Supervisors info:
Συρίγος Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κατσουγιάννη Κλέα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ροδοπούλου Σοφία, Διδάκτωρ, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction: Lung cancer is the most common cause of death from cancer worldwide. It is very difficult to make the prognosis for it, because it is a very harmful disease and the limited number- until now–of therapeutic solutions, having at the same time 5-year survival percentages not over 20%. The NSCLC constitutes the 85% of lung cancer incidents, while it can be divided in three main subtypes of lung cancer; Adenocarcinoma, Squamous Cell Lung Carcinoma and Large Cell Lung Carcinoma. It is more common on older adults with mean age at diagnosis to be the 70 years old. Nevertheless, there is an important small percent of patients who are younger than 50 years old. Studies have shown that younger patients are more frequently diagnosed with advanced stages of the disease and some of them make a notion of very aggressive disease.
Purpose: The scope of this dissertation is to investigate the clinical, histological and molecular characteristics of young patient’s age less than 50 years old and older patients age over 50, find their differences and some associations with the Progression Free Survival (PFS), Overall Survival (OS) and the probabilities for mutation of the EGFR gene.
Methods: Our study constitutes of 1242 patients with NSCLC from the oncological department of «Sotiria» Hospital during the period 2014-2020. All the cases of non-small cell lung cancers which were verified clinically or pathologically, where collected as well as the demographics and clinicopathological characteristics of these patients. We were interested in determining the Overall Survival of the patients and then to find the Progression Free Survival and the percentages for someone to be found with EGFR(+). We used Cox Proportional Hazards Models and Logistic Regression Models in each appropriate case, while we have adjusted for several confounding factors.
Results: In general, we did not find any difference in overall survival between the two age groups. The same was true for the progression free survival where we did not find any statistical significant difference. Nevertheless, we found that young patients have higher probabilities than the older patients to be found with positive EGFR. Analytically, even if it was found that young patients have 20% less percentages to die from the older patients (HR = 0.703; 95% CI: 0.431-1.145) this result did not found statistically significant (p-value = 0.077). Statistically significant was found that women had 23% less hazard to die from the older patients (HR = 0.774; 95% CI: 0.583-1.028; p-value = 0.077). Adenocarcinoma was more common in young patients (83.6%) than in older patients (55.3%), while Squamous carcinoma was more common in older patients than young patients (35.3% vs 8.2%). There was not any statistically significance difference between the two age groups about the staging (p-value = 0.714) and the number of symptoms (p-value = 0.349). On the other hand, older patients had 74%lower chances (OR = 0.264; 95% CI: 0.108-0.683) to be found with EGFR(+) and this result was statistically significant (p-value = 0.004). Last but not least for the progression free survival, young patients had higher risk, around 20%, (HR = 1.208; 95% CI: 0.782-1.865) from the older patients, but this result was not statistically significant (p-value = 0.395).
Conclusions: In this study we have shown that there is no significant difference in overall survival between the young versus older patients. Of course, we need to investigate more this relationship in the future and more studies are needed to be conducted.
Keywords:
Survival analysis, Non-small cell lung cancer, Lung cancer, Retrospective study
