| [Objective]This article compares the clinical characteristics and metastasis patternsof lung cancer patients in different age groups,and to clarify the influence of age on prognosis,and then analyze the prognostic factors.[Method]200947 eligible lung cancer patients diagnosed from the year of 2010 to 2013 were selected from SEER database.According to the age of diagnosis,the patients were divided into eight groups on the basis of a 10-year-old age subgroup.Chi-square test was used to compare the clinical features and metastasis patterns of different age groups.Using KM analysis(Kaplan-Meier)to draw survival curves of different age groups.Comparing the overall survival rate and lung cancer specific survival rate among different groups by logrank test.Using log rank univariate analysis and cox proportional risk regression model multivariate analysis identified and analyzed the factors significantly related to prognosis.[Result]Among the 200947 patients enrolled in this study,the lung cancer patients aged between seventy-one and eighty years were the most(30.9%).With the age of eighty as dividing line,before the age of eighty,the number of people suffering from lung cancer increases with age increase.After the age of eighty,the number of people suffering from lung cancer become fewer.The proportion of male lung cancer patients in fifty-one to eighty age group(including fifty-one to sixty age group,sixty-one to seventy age group and seventy-one to eighty age group)is higher.In thirty-one to eighty age group,the proportion of white people in lung cancer patients increased with the age increase.The proportion of single patients in twenty-one to thirty age group(64.6%)and over ninty age group(70.4%)was significantly higher than that in other groups.The proportion of primary lung cancer located in the upper lobe was lower(28.3%)in the twenty-one to thirty age group than in the other age groups,and higher(30.3%)in the lower lobe.In terms of differentiation degree,the proportion of high differentiation in twenty-one to thirty age group was significantly higher than that in other groups(26%).Except those patients over 90 years old,the lowest proportion(31.5%)of patients with adenocarcinoma was in twenty-one to thirty age group.The percentage of patients with AJCC stage I in twenty-one to thirty age group was higher than that in other age groups(31.1%).The proportion of patients with AJCC stage IV in forty-one to sixty age group(forty-one to fifty age group,fifty-one to sixty age group)was higher(57.1%,54%).The proportion of lung cancer patients aged 21 to 30 and 31 to 40 who underwent surgical treatment was significantly higher than that in other age groups(53.5%and 35.2%).Before the age of fifty,the number of patients participate chemotherapy increased with age.After the age of fifty,the proportion began to decline.The proportion of participate surgery and chemotherapy were the lowest in over ninty age group among lung cancer patients(1.6%,4.8%).Compared with other age groups,lung cancer patients aged twenty-one to thirty had a higher proportion of bone metastases(26%).The proportion of brain metastasis was higher in thirty-one to sixty age group(18.2%,21.1%,19.3%).Seventy-one to eighty age group,eighty-one to ninty age group and over 90 age group had higher proportion in lung metastasis than that in other groups(20.6%,26.6%,34.9%).Univariate analysis showed that the overall survival rate of lung cancer patients was negatively correlated with age(except that two-year and three-year overall survival rates slightly increased in sixty-one to seventy age group).The specific survival rate of lung cancer did not always decrease with age.In the view of specific survival of lung cancer,from twenty-one to sixty,the older the age,the worse the prognosis.The age group 61-70,71-80 and 81-90 had similar prognosis,which was better than 51-60 years old and worse than 41-50 years old.The prognosis was the worst in the age group over 90 years old.Except age,gender,race,marital status,primary site,differentiation degree,pathological type,stage,chemotherapy and operation were independent prognostic factors affecting the overall survival rate of lung cancer patients(p<0.05).Independent prognostic factors affecting the specific survival rate of lung cancer patients included gender,race,marital status,primary site,hemisphere,degree of differentiation,pathological type,stage,surgery and chemotherapy(p<0.05).[Conclusion]1.The clinical characteristics of lung cancer patients in different age groups were significantly different2.Bone metastases are common in lung cancer patients aged 21-30 years old,brain metastases are common in lung cancer patients aged 41-50 years old,and lung metastases are common in lung cancer patients over 70 years old3.In the view of overall survival,the older the age,the worse the prognosis.4.According to the specific survival of lung cancer,the prognosis of 51-60 years old patients was the worst,except for those over 90 years old.There was no significant difference in prognosis among 61-70,71-80 and 81-90 years old patients5.Male,elderly,white,poorly differentiated and undifferentiated of tumors,late staging,primary location in bronchus,pathological type of small cell carcinoma are all poor prognostic factors.Married,primary site of tumors in the middle lobe,adenocarcinoma,chemotherapy and surgery have better prognosis. |
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