Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Cancer. 2010 May 1;116(9):2234-41. doi: 10.1002/cncr.24966.
Conditional survival (CS) has emerged as a clinically relevant measure of prognosis for cancer survivors. The objective of this analysis was to provide melanoma-specific CS estimates to help clinicians promote more informed patient decision making.
Patients with melanoma and at least 5 years of follow-up were identified from the Surveillance Epidemiology and End Results registry (1988-2000). By using the methods of Kaplan and Meier, stage-specific, 5-year CS estimates were independently calculated for survivors for each year after diagnosis. Stage-specific multivariate Cox regression models including baseline survivor functions were used to calculate adjusted melanoma-specific CS for different subgroups of patients further stratified by age, gender, race, marital status, anatomic tumor location, and tumor histology.
Five-year CS estimates for patients with stage I disease remained constant at 97% annually, while for patients with stages II, III, and IV disease, 5-year CS estimates from time 0 (diagnosis) to 5 years improved from 72% to 86%, 51% to 87%, and 19% to 84%, respectively. Multivariate CS analysis revealed that differences in stages II through IV CS based on age, gender, and race decreased over time.
Five-year melanoma-specific CS estimates improve dramatically over time for survivors with advanced stages of disease. These prognostic data are critical to patients for both treatment and nontreatment related life decisions.
条件生存（CS）已成为癌症幸存者预后的一种有临床意义的衡量标准。本分析的目的是提供黑色素瘤特异性 CS 估计值，以帮助临床医生促进更明智的患者决策。
从监测、流行病学和最终结果登记处（1988-2000 年）中确定至少有 5 年随访的黑色素瘤患者。通过使用 Kaplan 和 Meier 方法，独立计算每个诊断后年份的幸存者的特定阶段、5 年 CS 估计值。使用包括基线幸存者函数的特定阶段多变量 Cox 回归模型，进一步按年龄、性别、种族、婚姻状况、解剖肿瘤位置和肿瘤组织学对不同亚组患者计算调整后的黑色素瘤特异性 CS。
I 期疾病患者的 5 年 CS 估计值每年保持在 97%不变，而 II、III 和 IV 期疾病患者的 5 年 CS 估计值从 0 时（诊断）到 5 年分别从 72%提高到 86%、51%提高到 87%和 19%提高到 84%。多变量 CS 分析显示，基于年龄、性别和种族的 II-IV 期 CS 差异随着时间的推移而减小。
随着时间的推移，患有晚期疾病的幸存者的黑色素瘤特异性 5 年 CS 估计值显著提高。这些预后数据对于患者的治疗和非治疗相关的生活决策都至关重要。
