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, commonly occurs in patients in the fourth and sixth decade of life. Common sites of metastasis include adrenal gland, bone, brain, and liver. Complications of non-small cell lung cancer are usually related to the site of metastasis. The 5-year relative survival of patients with non-small cell lung cancer is approximately 50%. Features associated with worse prognosis are genetic markers, tumor size, associated conditions, clinical fitness for surgery, presence of lymphatic invasion, location of lesion, 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 50%. The 5-year recurrence rate of non-small cell lung cancer is 24%.[1]
Natural History
- Most patients with non-small cell lung cancer are initially asymptomatic.
- The symptoms of non-small cell lung cancer usually develop in the fourth and sixth decade of life.
- Initially patients complain of chronic cough, diaphoresis, and weight-loss.
- If left untreated, patients with non-small cell lung cancer may develop malignant pleural effusion, acute respiratory failure, pneumonia, respiratory acidosis, and distant organ metastases.
Complications
- Common complications of non-small cell lung cancer, include:[1]
Prognosis
- 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 prognosis for malignant transformation of non-small cell lung cancer will depend on the histological grade
- 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%