Clinical Relevance of Conditional Survival of Cancer Patients in Europe: Age-Specific Analyses of 13 Cancers
Clinical Relevance of Conditional Survival of Cancer Patients in Europe: Age-Specific Analyses of 13 Cancers
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DOI：
10.1200/jco.2009.25.9697
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发表时间：
2010-05-20
影响因子：
45.3
通讯作者：
Coebergh, Jan-Willem W.
中科院分区：
文献类型：
--
作者：
Janssen-Heijnen, Maryska L. G.;Gondos, Adam;Coebergh, Jan-Willem W.
目的：当癌症幸存者希望在随访中获得准确的预后信息时，有条件的5年相对生存期可能是最合适的。我们利用欧洲大型数据库——欧洲癌症指标网络（EUNICE）——全欧洲10个专门的长期癌症登记处，估计了13种癌症的有条件5年相对生存率。患者和方法纳入1985年至2004年间确诊的15岁及以上患者。计算每个年龄组的条件5年相对生存率，每增加1年存活至10年。随访期为2000 - 2004年。结果所有皮肤黑色素瘤或结直肠癌、子宫内膜癌或睾丸癌患者，以及年轻的胃癌、声门癌、子宫颈癌、卵巢癌、甲状腺癌或非霍奇金淋巴瘤患者，在初始诊断后10年内的规定时间点存活，几乎没有任何额外的死亡率（条件5年相对生存率bbb95 %）。然而，声门上癌、肺癌、乳腺癌和肾癌患者以及大多数癌症的老年患者表现出大量的超额死亡率（有条件的5年相对生存率< 90%）。自黑色素瘤、胃癌、结直肠癌、子宫癌或睾丸癌的初始诊断以来，不同年龄组之间诊断时的相对生存差异基本上随着时间的推移而消失，但对于诊断为其他肿瘤的患者，相对生存差异仍然存在。随着时间的推移，不同阶段之间的差异变得越来越小，甚至消失了。结论有条件相对生存率随诊断时间、肿瘤类型和年龄的不同而有临床相关性的变化，可为癌症幸存者规划未来和医生制定监测时间表提供指导。
PurposeWhen cancer survivors wish to receive accurate information on their current prognosis during follow-up, conditional 5-year relative survival may be most suitable. We have estimated conditional 5-year relative survival for 13 cancers using a large European database-European Network for Indicators on Cancer (EUNICE)-of 10 dedicated long-standing cancer registries across Europe.Patients and MethodsPatients age 15 years and older diagnosed between 1985 and 2004 were included. Conditional 5-year relative survival for each age group was computed for every additional year survived up to 10 years. Period analysis with follow-up period 2000 to 2004 was used.ResultsAll patients with cutaneous melanoma or colorectal, endometrial, or testis cancer and younger patients with stomach, glottis, cervix, ovary, or thyroid cancer or non-Hodgkin's lymphoma exhibited hardly any excess mortality (conditional 5-year relative survival > 95%) given that they were alive at a defined time point within 10 years of initial diagnosis. However, patients with supraglottis, lung, breast, and kidney cancer, as well as older patients with most cancers exhibited substantial excess mortality (conditional 5-year relative survival < 90%). Initial differences in relative survival at diagnosis between age groups largely disappeared with time since initial diagnosis for melanoma, or stomach, colorectal, corpus uteri, or testicular cancer but persisted for patients diagnosed with other tumors. Differences between stage groups became smaller over time or disappeared.ConclusionConditional relative survival shows clinically relevant variations according to time since diagnosis, type of cancer, and age, and can help serve as a guide for cancer survivors in planning for their future and for doctors in planning schedules for surveillance.