Hou Haifeng, Meng Zixiu, Zhao Xuan, Ding Guoyong, Sun Ming, Wang Wei, Wang Youxin
School of Public Health, Taishan Medical University, Taian, China.
Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
Front Oncol. 2019 Jun 27;9:548. doi: 10.3389/fonc.2019.00548. eCollection 2019.
Esophageal cancer (EC) causes more than 400 thousand deaths per year, and half of them occur in China. There are discrepancies regarding the survival of EC patients between population-based surveillance studies and hospital-based studies. We aimed to synthesize the survival data from hospital-based EC studies in the Chinese population from 2000 to 2018 and to compare the survival rates between EC patients with different clinical classifications. The protocol of this systematic review was registered in PROSPERO (CRD-42019121559). We searched Embase, PubMed, CNKI, and Wanfang databases for studies published between January 1, 2000 and December 31, 2018. We calculated the pooled survival rates and 95% confidence intervals (CIs) by Stata software (V14.0). Our literature search identified 933 studies, of which 331 studies with 79,777 EC patients met the inclusion criteria and were included in meta-analyses. The pooled survival rates were 74.1% (95% CI: 72.6-75.7%) for 1-year survival, 49.0% (95% CI: 44.2-53.8%) for 2-years survival, 46.0% (95% CI: 42.6-49.5%) for 3-years survival, and 40.1% (95% CI: 33.7-46.4%) for 5-years survival. An increased tendency toward EC survival was verified from 2000 to 2018. In addition, discrepancies were observed between EC patients with different clinical classifications (e.g., stages, histologic types, and cancer sites). Our findings showed a higher survival rate in hospital-based studies than population-based surveillance studies. Although this hospital-based study is subject to potential representability and publication bias, it offers insight into the prognosis of patients with EC in China.
食管癌（EC）每年导致超过40万人死亡，其中一半发生在中国。基于人群的监测研究与基于医院的研究在食管癌患者的生存率方面存在差异。我们旨在综合2000年至2018年中国人群中基于医院的食管癌研究的生存数据，并比较不同临床分类的食管癌患者的生存率。本系统评价的方案已在PROSPERO（CRD-42019121559）中注册。我们在Embase、PubMed、CNKI和万方数据库中检索了2000年1月1日至2018年12月31日发表的研究。我们使用Stata软件（V14.0）计算汇总生存率和95%置信区间（CI）。我们的文献检索共识别出933项研究，其中331项研究涉及79777例食管癌患者，符合纳入标准并被纳入荟萃分析。1年生存率的汇总生存率为74.1%（95%CI：72.6-75.7%），2年生存率为49.0%（95%CI：44.2-53.8%），3年生存率为46.0%（95%CI：42.6-49.5%），5年生存率为40.1%（95%CI：33.7-46.4%）。2000年至2018年期间，食管癌生存率呈上升趋势得到验证。此外，不同临床分类（如分期、组织学类型和癌症部位）的食管癌患者之间存在差异。我们的研究结果表明，基于医院的研究中的生存率高于基于人群的监测研究。尽管这项基于医院的研究存在潜在的代表性和发表偏倚，但它为了解中国食管癌患者的预后提供了见解。
