Keegan Theresa H M, Ries Lynn A G, Barr Ronald D, Geiger Ann M, Dahlke Deborah Vollmer, Pollock Bradley H, Bleyer W Archie
Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California.
Surveillance Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Cancer. 2016 Apr 1;122(7):1009-16. doi: 10.1002/cncr.29869. Epub 2016 Feb 5.
With prior reports indicating a lack of progress in survival improvement in older adolescents and young adults (AYAs) aged 15 to 39 years with cancer compared with both younger and older patients with cancer, the current analysis provides an update of survival trends of cancers among AYAs, children, and older adults.
Data from the National Cancer Institute Surveillance, Epidemiology, and End Results database for 13 regions were used to ascertain survival trends of the 34 most frequent cancers diagnosed in AYAs compared with children and older adults.
As of 2002 through 2006, the 5-year relative survival rate for all invasive cancers in AYAs was 82.5% (standard error, 0.2%). In AYAs, 14 cancers demonstrated evidence of a statistically significant improvement in their 5-year relative survival since 1992. Survival improved less in AYAs than in children for acute myeloid leukemia and medulloblastoma. Fourteen cancers had survival improvements that were found to be less in AYAs compared with older adults, including hepatic carcinoma, acute myeloid leukemia, high-grade astrocytoma, acute lymphocytic leukemia, pancreatic carcinoma, low-grade astrocytoma, gastric carcinoma, renal carcinoma, cancer of the oral cavity and pharynx, Hodgkin lymphoma, ovarian cancer, fibromatous sarcoma, other soft tissue sarcoma, and thyroid carcinoma.
Improvements in the survival of several cancer types that occur frequently in AYAs are encouraging. However, survival does not appear to be improving to the same extent in AYAs as in children or older adults for several cancers. Further investment in exploring the distinct biology of tumors in this age group, and of their hosts, must be a priority in AYA oncology.
先前的报告表明，与年龄更小和更大的癌症患者相比，15至39岁的青少年及年轻成人（AYA）癌症患者在生存率提高方面缺乏进展，当前分析提供了AYA、儿童和老年成人癌症生存率趋势的最新情况。
使用来自国家癌症研究所13个地区监测、流行病学和最终结果数据库的数据，确定AYA中诊断出的34种最常见癌症与儿童和老年成人相比的生存趋势。
截至2002年至2006年，AYA中所有侵袭性癌症的5年相对生存率为82.5%（标准误，0.2%）。在AYA中，自1992年以来，14种癌症的5年相对生存率有统计学显著改善。急性髓细胞白血病和髓母细胞瘤在AYA中的生存率改善低于儿童。与老年成人相比，AYA中有14种癌症的生存率改善较低，包括肝癌、急性髓细胞白血病、高级别星形细胞瘤、急性淋巴细胞白血病、胰腺癌、低级别星形细胞瘤、胃癌、肾癌、口腔和咽癌、霍奇金淋巴瘤、卵巢癌、纤维肉瘤、其他软组织肉瘤和甲状腺癌。
AYA中几种常见癌症类型的生存率提高令人鼓舞。然而，对于几种癌症，AYA的生存率改善程度似乎不如儿童或老年成人。在AYA肿瘤学中，进一步投入探索该年龄组肿瘤及其宿主的独特生物学特性必须成为优先事项。
