Hoag Cancer Center, Newport Beach, California.
J Oncol Pract. 2005 Sep;1(3):84-92. doi: 10.1200/JOP.2005.1.3.84.
We sought to determine whether survival of patients managed at a large community hospital improved after an affiliated facility opened and its associated programs were initiated.
Survival data for patients with invasive cancer was obtained from the Hoag Hospital tumor registry for the successive periods 1986-1991 and for 1992-1999 for historical intramural comparisons; national Surveillance, Epidemiology, and End Results (SEER) program data for the same periods were used for contemporary and historical extramural comparisons.
We observed survival improved significantly during 1992-1999 compared with 1986-1991 for all patients with invasive cancers (P < .0001), and specifically for cancers of the breast (P = .026), lung (P = .012), prostate (P < .0001), stomach (P = .006), pancreas (P = .0001), and oral cavity (P = .024), with strong trends for improved survival for leukemia (P = .051) and rectal cancer (P = .063). Relative 5-year survival rates increased from 63% during 1986-1991 to 71% during 1992-1999, and were higher for 22 of 24 tumor types during the more recent period (P < .0001). Compared with SEER data, Hoag relative survival for all patients with invasive cancer was 63% versus 58% during 1986-1991, and 71% versus 64% during 1992-1999. Survival for Hoag patients was better than SEER rates for only 50% of malignancies (12 of 24) during 1986-1991 compared with 87% (21 of 24) during 1992-1999 (P = .013). In the most common tumor types, there were substantial improvements in survival for patients with regional disease at diagnosis. Improved survival was associated with earlier diagnosis and increased use of systemic treatment and combined modality therapy.
Patients with invasive cancer who were treated at an integrated community cancer center had better survival compared with historical survival and patients from the SEER registry. The findings are consistent with the hypothesis that the accelerated dissemination of new information resulted in earlier adoption of improved screening, diagnostic, and multidisciplinary treatment approaches, leading to higher survival rates.
我们旨在确定在一家大型社区医院附属机构开设并启动其相关项目后，患者的生存率是否有所提高。
我们从霍格医院肿瘤登记处获得了 1986-1991 年和 1992-1999 年连续时期浸润性癌症患者的生存数据，以便进行历史院内比较；同时使用同期和历史院外比较的国家监测、流行病学和最终结果（SEER）计划数据。
我们观察到，与 1986-1991 年相比，所有浸润性癌症患者在 1992-1999 年期间的生存率显著提高（P<.0001），特别是乳腺癌（P=.026）、肺癌（P=.012）、前列腺癌（P<.0001）、胃癌（P=.006）、胰腺癌（P=.0001）和口腔癌（P=.024），白血病（P=.051）和直肠癌（P=.063）的生存率也有明显改善的趋势。5 年相对生存率从 1986-1991 年的 63%增加到 1992-1999 年的 71%，在最近的时期，24 种肿瘤类型中有 22 种的相对生存率更高（P<.0001）。与 SEER 数据相比，1986-1991 年霍格医院所有浸润性癌症患者的相对生存率为 63%，而 1992-1999 年为 71%。在 1986-1991 年期间，只有 50%（24 种恶性肿瘤中的 12 种）的霍格医院患者的生存率优于 SEER 率，而在 1992-1999 年期间为 87%（24 种中的 21 种）（P=.013）。在最常见的肿瘤类型中，诊断时局部疾病患者的生存率有了显著提高。生存率的提高与更早的诊断以及更多地使用系统治疗和联合治疗模式有关。
在综合性社区癌症中心接受治疗的浸润性癌症患者的生存率优于历史生存率和 SEER 登记处的患者。这些发现与以下假设一致，即新信息的加速传播导致了更好的筛查、诊断和多学科治疗方法的早期采用，从而提高了生存率。
