Multiple tumours in survival estimates
Multiple tumours in survival estimates
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DOI：
10.1016/j.ejca.2008.11.030
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发表时间：
2009-04-01
影响因子：
8.4
通讯作者：
Brenner, Hermann
中科院分区：
文献类型：
--
作者：
Rosso, Stefano;De Angelis, Roberta;Brenner, Hermann
在基于癌症生存登记的国际比较中，通常的做法是将分析限制在原发性肿瘤上，并排除多种癌症。正确检测后续癌症的概率取决于注册表的运行时间，这导致被排除的患者比例不同，并可能导致有偏见的比较。我们评估了对包括多发原发肿瘤在内的年龄标准化相对生存估计的影响。参与EUROCARE-4合作研究的来自69个欧洲癌症登记处的2919023例恶性癌症的数据被使用。总共发现了183,683例多发性原发肿瘤，占所有考虑的癌症的总比例为6.3%，从0.4%（意大利那不勒斯）到12.9%（冰岛）不等。多发性肿瘤的比例因肿瘤类型的不同而有很大差异，对于那些发病率高、生存时间长的肿瘤（乳腺癌、前列腺癌和结肠直肠肿瘤），多发性肿瘤的比例更高。当包括多发性癌症患者时，5年相对生存率较低。在所有癌症中，女性的平均差异为-0.4个百分点，男性为-0.7个百分点，年龄较大的患者差异更大。在分析的45个癌症部位中，包括多发性肿瘤导致44个肿瘤的生存率降低，其中最大的差异是喉部（-1.9%）、口咽（-1.5%）和阴茎（-1.3%）。在国际比较的生存估计中包括多发性原发肿瘤是可取的，因为它减少了由于不同观察期、年龄、登记质量和登记完整性造成的偏倚。纳入的一般效果是根据多个原发灶和癌症部位的比例，以不同的数量降低生存估计。(C) 2008 Elsevier Ltd版权所有。
In international comparisons of cancer registry based survival it is common practice to restrict the analysis to first primary tumours and exclude multiple cancers. The probability of correctly detecting subsequent cancers depends on the registry's running time, which results in different proportions of excluded patients and may lead to biased comparisons. We evaluated the impact on the age-standardised relative survival estimates of also including multiple primary tumours.Data from 2,919,023 malignant cancers from 69 European cancer registries participating in the EUROCARE-4 collaborative study were used. A total of 183,683 multiple primary tumours were found, with an overall proportion of 6.3% over all the considered cancers, ranging from 0.4% (Naples, Italy) to 12.9% (Iceland). The proportion of multiple tumours varied greatly by type of tumour, being higher for those with high incidence and long survival (breast, prostate and colon-rectum). Five-year relative survival was lower when including patients with multiple cancers. For all cancers combined the average difference was -0.4 percentage points in women and -0.7 percentage points in men, and was greater for older registries. Inclusion of multiple tumours led to lower survival in 44 out of 45 cancer sites analysed, with the greatest differences found for larynx (-1.9%), oropharynx (-1.5%), and penis (-1.3%).Including multiple primary tumours in survival estimates for international comparison is advisable because it reduces the bias due to different observation periods, age, registration quality and completeness of registration. The general effect of inclusion is to reduce survival estimates by a variable amount depending on the proportion of multiple primaries and cancer site. (C) 2008 Elsevier Ltd. All rights reserved.