Stage 2 Lung Cancer Life Expectancy

6 Factors That Can Influence Survival Times

In This Article

Stage II non-small cell lung cancer is an intermediate stage of cancer in which the malignancy has begun to extend from the primary tumor to surrounding tissues. Although stage II lung cancers are still highly treatable, the progression of the disease from stage I can influence survival times.

Based on the cancer type and other factors (such as the size of the tumor and how far it has spread), stage II lung cancer has a five-year survival rate of between 53% and 60%. This means that 53% to 60% of people diagnosed at this stage will live for at least five years.

With that said, survival times are influenced by multiple variables, some of which can extend or reduce life expectancy. Knowing which risk factors are modifiable can help you make lifestyle changes to improve your chances of remission or disease-free survival.

Lung Cancer Staging

Lung cancer staging a process used to classify the severity of the disease. The staging of non-small cell lung cancer (NSCLC) utilizes the TNM system which determines the cancer stage based on the tumor's size and extent (T), whether nearby lymph nodes have cancer cells in them (N), and if there is evidence of the spread of cancer, also known as metastasis (M).

The cancer stage helps directs the appropriate course of treatment as well as predict the likely outcome (prognosis).

Stage II NSCLC is broken down into two substages:

  • Stage IIa lung cancer indicates a tumor size of between 4 centimeters and 5 centimeters (roughly 1½ inch and 2 inches, respectively). The tumor will also have grown into an airway or tissues surrounding the lungs. However, no lymph nodes will be affected, and there will be no evidence of metastasis.
  • Stage IIb lung cancer indicates that the tumor is either less than 3 centimeters (1¼ inch) in diameter and has spread to nearby lymph nodes, or a tumor is between 3 centimeters and 5 centimeters and has spread into the airways or surrounding tissues as well as nearby lymph nodes. There will be no evidence of metastasis.

NSCLC is staged differently than small cell lung cancer (SCLC), a less common form of the disease that is classified as either limited-stage or extensive-stage.

Stage II Survival Statistics

Cancer survival is typically described in terms of five-year survival rates. This is the percentage of people who live for a least five years following their diagnosis.

Epidemiologists and health authorities calculate survival in different ways. Some do so based on the TNM stage, while others calculate survival based on how extensively cancer has spread. Both methods have their advantages and drawbacks.

Survival Rates by TNM Stage

Estimating survival based on the TNM stage is an intuitive approach that "matches" stage to survival. Based on recent revisions to the TNM classification system, the five-year survival rate of stage II NSCLC is as follows:

5-Year Survival Rates by TNM Stage
Lung Cancer Stage 5-Year Survival Rate
IIa 60%
IIb 53%

Survival rates are not cast in stone. Some people can live well in excess of the five-year estimates, while others fall short. The drawback to the TNM approach is that certain basic factors—such as the location of the tumor and the degree of airway obstruction—can impact survival times and are not reflected in the estimates.

Survival Rates by Disease Extent

The National Cancer Institute utilizes a different approach to survival estimates under its Surveillance, Epidemiology, and End Results (SEER) Program. Rather than basing five-year estimates on the disease stage, the SEER program does so based on how extensively the cancer has spread. This is categorized in one of three ways:

  • Localized: No sign of cancer outside of the lung
  • Regional: Cancer that has spread to nearby lymph nodes or structures
  • Distant: Cancer that has spread to distant organs (metastatic disease)

One of the advantages of the SEER system is that is can be applied to both NSCLC and SCLC. On the downside, there is a significant overlap in definitions.

For example, stage I and stage IIa NSCLC are considered localized since there is no lymph node involvement. On the other hand, stage IIb NSCLC would be considered regional since lymph nodes are involved and, as such, would fall into the same category as stage IIIa NSCLC.

Under the SEER classification system, the five-year survival rate for stage IIa lung cancer is 59%, while the five-year survival rate for stage IIb lung cancer is 31.7%.

SEER 5-Year Survival Rates
Stage at Diagnosis Percent (%) Surviving
Localized 59%
Regional 31.7%
Distant 5.8%
Unstaged 8.3%

Factors Influencing Survival Rates

The course of stage II lung cancer can vary from person to person; there is no one set course. Multiple variables can influence five-year survival rates, some of which are modifiable and others of which are non-modifiable.

There are six distinct factors that are known to impact survival times in people with stage II NSCLC.

Variables that affect lung cancer survival
 Verywell / Emily Roberts

Age

Survival times in people with lung cancer tend to decrease in tandem with advancing age. This is in part because of diminishing general health but also because the immune system is less robust and less able to temper tumor growth. After the age of 60—the period in which most people with lung cancer are diagnosed—the five-year survival rate begins to drop precipitously.

5-Year Survival Rate by Age Group
Stage at Diagnosis Under 50 Ages 50-64 65 and Over
Localized 83.7% 67.4% 54.6%
Regional 47.7% 36.6% 28.3%
Distant 11% 7% 4.7%
Unstaged 32.1% 15.4% 6%

Sex

Sex also affects survival times in people with lung cancer, with women generally living longer than men. On the one hand, lung cancer tends to occur at a younger age in women; on the other, men are more likely to develop and die of the disease than women.

The variations in five- and 10-year survival rates are more than just incidental, affording women a nearly 20% improvement in five-year survival rates and a nearly 40% improvement in 10-year survival rates compared to men.

Lung Cancer Survival Rates by Sex
Sex 5-Year Survival Rate 10-Year Survival Rate
Women 19% 11.3%
Men 13.8% 7.6%
Overall 16.2% 9.5%

Performance Status

It is no surprise that your general health at the time of the diagnosis impacts how well you respond to treatment and how long you are likely to survive. People who are fit and active in their 70s, for example, are almost invariably more likely to do better than those in their 60s who are disabled due to their symptoms.

The ability to function in daily life with cancer is referred to as performance status (PS). It can be measured using one of two classification systems:

  • Eastern Cooperative Oncology Group (ECOG) Performance Status is a cancer-specific system that rates PS on a scale of 0 to 5 (0 being fully functional and 5 being dead)
  • Karnovsky Score is a generalized measure used in oncology and other diseases that rates PS on a scale of 0% to 100% (0% being dead and 100% being fully functional)

Based on the ECOG system, the five-year survival rate is delineated by performance status but is also described by median survival times (the amount of time in which 50% of people with the disease are still alive):

Lung Cancer Survival by Performance Status
Performance Status 5-Year Survival Rates Median Overall Survival
0 45.9% 51.5 months
1 18.7% 15.4 months
2 5.8% 6.7 months
3 0% 3.9 months
4 0% 2.4 months
5 Not applicable Not applicable

Smoking Status

Cigarette smoking not only increases your risk of getting cancer but decreases your survival time if you continue to smoke after being diagnosed or treated.

A 2010 review of studies in the British Medical Journal concluded that smoking after the diagnosis of early-stage lung cancer (stages I and II) reduces your five-year survival rate to 33%. This translates to a greater than 50% reduction in overall survival times for people with stage II NSCLC.

By contrast, quitting cigarettes increases five-year survival rates to around 70% independent of all other risk factors.

Lung Cancer Type

Not all lung cancers are the same. With NSCLC, some are more aggressive than others or inhabit different parts of the lungs. The three most common types include:

  • Lung adenocarcinoma: A type of NSCLC that develops in the outer edges of the lung and accounts for around 40% of all lung cancer diagnoses
  • Squamous cell lung carcinoma: A type that mainly affects the airways and accounts for 25% and 30% of all cases
  • Large cell lung carcinoma: A rare and typically aggressive form of NSCLC that can develop in any part of the lung

Each of these cancer types has different estimated survival rates, with lung adenocarcinoma being the most promising and large cell carcinoma being the least.

5-Year Survival Rates by NSCLC Type
NSCLC Type 5-Year Survival Rate
Lung adenocarcinoma 20.6%
Squamous cell lung carcinoma 17.6%
Large cell lung carcinoma 13.2%

Lung Cancer Surgery

Lung cancer surgery is a mainstay of treatment for stage II NSCLC. There are four types of surgery commonly used based on the size, location, and extent of the malignancy:

  • Wedge resection: Involves the removal of a wedge-shaped section of the lung, usually pursued if the tumor is small or there is a concern about lung function
  • Lobectomy: The preferred surgical method of surgery involving the removal one of the five lobes of the lungs (three on the right and two on the left)
  • Sleeve resection: Involves the removal of a part of the lung as well as a part of the main airway
  • Pneumonectomy: Involves the removal of an entire lung if the tumor’s location prevents less invasive surgeries

As a general rule, survival rates tend to decrease in tandem with the amount of lung tissue removed. This is especially true when comparing lobectomy to pneumonectomy.

According to a 2018 study published in the Journal of Thoracic Diseases, the five-year survival rate of people who undergo lobectomy is double that of those who undergo pneumonectomy (31.5% versus 15.6%, respectively).

This shouldn't suggest that pneumonectomy is "optional." In most cases, it is not, but there are borderline cases in which lobectomy may be considered, particularly in people with better performance status who are able to withstand adjuvant (secondary) chemotherapy or radiation therapy.

If a tumor is inoperable, a curative form of radiation, called stereotactic body radiotherapy (SBRT), may be used. SBRT can be just as effective as surgery in people with early-stage NSCLC with equal survival times.

A Word From Verywell

The survival time for people with lung cancer is rapidly improving compared to earlier generations. Back in the 1970s, the one-year survival rate for cancer was only 16%, increasing to 32% by 2011. Today, the rate is as high as 44%, with one in 10 women and one in 12 men living for 10 years or more.

It is important to remember that survival rates are only broad estimates of what to expect. By quitting cigarettes, exercising regularly, and pursuing a generally healthier lifestyle, you may not only be better equipped to cope with treatment but potentially extend your life expectancy as well.

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