According to an article recently published in the journal Chest, patients with Stage I (earliest stage) non–small cell lung cancer (NSCLC) have a median survival time of nine months, with only 6% of patients surviving for five years, if their cancer is left untreated. Because of this short survival time, treatment following diagnosis should not be delayed.
Lung cancer remains the leading cause of cancer-related deaths in the United States. The majority of lung cancers are not detected until the disease has already spread from its site of origin, which is why long-term survival remains suboptimal for this disease.
Patients with NSCLC whose cancer is still small and has not spread from its site of origin can achieve high rates of long-term survival with standard therapies. However, no studies have reviewed population-based data regarding the natural course of outcomes when Stage I NSCLC is left untreated.
Researchers from California recently conducted a study including 1,432 patients in the California Cancer Registry between 1989 and 2003 with Stage I NSCLC. These patients did not receive any surgery, chemotherapy, or radiation therapy. The following was observed:
- Overall survival at five years was 6% for Stage I NSCLC.
- Overall survival at five years was 11% for patients who were recommended surgery to remove their cancer but who refused.
- Median survival overall was nine months for patients with Stage I NSCLC and 14 months for those who were recommended surgery but refused.
- The vast majority of patients died from lung cancer.
The researchers concluded: “Long-term survival with untreated Stage I NSCLC is uncommon, and the vast majority of untreated patients die of lung cancer.” The authors also stated that “surgical resection or other ablative therapies should not be delayed even in patients with small lung cancers.” It is recommended that patients diagnosed with early NSCLC speak with their physician regarding their individual risks and benefits of immediate therapy.
Reference: Raz D, Zell J, Ou I, et al. Natural history of Stage I non-small cell lung cancer. Chest. 2007; 132:193-199.
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