Prognosis
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Kleincellige en niet-kleincellige longkanker: diagnose, behandeling en opvolgingPublished by: KCELast published: 2013Cancer du poumon à petites cellules et non à petites cellules : diagnostic, traitement et suiviPublished by: KCELast published: 2013Survival
Survival after definitive treatment of non-small cell lung cancer depends principally on stage of disease and ability to undergo standard treatment. Patients with adverse prognostic factors, including poor performance status and pretreatment weight loss, have a worse prognosis irrespective of treatment. Male sex and age are also independent predictors of lower survival.[280][281]
Patients whose tumours are resected, usually with sampling of draining lymph nodes, are assigned a pathological stage. Pathological stage is more accurate than clinical stage, as clinical stage relies on radiographic imaging that has a finite sensitivity and specificity. Comparing outcomes (survival) of patients who are staged surgically with patients who are staged clinically is difficult for multiple reasons. Many of the medical contraindications that prohibit surgery, such as older age, poor performance status, severe concurrent medical illness, and poor pulmonary function, are independent prognostic factors for survival. Furthermore, surgical upstaging (e.g., finding cancer in lymph nodes that appeared uninvolved by preoperative imaging) is known to occur in more than 20% to 25% of patients with clinical stage I disease.[282]
With these caveats, the 5-year survival rates for patients undergoing surgical (pathological) staging are as follows: stage IA1: 90%; stage IA2: 85%; stage IA3: 80%; stage IB: 73%; stage IIA: 65%; stage IIB: 56%; stage IIIA: 41%; stage IIIB: 24%; and stage IIIC: 12%. Survival for clinically staged patients is as follows: stage IA1: 92%; stage IA2: 83%; stage IA3: 77%; stage IB: 68%; stage IIA: 60%; stage IIB: 53%; stage IIIA: 36%; stage IIIB: 26%; stage IIIC: 13%; stage IVA: 10%; and stage IVB: 0%.[283]
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