Merrill R M, Henson D E, Barnes M
Department of Health Science, College of Health and Human Performance, Brigham Young University, Provo, UT 84602, USA.
Chest. 1999 Sep;116(3):697-703. doi: 10.1378/chest.116.3.697.
One- and 5-year probabilities of survival or death change once a patient has already survived > or = 1 year after diagnosis. The current paper reports these probabilities for lung cancer patients according to histologic subtype, stage, and age at diagnosis.
Cumulative observed survival rates were calculated and compared among 95,283 patients with histologically confirmed lung cancer (diagnosed from 1983 to 1992 and followed through 1995) by the life-table method using population-based tumor registries participating in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. On the basis of the cumulative survival estimates, we derived the probability of death in the next year, conditioned on having already survived to the start of the year (annual hazards), and the probability of survival conditioned on having already survived > or = 1 year (conditional survival). These rates were reported according to histologic subtype, stage, and age groups.
At the time of diagnosis, annual hazard rates differ greatly among histologic subtypes. However, by 5 years after diagnosis, the rates become similar. Bronchioloalveolar carcinoma displays the lowest annual hazards and small-cell carcinoma displays the highest annual hazards. Stage-age subcategories within histologic subtypes continue to show large differences in annual hazard rates. Five-year conditional survival probabilities are also reported, providing survival information that is consistent to that obtained from the annual hazards.
One- and 5-year prognosis for lung cancer patients is influenced by years already survived and histology, stage, and age at diagnosis. Annual hazards and conditional survival provides useful and more relevant information than conventional survival estimates for patients and their physicians. These statistics can be directly obtained from cumulative survival estimates and should be more widely reported.
一旦患者在确诊后已存活≥1年，其1年和5年的生存或死亡概率就会发生变化。本文根据组织学亚型、分期和确诊时的年龄报告肺癌患者的这些概率。
采用生命表法，利用参与美国国立癌症研究所监测、流行病学和最终结果（SEER）项目的基于人群的肿瘤登记处，计算并比较95283例组织学确诊肺癌患者（1983年至1992年确诊，随访至1995年）的累积观察生存率。根据累积生存估计值，我们得出了在已存活至年初的条件下（年度风险）下一年的死亡概率，以及在已存活≥1年的条件下（条件生存）的生存概率。这些比率根据组织学亚型、分期和年龄组进行报告。
在确诊时，不同组织学亚型的年度风险率差异很大。然而，到确诊后5年时，这些比率变得相似。细支气管肺泡癌的年度风险最低，小细胞癌的年度风险最高。组织学亚型内的分期-年龄亚类在年度风险率上继续显示出很大差异。还报告了5年条件生存概率，提供了与从年度风险中获得的生存信息一致的生存信息。
肺癌患者的1年和5年预后受已存活年限、组织学、分期和确诊时年龄的影响。与传统的生存估计相比，年度风险和条件生存为患者及其医生提供了有用且更相关的信息。这些统计数据可直接从累积生存估计值中获得，应更广泛地报告。
