Brenner Hermann, Gondos Adam, Arndt Volker
Division of Clinical Epidemiology & Aging Research, German Cancer Research Center, Bergheimer Str 20, D-69115 Heidelberg, Germany.
J Clin Oncol. 2007 Aug 1;25(22):3274-80. doi: 10.1200/JCO.2007.11.3431.
To disclose most recent trends in long-term cancer patient survival.
We estimated trends in 5- and 10-year relative survival of cancer patients in the United States in 1998 to 2003 from the 1973 to 2003 database of the Surveillance, Epidemiology, and End Results Program using recently introduced period-analysis modeling techniques that provide the most up-to-date and precise survival estimates.
Statistically significant and partly very substantial improvement in 5- and 10-year relative survival in the 1998 to 2003 period was seen for 14 of 24 of the assessed common forms of cancer, including breast and colorectal cancer. For example, by 2003, 5-year relative survival exceeded 90% for patients with breast cancer and reached levels of about two thirds for patients with colorectal cancer and kidney cancer and patients with non-Hodgkin's lymphoma. Unfortunately, 5-year relative survival remained essentially unchanged at approximately 16% for lung cancer patients, and, despite statistically significant improvement, as low as 7% for pancreatic cancer patients. Overall, improvement was most pronounced for patients with regional tumor spread and somewhat less so for patients with localized tumors, whereas hardly any improvement was achieved for patients with distant tumor spread.
Our analysis discloses further major improvement in prognosis for most, but not all forms of cancer in recent years. The largest contribution to this improvement comes from improved prognosis of patients with regional tumor spread.
揭示癌症患者长期生存的最新趋势。
我们利用监测、流行病学和最终结果计划1973年至2003年数据库中最近引入的时期分析建模技术,估计了1998年至2003年美国癌症患者5年和10年相对生存率的趋势,该技术能提供最新且精确的生存估计。
在评估的24种常见癌症类型中,有14种在1998年至2003年期间5年和10年相对生存率有统计学显著且部分非常显著的提高,包括乳腺癌和结直肠癌。例如,到2003年,乳腺癌患者的5年相对生存率超过90%,结直肠癌、肾癌和非霍奇金淋巴瘤患者达到约三分之二的水平。不幸的是,肺癌患者的5年相对生存率基本保持在约16%不变,胰腺癌患者尽管有统计学显著改善,但仍低至7%。总体而言,区域肿瘤扩散患者的改善最为明显,局部肿瘤患者的改善程度稍小,而远处肿瘤扩散患者几乎没有改善。
我们的分析揭示了近年来大多数但并非所有癌症形式的预后有进一步的重大改善。这种改善的最大贡献来自区域肿瘤扩散患者预后的改善。