From the Guidelines
The median overall survival for a patient with stage IIB (cT2aN1M0) adenocarcinoma of the lung is approximately 38 months, based on the 5-year survival rate of 38% for stage IIB patients, as reported in the study by Lim et al. 1. This estimate reflects outcomes for patients receiving standard-of-care treatment, which typically includes surgical resection followed by adjuvant chemotherapy. The survival rate at 5 years is about 30-40%. This particular case involves a peripheral tumor that is relatively small (T2a indicates tumor size >3cm but ≤4cm) with regional lymph node involvement (N1 indicates metastasis to ipsilateral peribronchial and/or hilar lymph nodes). The clinical classification (cT2aN1M0) and category cl. 3 adenocarcinoma histology suggests a moderately differentiated tumor. Some key points to consider in the management of this patient include:
- The use of adjuvant cisplatin-based chemotherapy, which has been shown to improve overall survival in patients with stages II and IIIA disease, as reported in the study by Cancer Care Ontario and American Society of Clinical Oncology 1.
- The importance of individualizing treatment decisions, taking into account the patient's performance status, age, comorbidities, and specific molecular characteristics of the tumor, as discussed in the study by American Society of Clinical Oncology/Cancer Care Ontario 1.
- The need for a thorough discussion of the benefits and risks of adjuvant therapy, including the potential for improved survival and the potential for adverse effects, as emphasized in the study by American Society of Clinical Oncology/Cancer Care Ontario 1. Prognosis can be influenced by several factors including the patient's performance status, age, comorbidities, completeness of surgical resection, response to adjuvant therapy, and specific molecular characteristics of the tumor such as EGFR, ALK, or ROS1 mutations which might make the tumor amenable to targeted therapies and potentially improve survival outcomes.
From the Research
Ca Pulmonis Dex Lobi Inferioris Peripherica cT2aN1M0 St. IIB Cat. Cl. 3 St. Adenocarcinoma Histology
- The provided studies do not directly address the median overall survival for a patient with Ca pulmonis dex lobi inferioris peripherica cT2aN1M0 St. IIB Cat. cl. 3 St. adenocarcinoma histology.
- However, some studies provide information on the overall survival of patients with lung adenocarcinoma:
- A study published in 2023 2 reported a median overall survival of 28.5 months for patients with stage IIIB/IV lung adenocarcinoma harboring uncommon EGFR mutations.
- A study published in 2017 3 reported a 5-year overall survival rate of 74.7% for high-risk patients with pathologic stage IB lung adenocarcinoma.
- A study published in 2009 4 discussed the objectives and benefits of treatment for advanced nonsmall cell lung cancer, but did not provide specific information on median overall survival for the specified patient group.
- A study published in 2022 5 reported that adjuvant chemotherapy reduced the risk of mortality for stage IB NSCLC patients with high-risk factors, but did not provide a specific median overall survival for the patient group in question.
- It is essential to note that the provided studies may not be directly applicable to the patient's specific situation, and the median overall survival may vary depending on various factors, including treatment options and individual patient characteristics.