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比例治愈模型应用于挪威的 23 个癌症部位。

Proportion cured models applied to 23 cancer sites in Norway.

机构信息

Department of Registration, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway.

出版信息

Int J Cancer. 2013 Apr 1;132(7):1700-10. doi: 10.1002/ijc.27802. Epub 2012 Dec 14.

DOI:10.1002/ijc.27802
PMID:22927104
Abstract

Statistical cure is reached when a group of patients has the same mortality as cancer-free individuals. Cure models predict the cured proportion and the median survival of fatal cases. Cure models have seldom been applied and tested systematically across all major cancer sites. Incidence and follow-up data on 23 cancer sites recorded at the Cancer Registry of Norway 1963-2007 were obtained. Mixture cure models were fitted to obtain trends and up-to-date estimates (based on period approach) assuming cured and uncured groups exist. The model converged for cancers of the mouth and pharynx, oesophagus, stomach, colon, rectum, liver, gallbladder, pancreas, lung and trachea, ovary, kidney, bladder, CNS, non-Hodgkin lymphoma (only for males) and leukemia. The proportion of cured patients increased 1963-2002 for both sexes, with the largest changes (in percent) seen for leukemia (46.4 and 46.7) and CNS (35.9, 42.0), males given first. Median survival time for the uncured cases increased for colon and rectal cancer, and there was a three- fold increase in median survival time for patients with fatal ovarian cancers. Cancers of bladder and CNS had the highest up-to-date proportion cured (in percent), 67.4 and 64.0, respectively, pancreas and liver were amongst the lowest (5.7 and 9.9, respectively). Cure models are useful when monitoring progress in cancer care, but must be applied and interpreted with caution. The absolute estimates of the cure proportion are speculative and should not be calculated where cure is not medically anticipated.

摘要

当一组患者的死亡率与无癌症个体相同时,即可达到统计学治愈。治愈模型可预测治愈比例和致命病例的中位生存时间。治愈模型很少在所有主要癌症部位进行系统地应用和测试。我们获得了挪威癌症登记处 1963-2007 年记录的 23 个癌症部位的发病和随访数据。采用混合治愈模型来获得趋势和最新估计值(基于时期法),假设存在治愈和未治愈组。对于口腔和咽、食管、胃、结肠、直肠、肝、胆囊、胰腺、肺和气管、卵巢、肾、膀胱、中枢神经系统、非霍奇金淋巴瘤(仅男性)和白血病,模型收敛。1963-2002 年,两性治愈患者的比例均有所增加,其中白血病(46.4%和 46.7%)和中枢神经系统(35.9%,42.0%)的变化最大。对于男性,首次接受治疗的患者的中位生存时间增加。未治愈病例的中位生存时间增加了结肠癌和直肠癌,致命卵巢癌患者的中位生存时间增加了三倍。膀胱癌和中枢神经系统癌症的最新治愈比例最高(分别为 67.4%和 64.0%),胰腺和肝脏的比例最低(分别为 5.7%和 9.9%)。在监测癌症治疗进展时,治愈模型很有用,但必须谨慎应用和解释。治愈比例的绝对估计值是推测性的,在医学上不预期治愈的情况下不应计算。

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