Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
Cancer. 2013 Oct 15;119(20):3589-92. doi: 10.1002/cncr.28273. Epub 2013 Aug 1.
Measures of prognosis are typically estimated from the time of diagnosis. However, these estimates become less relevant as the time from diagnosis increases for a patient. Conditional survival measures the probability that a cancer patient will survive some additional number of years, given that the patient has already survived for a certain number of years. In the current study, the authors analyzed data regarding patients with stage III melanoma to demonstrate that survival estimates from the time of diagnosis underestimate long-term survival as the patient is followed over time. The probability of surviving to year 5 for patients at the time of presentation compared with patients who had already survived for 4 years increased from 72% to 95%, 48% to 90%, and 29% to 86%, respectively, for patients with substage IIIA, IIIB, and IIIC disease. Considering the major role played by survival estimates during follow-up in patient counseling and the development of survivorship programs, the authors strongly recommend the routine use of conditional survival estimates.
预后指标通常是从诊断时开始估计的。然而，随着患者从诊断到现在的时间增加，这些估计的相关性会降低。条件生存衡量的是在癌症患者已经存活了一定年限的情况下，他们在未来额外多少年还能存活的概率。在当前的研究中，作者分析了 III 期黑色素瘤患者的数据，以证明从诊断时开始的生存估计会随着时间的推移低估长期生存。与已经存活了 4 年的患者相比，当时就诊的患者在第 5 年的生存概率分别从 72%增加到 95%、48%增加到 90%、29%增加到 86%，分别用于 IIIA 亚期、IIIB 期和 IIIC 期疾病的患者。考虑到在随访期间生存估计在患者咨询和生存计划制定中所起的重要作用，作者强烈建议常规使用条件生存估计。
