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Clinical characteristics and survival in early-onset lung cancer: a multicenter cohort study
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DOI：10.3389/fonc.2026.1906257.png)
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Abstract
En 中文
IntroductionThe characteristics of early-onset lung cancer (EOLC) have not been extensively studied. Our research aimed to comprehensively assess the clinicopathological; genetic features and prognosis of EOLC.Materials and methodsIn this retrospective study of lung cancer patients diagnosed at 26 Chongqing hospitals between January 2019 and December 2022 (18-74 years); we stratified them into early-onset lung cancer (<50 years) and late-onset lung cancer (≥50 years) groups. Furthermore; we used propensity score matching to balance baseline characteristics; compare overall survival and lung cancer-specific survival between early-onset lung cancer (EOLC) and late-onset lung cancer (LOLC) groups; and perform subgroup comparisons.ResultsA total of 6; 883 lung cancer patients were included in the final analysis; comprising 690 patients with EOLC and 6; 193 patients with LOLC. Compared with the LOLC group; the EOLC group had more females and never-smokers. In clinical features; EOLC patients predominantly had adenocarcinoma (69.7% vs. 52.2%); more often presented with stage IV disease (49.3% vs. 44.0%); and had higher rates of bone (22.8% vs. 16.9%) and brain metastases (18.4% vs. 10.8%); yet were more likely to undergo surgery (31.0% vs. 22.4%). Significant differences in mutation rates were observed for HER2 (10.1% vs. 1.6%). After propensity score matching; late-onset was identified as an independent risk factor for adverse survival outcomes; the median overall survival was 42.7 months for EOLC versus 32.9 months for LOLC; with 1-; 3-; and 5-year survival rates of 78.0%; 54.4%; and 42.2% in the EOLC group; compared with 75.5%; 47.8%; and 35.4% in the LOLC group.ConclusionsDespite more aggressive clinicopathological features; EOLC was associated with better survival outcomes. Moreover; distinct driver gene alteration profiles highlight the need to identify targetable alterations and implement targeted therapy in this enriched population.
Keywords:
prognosis
survival
molecular
clinical characteristic
early-onset lung cancer
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