Kaul Sapna, Kirchhoff Anne C, Boucher Kenneth M, Dietz Andrew C
Preventive Medicine and Community Health, University of Texas Medical Branch, United States.
Pediatric Hematology/Oncology and Huntsman Cancer Institute, University of Utah, United States.
Cancer Epidemiol. 2015 Dec;39(6):1071-7. doi: 10.1016/j.canep.2015.09.006. Epub 2015 Oct 1.
Few studies have evaluated conditional survival (probability of surviving y years given patients have already survived x years) for pediatric/adolescent patients diagnosed with cancer. To provide more accurate information on ongoing survival, we evaluate conditional survival for pediatric and adolescent patients with cancer.
The statewide Utah Cancer Registry identified 3344 patients born in Utah diagnosed with cancer at ages 0-21 years, from 1973 to 2009. The Utah Population Database provided demographic information. We estimated five-year conditional survival at diagnosis, and one and three years after diagnosis, by risk factors such as cancer type, sex, diagnosis age and treatment era (1973-1994 vs. 1995-2009).
Conditional survival estimates at one (85.1%, 95% CI: 83.7-86.5) and three years (92.9%, 95% CI: 91.8-93.9) after diagnosis were significantly higher than survival at diagnosis (77.2%, 95% CI: 75.6-78.9), although results varied by cancer type and initial prognosis. Diagnosis age affected survival for cancers where age is a risk factor. For example, five-year survival at one year after diagnosis was higher for younger (≤ 18 months of age) patients compared to older (>18 months) patients with neuroblastoma (95.4%, 95% CI: 90.9-99.9 vs. 56.8%, 95% CI: 41.8-71.7, p<0.001). Conditional survival improved over time for many cancers. Minimal differences were observed by sex.
Substantial improvements were observed in conditional survival at one and three years after diagnosis compared with survival at diagnosis. Several risk factors affected these outcomes. Clearer understandings of survival will help in administering effective survivorship care and decreasing prognosis-related anxiety/stress for patients and families.
很少有研究评估被诊断患有癌症的儿科/青少年患者的条件生存率（即患者已存活x年的情况下再存活y年的概率）。为了提供关于持续生存的更准确信息，我们评估了患有癌症的儿科和青少年患者的条件生存率。
犹他州全州癌症登记处识别出1973年至2009年期间在犹他州出生、0至21岁被诊断患有癌症的3344名患者。犹他州人口数据库提供了人口统计学信息。我们根据癌症类型、性别、诊断年龄和治疗时代（1973 - 1994年与1995 - 2009年）等风险因素，估计了诊断时、诊断后1年和3年的五年条件生存率。
诊断后1年（85.1%，95%可信区间：83.7 - 86.5）和3年（92.9%，95%可信区间：91.8 - 93.9）的条件生存率估计值显著高于诊断时的生存率（77.2%，95%可信区间：75.6 - 78.9），尽管结果因癌症类型和初始预后而异。诊断年龄影响年龄为风险因素的癌症的生存率。例如，诊断后1年，年龄较小（≤18个月）的神经母细胞瘤患者的五年生存率高于年龄较大（>18个月）的患者（95.4%，95%可信区间：90.9 - 99.9 vs. 56.8%，95%可信区间：41.8 - 71.7，p<0.001）。许多癌症的条件生存率随时间有所改善。性别之间观察到的差异极小。
与诊断时的生存率相比，诊断后1年和3年的条件生存率有显著改善。几个风险因素影响了这些结果。对生存率更清晰的了解将有助于提供有效的生存护理，并减轻患者及其家庭与预后相关的焦虑/压力。
