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, patients with non-small cell lung cancer may progress to develop metastases to adjacent lymph nodes or distant organ metastases to liver, bones (spine), or brain. Common complications of non-small cell lung cancer include malignant pleural effusion, acute respiratory failure, and pneumonia. 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%.

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, and 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:

• Acute respiratory failure
• Respiratory acidosis
• Malignant pleural effusion
• Metastases
• Pneumonia

Prognosis

• Non-small cell lung cancer prognosis is generally regarded as poor, with an all-stage 5% survival rate of 52%.
• 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, such as:

Non–small cell lung cancer survival rate by stage

Stage	5-year survival rate
IA	49%
IB	45%
IIA	30%
IIB	31%
IIIA	14%
IIIB	5%
IV	1%

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