What is the 5-year disease-free survival (DFS) rate?

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Last updated: October 23, 2025 • View editorial policy

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5-Year Disease-Free Survival (DFS) Rates in Cancer

The 5-year disease-free survival (DFS) rate varies significantly by cancer type and stage, ranging from approximately 29% to 80% depending on the specific malignancy, stage at diagnosis, and treatment approach.

Anal Cancer

  • 5-year DFS for anal carcinoma is approximately 56% for patients treated with preoperative chemoradiation followed by resection and postoperative chemotherapy with a doxorubicin-based regimen 1
  • DFS is significantly impacted by tumor size, lymph node involvement, and gender, with male sex and positive lymph nodes being independent negative prognostic factors 1
  • Patients with T1-T2 tumors with N2-3 disease have a better 5-year survival rate (72.7%) compared to those with T3-T4 tumors with nodal involvement (39.9%) 1

Gastric Cancer

  • In the MAGIC and FNCLCC trials evaluating perioperative chemotherapy for gastric cancer, the 5-year DFS rates were:
    • 34% for patients receiving perioperative chemotherapy versus 19% for surgery-only group (HR 0.65, P=0.003) 1
  • DFS is significantly better in early gastric cancer stages, with T1/T2 node-negative cases exceeding 80% 5-year survival probability 1

Hodgkin Lymphoma

  • 5-year failure-free survival (equivalent to DFS) for patients with locally extensive Hodgkin lymphoma is approximately 82% 1
  • For patients with stage III-IV Hodgkin lymphoma, the 5-year failure-free survival rate is approximately 67% 1
  • Treatment regimens like ABVD and Stanford V show comparable 5-year PFS rates of 74% and 71%, respectively 1

Ewing Sarcoma

  • 5-year DFS for patients with Ewing sarcoma varies significantly based on disease stage and treatment approach:
    • For patients with localized disease at diagnosis who received high-dose chemotherapy (HDT), 5-year progression-free survival (PFS) is approximately 49% 1
    • For patients with metastatic disease at diagnosis who received HDT, 5-year PFS is approximately 34% 1
    • For patients with localized disease at recurrence who received HDT, 5-year PFS drops to approximately 14% 1

Breast Cancer

  • For metastatic breast cancer patients who undergo local treatment for solitary metastases followed by adjuvant systemic therapy, 5-year DFS ranges from 36% to 52% 1
  • In patients with oligometastatic breast cancer treated with high-dose chemotherapy and autologous stem cell transplantation after curative local treatment, 5-year relapse-free survival was 52% overall and 59% in the subgroup with distant metastases only 1

Soft Tissue Sarcoma

  • 5-year DFS for high-grade extremity soft tissue sarcoma treated with preoperative chemoradiation followed by surgery and postoperative chemotherapy is approximately 70%, compared to 42% for historical controls 1
  • The RTOG 9514 study showed a 5-year DFS of 56% for patients with large (≥8 cm), high-grade soft tissue sarcoma treated with preoperative chemoradiation followed by resection and postoperative chemotherapy 1

Colon Cancer

  • 5-year DFS has been validated as a surrogate endpoint for overall survival in adjuvant colon cancer trials 2, 3, 4, 5
  • Recent data from a large cohort study of right-sided colon cancer showed a 5-year DFS rate of 57.6% following curative-intent resection 6
  • The correlation between 3-year DFS and 5-year OS in colon cancer trials is strong (R² = 0.89), making DFS a reliable endpoint 5

Clinical Implications

  • DFS is increasingly used as a primary endpoint in clinical trials as it provides earlier assessment of treatment efficacy compared to overall survival 2, 4, 5
  • Factors that negatively impact DFS across multiple cancer types include:
    • Advanced T stage 1, 6
    • Lymph node involvement 1, 6
    • Male sex (in some cancers) 1
    • Poor response to induction therapy 1
    • Metastatic disease at presentation 1

Common Pitfalls in DFS Assessment

  • Extended survival after recurrence can reduce the association between DFS and overall survival, requiring longer follow-up (6-7 years) to demonstrate overall survival improvements 3
  • This effect is more pronounced in earlier stage disease (e.g., stage II vs. stage III colon cancer) 3
  • DFS definitions may vary between studies, making direct comparisons challenging 4, 5
  • The predictive value of DFS for overall survival may be affected by effective post-recurrence therapies that extend survival after disease recurrence 3

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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