2012;4(5):474-84. doi:10.3978/j.issn.2072-1439.2012.05.11, Pinto JA, Vallejos CS, Raez LE, et al. National Institutes of Health. (D) Survival analysis by treatment, all cancer deaths. The most prevalent treatment was radiotherapy plus chemotherapy (30.3%), followed by chemotherapy (23.7%), surgery plus chemotherapy (8.9%), and surgery plus radiotherapy plus chemotherapy (6.6%).
Survival analysis by sex, cancer deaths.
A stage 3 lung cancer diagnosis can be daunting, but the fact that it is "advanced" does not mean it is untreatable. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07, Lu T, Yang X, Huang Y, et al. JCO Oncology Practice Different from clinical trials, in general, PS0/1 are accepted, but these patients are not selected; the prescriber should carefully look at all inclusion criteria of the approval-treatment study so that we can drop the disparities between the clinical benefit of the clinical trials and the clinical benefit of the real-world evidence, once those inclusion criteria will be applied precisely to the sample population that is designed. Cancer Manag Res. Variables with P < .20 in the univariate analysis were included in the Cox regression analysis with the backward elimination method (P < .05 to stay). Reviewers These recipes focus on antioxidant-rich foods to better protect you and your loved ones. A 2015 study from the University of Nebraska reported that 73% of the 5,683 participants with lung cancer had a comorbid illness. 2011;3:139-48. doi:10.2147/CLEP.S17191, Zappa C, Mousa SA. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Since our study includes an extensive period of data collection, a significant number of patients who have undergone chemotherapy plus radiotherapy did not benefit from recent or more advanced therapeutical tools like immunotherapy. Oncol Lett. TABLE 1 Number and Percentage of Patients With Stage IIIA Lung Cancer (N = 3,363). Small cell lung cancer (SCLC) is an aggressive type of lung cancer that often spreads quickly. More recent drugs and equipment may be responsible for some differences between our study and more recent publications. Many can live for far longer than this. Lung cancer survival rates in general tend to decrease the older you get. According to 2014 research publishing in Oncology Letters, the median survival time for people with post-surgical recurrence (for all stages) is 21.9 months. Both methods have their benefits and drawbacks. Nodal status was confirmed by thorax computed tomography (CT), positron emission tomography-CT, or invasive stage of the mediastinum with mediastinoscopy. stage 3 non-small cell lung cancer (NSCLC), Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications, Lung and bronchus cancer SEER 5-year relative survival rates, 2010-2016 bystage at diagnosis and age, both sexes, all races (includes Hispanic), Tobacco smoking after diagnosis of cancer: Clinical aspects, Quantified smoking status and non-small cell lung cancer stage at presentation: analysis of a North Indian cohort and a systematic review of literature. Cancer Research UK. Also, when it is mentioned as a better prognosis in the surgery subgroup and with the smaller tumors, we might have an omitted variable bias, as although all tumors were IIIA stage, lymph nodes were not accessed, and there was not a correlation between T stage (or a tumor cutoff measure) and surgery in this cohort.
The local research ethics committee previously approved this study, registered under protocol 49258615.4, and informed consent was not required. Limiting processed foods and red meats can help ward off cancer risk.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. For people undergoing surgery for stage 3a NSCLC, a pre-operative course of chemotherapy (called neoadjuvant chemotherapy) can improve survival times, in part by lowering the risk of lung cancer recurrence. (C) Survival analysis by patients' region, cancer deaths. Descriptive analysis using central tendency, absolute and relative frequencies, and dispersion measures was performed. Still, compared with the PACIFIC trial three-year OS patients', our study has shown worse global survival rates in the therapeutical modalities that include surgical approach as indicated in the international guidelines.
Studies have shown that smoking not only reduces the response rates to cancer therapy compared to quitting (45% vs. 75%, respectively) but also cuts the two-year survival rates by 41%., In people with stage 3 NSCLC specifically, heavy smoking (defined as more than 60 pack-years) after the diagnosis decreases the probability of survival by almost 30% compared to quitting.. This advanced stage of the disease, in which the primary tumor has begun to invade nearby lymph nodes or structures, is sometimesbut not alwaysable to be treated with surgery. ASCO Author Services Read our, How Non-Small Cell Lung Cancer Is Diagnosed, How Non-Small Cell Lung Cancer Is Treated. Our study has also evidenced that the patients submitted to the multimodal treatment, including surgery, were well selected, bearing in mind the survival benefit regarding the chemotherapy plus radiotherapy treatment. These characteristics generally influence the treatment response rate and survival times in people with NSCLC.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. How Is Lung Cancer Treated in Older Adults? The Oncocentro Foundation of Sao Paulo (FOSP) partially granted this article.
Some limitations of this study include the lack of availability of chemotherapy schemes and radiotherapy dosages, and unfortunately, in our study, we also could not distinguish the rate of patients referred to sequential or concurrent chemoradiotherapy treatment. Asian Pac J Cancer Prev. When treated with chemotherapy and radiotherapy for patients deemed unresectable, survival time could be more effective, as reported by Gray et al19 in the PACIFIC 3-year OS study, showing the average OS time of 57 months with immunotherapy use in patients with stage III NSCLC. In the Cox multiple regression analysis, the independent risk factors related to all-cause deaths included sex, age, patients' region, the proposed treatment, and the histologic cancer type. Stage III non-small-cell lung cancer: Population-based patterns of treatment in British Columbia, Canada, Concurrent chemo-radiotherapy in non-small cell lung cancer, Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer, Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC, Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: A phase III randomized controlled trial, Comparison of survival rates after a combination of local treatment and systemic therapy vs systemic therapy alone for treatment of stage IV non-small cell lung cancer, Systemic therapy treatment patterns in patients with advanced non-small cell lung cancer (NSCLC): PIvOTAL study, Delay in diagnosis: The experience in Denmark, Eligibility for concurrent chemotherapy and radiotherapy of locally advanced lung cancer patients: A prospective, population-based study, Quality of integrated care for patients with non-small cell lung cancer: Variations and determinants of care, Palliative systemic therapy for advanced non-small cell lung cancer: Investigating disparities between patients who are treated versus those who are not, Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small-cell lung cancer, Sequential vs concurrent chemoradiation for stage III non-small cell lung cancer: Randomized phase III trial RTOG 9410, Professional English and Academic Editing Support, http://creativecommons.org/licenses/by-nc-nd/4.0/, 2318 Mill Road, Suite 800, Alexandria, VA 22314, 2022 American Society of Clinical Oncology. In the univariate analysis, the risk of all-cause death was HR = 0.75 (95% CI, 0.70 to 0.82; P < .001), 1.26 (95% CI, 1.14 to 1.38; P < .001), 1.46 (95% CI, 1.33 to 1.60; P < .001), and 0.74 (95% CI, 0.63 to 0.87; P < .001) respectively, related to female patients, patients age between 61 and 70 years, patients age older than 70 years, and patients from other states (Table 6). The staging of non-small cell lung cancer (NSCLC) involves the TNM classification system, which categorizes the disease based on the tumor's size and extent (T), whether lymph nodes are affected (N), and whether cancer has spread, or metastasized, to distant organs (M).
Prognosis of recurrent non-small cell lung cancer following complete resection. Lung cancer surgery is indicated only for stage 3a NSCLC. There are six factors known to influence survival rates in people with stage 3 lung cancer. J Thorac Oncol. Our real-life 19-year cohort study has shown that only 30.3% of the total patients with stage III NSCLC have been submitted to standard chemotherapy and radiotherapy treatment. The histologic cancer type included adenocarcinoma, squamous cell carcinoma, large-cell lung carcinoma, NSCLC (it was not possible to identify histologic subtype after immunohistochemical analysis), undifferentiated carcinoma, and others. The patients who had undergone treatment for other neoplasms and those with small-cell lung cancer were excluded. doi:10.21037/tlcr.2019.04.01, Singh N, Aggarwal AN, Gupta D, Behera D, Jindal SK.
2018;3(3):e000344. There are varying five-year survival rates for stage 3 non-small cell lung cancer (NSCLC), ranging from as high as 33% to as low as 13%. Clin Epidemiol. Male sex is considered an independent indicator of poorer outcomes in people with lung cancer in general. Additionally, 15.5% of patients were treated with the standard treatment, as indicated in the recent guidelines that include chemotherapy plus surgery or chemotherapy plus surgery plus radiotherapy. In some studies, nearly half of all patients with advanced NSCLC did not receive any systemic therapy because of a poor performance status.36, The multivariate risk factors associated with OS in patients with stage III lung cancer have shown that the multimodal treatment surgery plus radiotherapy plus chemotherapy or chemotherapy plus surgery significantly decreased the risk of death.
The patients with large-cell lung carcinoma were those with an increased risk of all-cause death compared with patients with adenocarcinoma, adjHR = 1.42 (95% CI, 1.14 to 1.76; P = .002; Table 7). AJCC stage groupings and TNM definitions. This real-life observational study has provided additional valuable evidence of the patients' profile treated in reference cancer centers as well cancer and all causes of mortality. Lung cancer is currently the first-ranking cause of cancer-related deaths globally, accounting for 17% and 9% of all cancers in men and women, respectively,1-5 accounting for more than 1.8 million deaths in 2020 (18.0% of the total). (F) Survival analysis by histologic cancer type, all-cause deaths. All histologic types increase the risk of death by cancer than adenocarcinoma (Table 4). The loss of performance status was probably the leading cause of 21% of patients submitted to other treatment and 23.7% submitted to chemotherapy only. What Is Stage 2 Lung Cancer Life Expectancy? Stage 3 NSCLC is further divided into three substages: Can often be treated with surgery in much the same way as stage 1 and stage 2 lung cancer, albeit with a greater risk of recurrence, Considered inoperable and are primarily treated with chemotherapy and radiation therapy. The epidemiology of lung cancer. 10 Reasons to Quit Smoking After Getting Cancer, Quality of Life After Lung Cancer Surgery.
Lung cancer survival statistics: One-, five-, and 10-year survival for lung cancer, Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and End Results Program, Non-small cell lung cancer: current treatment and future advances, Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades, Prognostic factors in stage III non-small-cell lung cancer patients, Comorbidity and survival in lung cancer patients, Prognosis of recurrent non-small cell lung cancer following complete resection, Improved survival associated with neoadjuvant chemoradiation in patients with clinical stage IIIA(N2) non-small-cell lung cancer. These common scenarios may explain our finding that 54.1% of patients were not treated with standard therapy (chemotherapy, other treatments, and best supportive care).
Contact Us The median cancer-specific survival (in months) was 19.3 (95% CI, 17.9 to 20.9) in patients submitted to radiotherapy plus chemotherapy, 12.1 (95% CI, 11.1 to 12.9) to chemotherapy, 36.9 (95% CI, 29.6 to 43.2) to surgery plus chemotherapy, and 41.3 (95% CI, 32.1 to 61.3) to chemotherapy plus radiotherapy plus surgery. ASCO Career Center Certain stage 3 lung cancers can be cured, and others can be effectively be managed with longer progression-free survival time than ever before. Editorial Roster
Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments). Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P. Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications. The life expectancy of a person with stage three lung cancer is influenced by multiple factors, such as how far the cancer has spread to other areas in the body. Curran et al evaluated whether sequential or concurrent chemotherapy is the optimal combination strategy in a three-arm phase III trial. This may show a substantial difference between the recruited clinical trials' patients and the real-life patients' characteristics in daily routine treatment.
Cancer Epidemiol Biomarkers Prev. In the same way, the frequency of positron emission tomography-CT and invasive mediastinal staging was not evaluated. The results have shown that the median survival times were 14.6, 17.0, and 15.6 months for a sequential arm and two concurrent therapies regimens, respectively.38 In our study, the median survival time in the chemotherapy and radiotherapy combined strategy was 19.3 months (95% CI, 17.9 to 20.9) to radiotherapy plus chemotherapy considering cancer-specific death, and 5-year OS was 12.8% (95% CI, 10.1 to 15.8). Differences in age, previous treatment, stage, nodal metastasis extension, and comorbidities in the patients enrolled in stage III lung cancer clinical trials limit the applicability of the results in the real-life general population attended in the oncologic hospitals.
In the Cox multiple regression analysis, the independent risk factors associated with CSS were sex, age, patients' region, the treatment, and the histologic cancer type. 7 JCO Clinical Cancer Informatics Transl Lung Cancer Res. 2019;10(13):3021-7. doi:10.7150/jca.30723, Jassem J. TABLE 6 Univariate Analysis of Risk Factors Associated With OS in Patients With Stage III Lung Cancer.
JCO Precision Oncology, ASCO Educational Book By understanding the factors that influence lung cancer survival, you can make informed choices about your health if you are diagnosed with stage 3 NSCLC.
With stage 3 NSCLC specifically, women have a five-year survival rate of 13.7% compared to 11.6% in mena 2% difference. While the TNM approach provides a generalized overview of survival times, there is wide variation in how stage 3 lung cancers can progress and are treated. Stage 3 lung cancer, for example, with a 13% five-year survival rate, falls into the same regional category as stage 2b, even though the latter has a 53% five-year survival ratea difference of nearly 40%. Enter words / phrases / DOI / ISBN / authors / keywords / etc. Patients with stage IIIA lung cancer are highly distinct from those included in clinical trials, resulting in limited use of the evidence presented in these studies. November 19, 2021. (A). TABLE 7 Multivariate Analysis of Risk Factors Associated With OS in Patients With Stage III Lung Adenocarcinomaa. Univariate and multivariate analyses were conducted to evaluate the primary patients' characteristics leading to better OS and cancer-specific survival. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. This study aimed to describe the patterns of treatment and primary clinical patients' characteristics in a real-life 19-year large cohort of patients with stage IIIA lung cancer and leading cancer and all-cause death risk factors to OS in these patients. This plays a significant role in stage 3 lung cancer life expectancy. In conclusion, our real-life cohort study, with lengthy follow-up, has shown that only 30.3% of the total patients with stage III NSCLC have been submitted to standard chemotherapy and radiotherapy treatment.
Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology.
All the authors would like to thank the administrative staff of the Epidemiology Directorate of Oncocentro Foundation of Sao Paulo (FOSP) for the data acquisition and cancer registry of the State of Sao Paulo (SISRHC).
Comparatively, stage 2b and stage 3a lung cancers have similar features and treatment approaches, as do stage 3b and stage 4a lung cancers.
These statistics are based on people of different ages, some of whom are in good health and others of whom are not. The age-standardized incidence rate of lung cancer is 22.4 (31.5 in males and 14.6 in females) per 100,000 people, and the age-standardized mortality rate is 18.0 (22.4 in men and 11.2 in women) per 100,000 persons.4-15, More than 85% of newly diagnosed lung cancer are nonsmall-cell lung cancer (NSCLC), and nearly 30% of patients are in stage III on admission. TABLE 4 Univariate Analysis of Risk Factors Associated With CSS in Patients With Stage III Lung Cancer. ESMO Open. Multiple factors can influence life expectancy, some of which are modifiable and others that are inherent and non-modifiable. Conception and design: Fernando Conrado Abro, Frederico Rafael Moreira, Igor Renato Louro Bruno de Abreu, Marcelo Giovanni, Riad Naim Younes, Collection and assembly of data: Fernando Conrado Abro, Igor Renato Louro Bruno de Abreu, Marcelo Giovanni Marciano, Data analysis and interpretation: Fernando Conrado Abro, Frederico Rafael Moreira, Igor Renato Louro Bruno de Abreu, Riad Naim Younes, Final approval of manuscript: All authors, Accountable for all aspects of the work: All authors.
The median survival time in patients grouped by treatment type (in months) was 12.1 (95% CI, 11.1 to 12.9) to chemotherapy, 36.9 (95% CI, 29.6 to 43.2) to surgery plus chemotherapy, 19.3 (95% CI, 17.9 to 20.9) to radiotherapy plus chemotherapy, 41.3 (95% CI, 32.1 to 61.3) to chemotherapy plus radiotherapy plus surgery, 2.7 (95% CI, 2.3 to 3.5) in patients with palliative care and, 16.3 (95% CI, 13.7 to 19.8) in patients submitted to other treatments (surgery only or radiotherapy only or surgery plus radiotherapy; Table 2). With stage 3 NSCLC specifically, the median survival time for people lung adenocarcinoma is 30 months, and 18 months in those with squamous cell carcinoma, according to a 2016 study in the Asian Pacific Journal of Cancer Prevention. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center. Real-life stage III lung cancer studies are rare, and the patients followed are almost always in contrast with the best-fitted patients enrolled in clinical trials. Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: Patients, Clinical Stages, and Cancer Registry, Patients', Clinical Stages, and Treatment Characteristics, OS by Patients' Treatment: All-Cause Deaths, Univariate Analysis: OS and All-Cause Deaths, Multivariate Analysis: OS and All-Cause Deaths, AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST. National Cancer Institute. TABLE 3 Analysis of OS by Cancer Treatment in Patients Diagnosed With Stage III Lung Cancer. Nearly 54.1% of patients have not been treated with the standard treatment, according to the guidelines.