Stage 3 Lung Cancer Life Expectancy

6 Factors That Can Influence Survival Times

There are different five-year survival rates for stage 3 non-small cell lung cancer (NSCLC), ranging from as high as 33% to as low as 13%. This advanced stage of the disease, in which the primary tumor has begun to invade nearby lymph nodes or structures, is sometimes—but not always—able to be treated with surgery. This plays a significant role in stage 3 lung cancer life expectancy.

Still, there are many variables that can influence survival times. Some are out of your control, but others (like smoking) are modifiable and can increase life expectancy dramatically. By understanding the factors that influence lung cancer survival, you can make informed choices about your health if diagnosed with stage 3 NSCLC.

Characteristics of Stage 3 Lung Cancers

Lung cancer staging is primarily used to direct the appropriate course of treatment and predict the likely outcome (known as the prognosis).

The staging of non-small cell lung cancer (NSCLC) involves the TNM classification system, which categorizes the disease based on the tumor's size and extent (T), whether lymph nodes are affected (N), and whether cancer has spread, or metastasized, to distant organs (M).

Stage 3 NSCLC is further divided into three substages:

  • Stage 3a lung cancer is classified as locally advanced disease. This means that cancer has spread to lymph nodes on the same side of the lung as the primary tumor. Cancer may also be found in the bronchus, pleura, diaphragm, chest wall, breastbone, backbone, phrenic nerve, pericardium, vena cava, aorta, pharynx, trachea, esophagus, and/or carina (the area where the trachea attaches to the bronchus).
  • Stage 3b lung cancer is classified as advanced disease. It means that cancer has spread to the opposite side of the chest or to supraclavicular lymph nodes located above the collarbone. Additional tumors may also be found in the same area as the primary tumor.
  • Stage 3c lung cancer is considered a progression of stage 3b with the addition of one or more tumors on the same or separate lobe of the lung. (There are three lobes on the right lung and two on the left.) Cancer may also be found in the same area as the primary tumor.
Stage 3a
Stages 3b and 3c

Stage 3 Survival Statistics

Life expectancy in people with cancer is typically described in five-year survival rates, defined as the percentage of people who live for at least five years following their diagnosis. Many can live for far longer than this.

The methods by which five-year survival rates are calculated can vary. Some scientists base their estimates on the TNM stage, while others do so based on the extent of the disease in the body. Both methods have their benefits and drawbacks.

Survival Rates by TNM Stage

The current five-year estimates based on the TNM staging system were updated in 2018 with the introduction of the stage 3c classification.

5-Year Survival Rates by TNM Stage
Lung Cancer Stage 5-Year Survival Rate
3a 36%
3b 26%
3c 13%

While the TNM approach provides a generalized overview of survival times, there is wide variation in how stage 3 lung cancers can progress and are treated. Some basic factors—like the location of the tumor and the degree of airway obstruction—can significantly impact survival times and are not reflected in a system like this.

There is also considerable overlap in the diagnostic criteria. Comparatively, stage 2b and stage 3a lung cancers have similar features and treatment approaches, as do stage 3b and stage 4a lung cancers.

Survival Rates by Disease Extent

To better address the wide variability of lung cancer in all of its stages, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program took a simpler approach, basing survival rates on the progression of the disease rather than the stage.

Under the SEER system, survival rates are based on the extent of the disease in the body, irrespective of the type. Instead of multiple categories and subcategories, there are only three:

  • Localized: Cancer that is limited to lung tissue only
  • Regional: Cancer that has spread to nearby lymph nodes or structures
  • Distant: Cancer that has spread to distant organs (metastatic disease)

Under the SEER classification system, stage 3 NSCLC is regarded as regional disease with a five-year survival rate of 31.7%.

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

One of the drawbacks of the SEER classification system is, again, the overlap of definitions. Stage 3 lung cancer, for example, falls into the same regional category as stage 2b, even though the latter has a 53% five-year survival rate—a difference of nearly 40%.

Factors Influencing Survival Rates

Lung cancer is different for everyone. There is no one set course, and survival rates can only provide a rough estimate of the likely outcome. Multiple factors can influence life expectancy, some of which are modifiable and others that are inherent and non-modifiable.

There are six factors known to influence survival rates in people with stage 3 lung cancer.

Age

Lung cancer survival rates in general tend to decrease the older you get. Although the average age of diagnosis is 70, a significant number of people are diagnosed in their 60s, 50s, and even younger.

Not only are people over 70 more likely to be in poorer health, but their immune system will generally be less responsive and less able to temper the growth of cancerous tumors.

In people with stage 3 NSCLC specifically, being 65 or older decreases five-year survival rates by nearly 40% compared to a matched set of adults under 50.

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%

Smoking Status

Smoking affects every stage of lung cancer, from the onset of the disease to the overall survival times. By contrast, the benefits of quitting cigarettes don't only extend to people with early-stage lung cancer but also to those with advanced stage 3 and stage 4 disease.

Studies have shown that smoking not only reduces the response rates to cancer therapy compared to quitting (45% vs. 75%, respectively) but also cuts the two-year survival rates by 41%.

In people with stage 3 NSCLC specifically, heavy smoking (defined as more than 60 pack-years) after the diagnosis decreases the probability of survival by almost 30% compared to quitting.

Sex

Male sex is considered an independent indicator of poorer outcomes in people with lung cancer in general. According to a 2018 study in ESMO Open, women have a 27% decreased risk of death due to NSCLC compared to a matched set of men with the same type of lung cancer.

This is reflected in research from the United Kingdom in which women are nearly 40% more likely to survive for 10 years with lung cancer than men.

With stage 3 NSCLC specifically, women have a five-year survival rate of 46% compared to 37% in men—a nearly 20% difference.

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%

Type of Lung Cancer

There are many different types and subtypes of NSCLC, some of which are more aggressive than others. The three most common are:

These characteristics generally influence the treatment response rate and survival times in people with NSCLC.

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%

With stage 3 NSCLC specifically, the median survival time for people lung adenocarcinoma is 30 months and 18 months in those with squamous cell carcinoma, according to a 2016 study in the Asian Pacific Journal of Cancer Prevention.

Comorbidities

Comorbidity is a term used to describe co-occurring illnesses. In people with lung cancer, the likelihood of a comorbid condition is high; diabetes, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF) are the most common additional diagnoses.

A 2015 study from the University of Nebraska reported that 73% of the 5,683 participants with lung cancer had a comorbid illness. Of these, three comorbidities were linked to decreased overall survival in people with regional (stage 3b to stage 3c) disease.

Regional NSCLC Comorbidity and Survival
Comorbid Condition Reduction in Overall Survival
Congestive heart failure -26%
Kidney disease -44%
Dementia -233%

Type of Surgery

Lung cancer surgery is indicated only for stage 3a NSCLC. Even so, there is a high risk of recurrence following stage 3 lung cancer surgery, which alone decreases survival times.

According to 2014 research publishing in Oncology Letters, the median survival time for people with post-surgical recurrence (for all stages) is 21.9 months. For people with stage 3 disease, no less than 33.9% experienced a cancer recurrence.

For people undergoing surgery for stage 3a NSCLC, a pre-operative course of chemotherapy (called neoadjuvant chemotherapy) can improve survival times, in part by lowering the risk of lung cancer recurrence.

The choice of surgery can also influence survival times. The use of lobectomy (in which a lobe of a lung is removed) tends to afford longer survival times than a pneumonectomy (in which an entire lung is removed).

When used with neoadjuvant chemotherapy, lobectomy is associated with a 33% five-year survival rate in people with stage 3a lung cancer. By contrast, pneumonectomy with neoadjuvant chemotherapy translates to a 20.7% five-year survival rate.

A Word From Verywell

A stage 3 lung cancer diagnosis can be daunting, but the fact this it is "advanced" does not mean that is untreatable. Certain stage 3 lung cancers can be cured, and others can be effectively be managed with longer progression-free survival time than ever before.

When diagnosed with stage 3 lung cancer, try not to focus on survival rates. These statistics are based on people of different ages, some of whom are in good health and others of whom are not. Instead, focus on factors that can improve your chances of survival, including smoking cessation, proper nutrition, and exercise.

The stronger and more fit you are, the more likely you to tolerate treatment and maintain a good quality of life.

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