Does your outlook change depending on whether your cancer returns?

This study looked at the risks of lung cancer recurrence (return after treatment) and mortality rates following recurrence. 

Treatment for early-stage lung cancer (cancer that has not spread to other areas) typically involves a combination of surgery, chemotherapy and radiation. Patients usually receive chemotherapy and/or radiation if their cancer has started to spread. However, cancer recurs in 30-70% of patients despite treatment. Because patients are less likely to survive following a recurrence, predicting whether a patient’s cancer might return is therefore very important. 

The current study examined the risk of recurrence, and the risk to overall survival, in lung cancer. 2098 patients were included in this study. Almost 80% of these patients were male, and the most common type of lung cancer was non-small cell lung cancer. Patients were compared based on their original stage of lung cancer, and whether or not their cancer was surgically treated. Patients were followed for 5 years.

After 5 years, 19% of patients were still alive. The stage of cancer at first diagnosis was associated with survival. Patients with stage 1 disease had a 34.2 times higher risk of mortality following a recurrence than following the original diagnosis. For patients with stage 4 disease, the risk was only 2.24 times higher following a recurrence.

Recurrence rates ranged from 33.9% to 62.8% for early stage patients who underwent surgery. The recurrence rate was 24.3% for stage 4 patients who did not undergo surgery. However, patients receiving non-surgical treatment had 32% risk of recurrence compared with 17% of surgical patients.

Patients who received surgical treatment had better outcomes than those with non-surgical treatment. Patients with stages 1–3a cancer who were not treated with surgery were 3.46 times less likely to survive than patients who underwent surgery. Patients with stages 3b–4 cancer who were treated with surgery were 60% more likely to survive than those who did not undergo surgery.

This study concluded that survival rates, risk of recurrence and the likeliness of cancer to spread is dependent on the initial stage of cancer.