What is the prognosis of non-small cell lung cancer (NSCLC)?

Updated: Aug 27, 2019
  • Author: Sat Sharma, MD, FRCPC; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Most patients with stage I and stage II disease require preoperative or intraoperative mediastinal dissection for accurate staging prior to lung resection. The overall surgical mortality rate following lung resection is 3.7%. The mortality rate is higher (6-9%) in patients requiring pneumonectomy and in patients older than 70 years. The overall 5-five year survival rate may depend on whether the tumor is stage T1 or stage T2. The overall 5- and 10-year survival rates are 75% and 67%, respectively, in patients who undergo resection for stage I disease.

Patients with stage IA (T1 N0) disease have a significantly higher survival rate (82% at 5 yr) compared with those with stage IB (T2 N0) disease (68% at 5 yr and 60% at 10 yr). [8]

Patients with stage IIA (T1 N1) tumors have a survival rate of approximately 50% at 5 years, whereas patients with stage IIB (T2 N1 and T3 N0) tumors have a 40% survival rate.

Patients with stage IIIA (T1 or T2 N2) tumors have been reported to have a 5-year survival rate of 29%. The 5-year survival rate in patients with complete resection of stage IIIB tumors is 49% in T3 N0 disease, 27% in T3 N1 disease, and 15% in T3 N2 tumors. For patients with stage IV disease, the median survival is 8.5-21 weeks, and the 1-year survival rate is 10%.

See Non-Small Cell Lung Cancer Staging for summary tables.

The overall 5-year survival rate is grim because most patients with NSCLC present with locally advanced or metastatic disease. Approximately 65-80% of patients present with unresectable disease. At present, the National Cancer Institute and other medical associations and regulatory bodies do not recommend early screening for lung cancer as part of a periodic health examination.

A number of studies are currently under way to find improved treatments for non-small cell lung cancer. [9, 10, 11]


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