Trends in incidence and long-term survival of Japanese women with vulvar cancer: a population-based analysis
Trends in incidence and long-term survival of Japanese women with vulvar cancer: a population-based analysis
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DOI：
10.1007/s10147-019-01453-7
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发表时间：
2019-09-01
影响因子：
3.3
通讯作者：
Kimura, Tadashi
中科院分区：
文献类型：
--
作者：
Tanaka, Yusuke;Ueda, Yutaka;Kimura, Tadashi
目的外阴癌在亚洲人群中的发病率和长期生存分析，由于其罕见性，尚未得到充分描述。本研究的目的是使用日本大坂市基于人群的癌症登记数据，确定日本人群外阴癌的发病率和长期生存率的趋势。方法采用日本1985年模型人群，计算1976 - 2010年确诊的389例外阴鳞状细胞癌（SCC）的年龄标化发病率。年龄标准化发病率的年变化百分比（APC）由联合点回归模型估计。采用队列或分期方法分析了1976年至2008年诊断的290例外阴鳞状细胞癌患者的5年和10年相对生存率。使用10年相对生存率，还计算了诊断后存活数年的患者的条件5年生存率。结果我们发现，外阴癌的年龄标准化发病率在1979年至1992年期间呈下降趋势（APC - 6.3%; 95%置信区间（CI）[-11.3%至-1.0%]），而在1993年至2010年期间呈上升趋势（APC 1.9%; 95%CI [-0.7%至4.6%]）。1976-2000年和2001-2008年两个时期的5年和10年相对生存率没有统计学显著差异。观察到诊断后2年的条件性5年生存率统计学显著增加（48.4%; 95% CI [41.1-55.3] vs 75.6%; 95% CI [64.0-83.9]）。结论：尽管日本人群外阴癌发病率呈上升趋势，但外阴癌的相对生存率在本研究的35年中没有变化。我们发现外阴癌的条件性5年生存率，随着患者生存时间的延长，接近100%。这些数据可以为患者和临床医生提供有价值的信息。
Objective The incidence and long-term survival analysis for vulvar cancer, due to its rarity, has not been fully described in Asian population. The objective of the study is to determine the trends in incidence and long-term survival for vulvar cancer in a Japanese population, using a population-based cancer registry data in Osaka, Japan. Methods The age-standardized incidence rate of 389 cases of vulvar squamous cell carcinoma (SCC) diagnosed between 1976 and 2010 was calculated, using the 1985 model population of Japan. The annual percentage change (APC) of the age-standardized incidence was estimated by the joinpoint regression models. The 5- and 10-year relative survival of 290 cases with vulvar SCC diagnosed between 1976 and 2008 were analyzed, using a cohort or period approach. Using the 10-year relative survival, the conditional 5-year survival for patients who lived for some years after diagnosis was also calculated. Results We have found that the age-standardized incidence rate for vulvar cancer trended downward during the period of 1979-1992 (APC - 6.3%; 95% confidence interval (CI) [- 11.3% to - 1.0%]), whereas it trended upward from 1993 to 2010 (APC 1.9%; 95% CI [- 0.7% to 4.6%]). There was no statistically significant difference for the 5- and 10-year relative survival between the two periods of 1976-2000 and 2001-2008. A statistically significant increase in the conditional 5-year survival at 2 years after diagnosis was observed (48.4%; 95% CI [41.1-55.3] versus 75.6%; 95% CI [64.0-83.9]). Conclusion Despite an increasing trend in vulvar cancer incidence among Japanese population, the relative survival rate for vulvar cancer did not change over the 35 years of this study. We found that the conditional 5-year survival for vulvar cancer, as patients survived additional years, approached within reach of 100%. These data can provide valuable information for both patients and clinicians.