Bronchogenic carcinoma in patients younger than 40 years.

Bronchogenic carcinoma is reported to be more rapidly fatal in young persons than in older persons. We wondered whether young patients experience a more virulent form of lung cancer or whether other factors might contribute to poor survival. We reviewed the records of 113 Mayo Clinic patients younger than 40 years with histologically proven bronchogenic carcinoma diagnosed between 1956 and 1976. One hundred four patients (92%) had symptoms for a mean duration of 4 months before diagnosis. The disease was categorized as Stage I in 9 patients, Stage II in 6, and Stage III in 98. Fifty-six patients underwent thoracotomy. The procedure was curative in 17 and palliative in 14; in 25, the lesion was unresectable. Respective 1-year and 2-year survivals were 71% and 35% after curative resection and 79% and 28% after palliative resection. The 1-year survival was 82% for patients in Stage I, 40% for Stage II, and 26% for Stage III. Without resection, only 16% of patients lived 1 year or longer. Advanced disease at presentation characterized this group of young patients.