2543 - Clinical and Pathological Characteristics of Exceptionally Young Patients with Multiple Primary Lung Cancers (ExY-MPLC) - Updated Data
Presenter(s)
X. Zhang1, X. Wu2, X. Wu3, M. Xu4, and Y. Liu2; 1Department of Radiation Oncology, Peking University Shenzhen Hospital,Shen Zhen,China, shenzhen, Guangdong, China, 2Department of Radiation Oncology, Peking University Shenzhen Hospital, Shenzhen, China, 3Department of Oncology, Peking University Shenzhen Hospital, Shenzhen, China, shenzhen, Guangdong, China, 4Department of Radiation Oncology, Peking University Shenzhen Hospital, Shenzhen, China, shenzhen, Guangdong, China
Purpose/Objective(s): Exceptionally young multiple primary lung cancer (ExY-MPLC) in patients under 30 y/o is an exceptionally rare and understudied clinical phenomenon. To address the paucity of data, this study characterizes the clinical and pathological patterns, management approaches, and outcomes in this unique cohort of ExY-MPLC patients, aiming to inform early diagnosis and therapeutic decision-making.
Materials/Methods: We conducted a retrospective review of 45 ExY-MPLC patients (including 94 tumors) aged <30 y/o treated at our institution from December 2019 to February 2025. Comprehensive data on demographics, tumor spatial distribution, surgical interventions, and histopathological features were analyzed.
Results: Out of 45 patients, 15 patients (33.3%) were aged =25 y/o and 30 patients (66.7%) were aged 26–30 y/o, with a striking female predominance (75.6%). Most patients were never-smokers (88.9%), and 13.3% reported familial cancer history. Tumor localization patterns revealed 28.9% within the same lobe, 55.6% ipsilateral, and 15.6% bilateral. Among 94 tumors, the distribution across different lung lobes was as follows: left upper lobe (LUL, 27.7%), left lower lobe (LLL, 17.0%), right upper lobe (RUL, 17.0%), right middle lobe (RML, 13.8%), and right lower lobe (RLL, 24.5%). All patients presented with synchronous tumors and underwent synchronous surgical intervention. Pathological heterogeneity was prominent, with 62.2% exhibiting distinct histologic subtypes between tumors, whereas 37.8% demonstrated concordant subtypes. Adenocarcinoma in situ (43.6%) and minimally invasive adenocarcinoma (54.3%) predominated, with invasive adenocarcinoma accounting for only 2.1%. Tumor staging revealed 40.4% were Tis, 59.6% were T1mi. The TNM staging classified 40.4% of tumors as stage 0, 59.6% as stage IA1.
Conclusion: ExY-MPLC is characterized by a high prevalence of non-smoking females, a notable proportion of family history, higher prevalence of synchronous tumors and early-stage adenocarcinomas. These findings highlight the necessity of exploring genetic predispositions and refining surveillance protocols for this distinct population.