), 4664 (40.2%), and 3643 (22.5%) had stage I-II disease, respectively (P<0.001). Across all stages, very young women had a significant survival advantage over the young and older groups with 5-year disease-specific survival estimates at 78.8% vs 58.8 and 35.3%, respectively (P<0.001). This survival difference between the age groups persists even after adjusting for race, stage, grade, and surgical treatment. Reproductive age (16-40 years) women with stage I-II epithelial ovarian cancer who received uterine-sparing procedures had similar survivals compared to those who underwent standard surgery (93.3% vs 91.5%, P=0.26). Younger women with epithelial ovarian cancer have a survival advantage compared to older patients.