Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States
Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States
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DOI：
10.1053/jhep.2001.21041
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发表时间：
2001-01-01
期刊：
影响因子：
13.5
通讯作者：
Key, C
中科院分区：
文献类型：
--
作者：
El-Serag, HB;Mason, AC;Key, C
最近在美国肝细胞癌发病率的增加被认为是这种恶性肿瘤死亡率上升的基础。然而，目前尚不清楚肝细胞癌（HCC）患者的生存率是否在同一时期发生了变化。我们使用美国国家癌症研究所的SEER数据库（监测、流行病学和最终结果），研究了20年内组织学证实的肝癌患者的时间变化和生存决定因素。1977 ~ 1996年，SEER生存数据库对7,389例肝癌患者进行了随访，总的1年相对生存率从1977-1981年的14%（95%CI：12-16）上升到1992 ~ 1996年的23%（95%CI：21-24）。在相同的两个时间段之间，S年生存率的改善较少，从2%增加到2%。（95% CI：1-3）至仅5%（95%置信区间：中位生存期从1977年至1981年的0.57年略增至1992年至1996年的0.64年。男女之间或族裔群体之间的存活率没有显著差异。在1987年至1991年期间，一小部分（0.8%）患者接受了根治性手术;这些患者的1年生存率为59%（95% CI：35-83%），5年生存率为35%（95% CI：12-58%）。1992-1996年期间的比率类似。总之，在1977年至1996年期间，HCC患者的生存率略有改善。这种明显的益处大多数仅限于癌症诊断后的第一年，这增加了提前期偏倚的可能性。没有与性别或种族相关的显著差异。
The recent increase in the incidence of hepatocellular cancer in the United States is thought to underlie the rising mortality of this malignancy. However, it remains unknown whether survival of patients with hepatocellular carcinoma (HCC) has changed during the same time period. Using the SEER database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute, we examined the temporal changes and determinants of survival among patients with histologically proven HCC over a 20-year period. Between 1977 and 1996, 7,389 patients diagnosed with HCC were followed in the survival database of SEER, The overall 1-year relative survival rate increased from 14% (95% confidence intervals (CI): 12-16) during 1977-1981 to 23% (95% CI: 21-24) during 1992 to 1996. Between the same two time periods, less improvement was seen in the S-year survival rates, which increased from 2% (95% CI: 1-3) to only 5% (95% CI: 4-7), The median survival increased slightly from 0.57 years during 1977 to 1981 to 0.64 years during 1992 to 1996, In general, there were no significant differences in survival between men and women or between ethnic groups. During 1987 to 1991, a small fraction (0.8%) of patients underwent radical surgery; these patients had 1-year survival of 59% (95% CI: 35-83%), and 5-year survival of 35% (95% CI: 12-58%). Similar rates were seen during 1992-1996. In conclusion, a small improvement in survival of patients with HCC was seen between 1977 and 1996. Most of this apparent benefit is restricted to the first year following cancer diagnosis, raising the possibility of lead-time bias. There were no significant differences related to gender or ethnicity.