Yuan Y, Ross J, Shi Q, Davis F G
School of Public Health, University of Alberta, Edmonton, AB.
Curr Oncol. 2017 Oct;24(5):e341-e347. doi: 10.3747/co.24.3579. Epub 2017 Oct 25.
"Conditional survival probability" is defined as the probability that a patient will survive an additional time, given that the patient has already survived a defined period of time after diagnosis. Such estimates might be more relevant for clinicians and patients during post-diagnosis care, because survival probability projections are based on the patient's survival to date. Here, we provides the first population-based estimates of conditional survival probabilities by histology for brain cancer in Canada.
Canadian Cancer Registry data were accessed for patients diagnosed with primary brain cancers during 2000-2008. Kaplan-Meier survival probabilities were estimated by histology. Conditional survival probabilities at 6 months (short-term, denoted scs) and 2 years (long-term, denoted lcs) were derived from the Kaplan-Meier survival estimates for a range of time periods.
Among the 20,875 patients who met the study criteria, scs increased by a margin of 16-18 percentage points from 6-month survivors to 2-year survivors for the three most aggressive brain cancers. The lcs for 2-year survivors was 66% or greater for all tumour groups except glioblastoma. The lcs for 4-year survivors was 62% or greater for all histologies. For glioblastoma and diffuse astrocytoma, the lcs increased each year after diagnosis. For all other histologies, the lcs first increased and then plateaued from 2 years after diagnosis. The lcs and scs both worsened with increasing older age at diagnosis.
We report histologically specific conditional survival probabilities that can have value for clinicians practicing in Canada as they plan the course of follow-up for individual patients with brain cancer.
“条件生存概率”的定义是,假定患者在确诊后已经存活了一段特定时间,其在额外一段时间内存活的概率。此类估计对于临床医生和患者在诊断后的护理中可能更具相关性,因为生存概率预测是基于患者迄今为止的生存情况。在此,我们提供了加拿大基于人群的脑癌组织学条件生存概率的首次估计。
获取了加拿大癌症登记处2000 - 2008年期间诊断为原发性脑癌患者的数据。通过组织学估计了Kaplan - Meier生存概率。6个月(短期,记为scs)和2年(长期,记为lcs)的条件生存概率是从一系列时间段的Kaplan - Meier生存估计中得出的。
在符合研究标准的20875名患者中,对于三种最具侵袭性的脑癌,scs从6个月存活者到2年存活者增加了16 - 18个百分点。除胶质母细胞瘤外,所有肿瘤组2年存活者的lcs为66%或更高。所有组织学类型4年存活者的lcs为62%或更高。对于胶质母细胞瘤和弥漫性星形细胞瘤,lcs在诊断后每年都增加。对于所有其他组织学类型,lcs在诊断后2年开始先增加然后趋于平稳。lcs和scs均随着诊断时年龄的增加而恶化。
我们报告了按组织学分类的条件生存概率,这对于在加拿大执业的临床医生在为个体脑癌患者规划后续治疗方案时可能具有价值。