Non small cell lung cancer natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2], Maria Fernanda Villarreal, M.D. [3]
Overview
If left untreated, non-small cell lung cancer progression occurs slowly and is then followed by local invasion to lymph nodes and distant metastasis. Non-small cell lung cancer is a locally aggressive tumor, which commonly occurs in adult patients between 65 to 74 years. Common sites of metastasis include the adrenal gland, bone, brain, and liver. Complications of non-small cell lung cancer include acute respiratory failure, respiratory acidosis, malignant pleural effusion, metastases, and pneumonia. The 5-year relative survival of patients with non-small cell lung cancer is approximately 50%. Features associated with worse prognosis are presence of lymphatic invasion, location of lesion, gene expression profile, performance status, presence of satellite lesions, and presence of regional or distant metastases. Prognosis is generally regarded as poor with an all-stage average survival rate of 25%. The 5-year recurrence rate of non-small cell lung cancer is approximately 24%.
Natural History
The majority of patients with non-small cell lung cancer are initially asymptomatic.[1]
- The symptoms of non-small cell lung cancer usually develop in adult patients between 65 to 74 years.
- Initially, patients complain of chronic cough, diaphoresis, and weight-loss.[2][3]
- If left untreated, patients with non-small cell lung cancer may develop local invasion to lymph nodes and distant metastasis.
- Common sites of metastasis include the adrenal gland, bone, brain, and liver.
Complications
Common complications of non-small cell lung cancer, include:[1]
Prognosis
Non-small cell lung cancer prognosis and recurrence depends on the origin of primary tumor, histological type, and stage.[1]
- Non-small cell lung cancer prognosis is generally regarded as poor.
- Non-small cell lung cancer survival rate ranges from 1% to 52% (stage I to stage IV).
- The recurrence rate of non-small cell lung cancer is 24%.
The development of complications is associated with worse prognosis. The median survival time of non-small cell lung cancer following a cancer-related complication, such as malignant pleural effusion, is approximately 1 to 3 months.[4]
- Features associated with worse prognosis, include:
- Presence of lymphatic invasion
- Unfavorable genetic expression profile
- Location of lesion
- Performance status
- Presence of satellite lesions
- Presence of regional or distant metastases
- The table below summarizes the 5-year survival rate according to non-small cell lung cancer stage:
Stage 5-year survival rate IA 49% IB 45% IIA 30% IIB 31% IIIA 14% IIIB 5% IV 1%
References
- ↑ 1.0 1.1 1.2 Soares M, Darmon M, Salluh JI, Ferreira CG, Thiéry G, Schlemmer B, Spector N, Azoulay E (2007). "Prognosis of lung cancer patients with life-threatening complications". Chest. 131 (3): 840–6. doi:10.1378/chest.06-2244. PMID 17356101.
- ↑ Travis WD; Brambilla E; Müller-Hermelink K; Harris C; Kleihues C; Sobin P. https://www.iarc.fr/wp-content/uploads/2018/07/BB10.pdf
|chapterurl=missing title (help) (PDF). World Health Organization Classification of Tumours; Pathology and genetics of tumors of the lung, pleura, thymus, and heart. IARC Press. pp. 53–58. ISBN ISBN 92 832 2418 3 Check|isbn=value: invalid character (help). - ↑ Travis WD; Brambilla E; Müller-Hermelink K; Harris C; Kleihues C; Sobin P. https://www.iarc.fr/wp-content/uploads/2018/07/BB10.pdf
|chapterurl=missing title (help) (PDF). World Health Organization Classification of Tumours; Pathology and genetics of tumors of the lung, pleura, thymus, and heart. IARC Press. pp. 53–58. ISBN ISBN 92 832 2418 3 Check|isbn=value: invalid character (help). - ↑ Muduly D, Deo S, Subi T, Kallianpur A, Shukla N (2011). "An update in the management of malignant pleural effusion". Indian J Palliat Care. 17 (2): 98–103. doi:10.4103/0973-1075.84529. PMC 3183615. PMID 21976848. Vancouver style error: initials (help)