Viscomi Silvia, Pastore Guido, Mosso Maria Luisa, Terracini Benedetto, Madon Enrico, Magnani Corrado, Merletti Franco
Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit of the Center for Cancer Epidemiology and Prevention, CPO Piemonte, S.Giovanni Hospital, Turin, Italy.
Haematologica. 2003 Sep;88(9):974-82.
Survival after childhood cancer has shown a steady improvement from the late 1970s in most developed countries. Since 1967 the Childhood Cancer Registry of Piedmont has been collecting cases of malignant tumor, diagnosed in children aged 0-14 years, living in Piedmont. This work aims to update survival rates to 31.12.2000.
This study includes 2,678 children diagnosed between 1970-98. Vital status was assessed at the Registry Office of the town of residence. One thousand four-hundred ninety cases were reported to be alive, 1170 dead and for 18 the status was unknown. Thirty-three cases registered with a death certificate only were excluded. Completeness of follow-up was 99.3%. All tumor types were classified according to the Birch-Marsden classification. Histologic verification was available for 94.4% of cases.
Survival at 5 years increased over the period 1970-98 for all tumor types with a statistically significant trend over time (p<0.0001). The 5 year survival rate for acute lymphoblastic leukemia (ALL) increased steadily from 24.7% (95%CI 15.0-34.3) to 87.6% (80.9-94.3), for acute non-lymphoblastic leukemia (ANLL) from 0.0% to 38.1% (17.3-58.9), and for non-Hodgkin's lymphomas from 25.2% (0.6-49.8) to 79.7% (61.9-97.5). Five year survival rates of children with central nervous system tumors increased from 33.4% in 1970-74 to 78.5% in 1990-94 and decreased in 1995-98 to 70.9%. Age <1 year and >50,000x10(6) cells/L at diagnosis were negative prognostic factors for ALL. Age <1 year was a favorable prognostic factor for neuroblastoma.
Survival of children with all types of tumors improved in Piedmont. This improved survival is comparable to that reported by other European and North American population-based cancer registries.
在大多数发达国家，自20世纪70年代末以来，儿童癌症患者的生存率稳步提高。自1967年起，皮埃蒙特儿童癌症登记处开始收集居住在皮埃蒙特地区、年龄在0至14岁之间被诊断为恶性肿瘤的病例。这项工作旨在更新至2000年12月31日的生存率。
本研究纳入了1970年至1998年间诊断的2678名儿童。在其居住城镇的登记办公室评估生命状态。报告显示，1490例存活，1170例死亡，18例状态不明。仅登记有死亡证明的33例被排除。随访完整性为99.3%。所有肿瘤类型均根据伯奇 - 马斯登分类法进行分类。94.4%的病例有组织学验证。
1970年至1998年间，所有肿瘤类型的5年生存率均有所提高，且随时间有统计学显著趋势（p<0.0001）。急性淋巴细胞白血病（ALL）的5年生存率从24.7%（95%可信区间15.0 - 34.3）稳步提高到87.6%（80.9 - 94.3），急性非淋巴细胞白血病（ANLL）从0.0%提高到38.1%（17.3 - 58.9），非霍奇金淋巴瘤从25.2%（0.6 - 49.8）提高到79.7%（61.9 - 97.5）。中枢神经系统肿瘤患儿的5年生存率从1970 - 1974年的33.4%提高到1990 - 1994年的78.5%，在1995 - 1998年降至70.9%。诊断时年龄<1岁以及细胞计数>50,000x10(6)/L是ALL的不良预后因素。年龄<1岁是神经母细胞瘤的有利预后因素。
皮埃蒙特地区所有类型肿瘤患儿的生存率均有所提高。这种生存率的提高与其他欧洲和北美基于人群的癌症登记处报告的情况相当。
