Barnholtz-Sloan Jill S, Severson Richard K, Vaishampayan Ulka, Hussain Maha
Division of Hematology/Oncology, Department of Internal Medicine, Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
Cancer Causes Control. 2003 Sep;14(7):681-5. doi: 10.1023/a:1025675303370.
The purpose of this study is to examine differences in survival after diagnosis with distant stage prostate cancer by decade of diagnosis.
Subjects are 3337 Caucasian and 1947 African-American men with newly diagnosed primary distant stage prostate cancer between 1973 and 1997, with follow-up through 2001, from the Detroit SEER registry. The proportion of men within each category of each variable of interest is calculated. Relative survival is used to examine survival patterns over time. Kaplan-Meier and Cox proportional hazard models are also used to examine the relationship between decade of diagnosis and survival between short term (< or = 24 months) and long term (> 24 months) survivors.
Relative survival has increased over the past three decades although this trend is not statistically significant. Relative survival is similar by race and decreases with increasing grade of tumor. Survival for men living < or = 24 months after diagnosis is similar over time. However, for men living > 24 months after diagnosis, there is a significant difference over time (p < 0.0001).
CONCLUSION(S): In general, relative survival has been improving over the past three decades. However, it is the long term survivors (> 24 months) that are the primary contributors to this difference in survival by decade of diagnosis.
本研究旨在按诊断年代检查远处转移期前列腺癌诊断后的生存差异。
研究对象为1973年至1997年间新诊断为原发性远处转移期前列腺癌的3337名白种人和1947名非裔美国男性，数据来自底特律监测、流行病学和最终结果（SEER）登记处，随访至2001年。计算每个感兴趣变量各分类中的男性比例。采用相对生存率来研究随时间的生存模式。还使用Kaplan-Meier法和Cox比例风险模型来研究诊断年代与短期（≤24个月）和长期（>24个月）幸存者生存之间的关系。
在过去三十年中，相对生存率有所提高，尽管这一趋势无统计学意义。相对生存率按种族相似，且随肿瘤分级增加而降低。诊断后存活≤24个月的男性生存率随时间相似。然而，对于诊断后存活>24个月的男性，随时间存在显著差异（p<0.0001）。
总体而言，在过去三十年中相对生存率一直在提高。然而，正是长期幸存者（>24个月）是按诊断年代划分的生存差异的主要贡献者。
