Profiling of young patients with lung cancer: a retrospective 10-year analysis

<bold>Introduction:</bold> Lung Cancer (LC) incidence has been increasing over time. The diagnosis of LC in young patients is infrequent, but the disease course is often more aggressive in this group. <bold>Methods:</bold> Retrospective analysis of clinical records of LC patients 50 years old or younger at time of diagnosis, followed in the Oncology Clinic of our secondary hospital between January 2012-November 2023. We collected each patient’s demographic, clinical and histopathological data. <bold>Results:</bold> 1004 patients were evaluated; 67 who met the inclusion criteria were selected. More than half were male, the youngest being 35 years old. 80% of patients had smoking history. The most frequent comorbidity was Chronic Obstructive Pulmonary Disease. About a third of patients had family history of cancer, seven of whom had LC family history. Eight patients were diagnosed through incidental findings. Most lesions involved the right upper lobe (41.5%). The most common histological subtype was Adenocarcinoma (64.6%). 64.6% of patients were diagnosed with metastatic disease, 15.4% with early stage and 20% locally advanced. Regarding mutations, eight patients (12.3%) were EGFR positive, three had an ALK translocation and one ROS1. 10 of the 24 patients evaluated for PDL1 expression had a percentage higher than 50%. Most patients had ECOG performance status (PS) 0-1 (73.4%). 58.5% of patients have died. <bold>Conclusion:</bold> Although younger patients with LC have lower morbidity, a better PS and, thus, appear more suitable for treatment, the disease course is often aggressive and patients present unfavorable response to treatment. Gene mutation and PD-L1 assessment are standard practice but can be especially significant in this subgroup of patients.