Shao Ning, Wan Fangning, Abudurexiti Mierxiati, Wang Jun, Zhu Yao, Ye Dingwei
Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Front Oncol. 2019 Jul 15;9:591. doi: 10.3389/fonc.2019.00591. eCollection 2019.
As conditional survival could provide more relevant prognostic information at each follow-up time, the present study aimed to assess conditional overall survival (COS) based on two cohorts and assess the risks of death due to renal cell carcinoma (RCC) vs. other causes. The Fudan University Shanghai Cancer Center (FUSCC) and Surveillance, Epidemiology, and End Results (SEER) database were used as the source of data for our analysis. COS and cancer-specific survival were evaluated using the Kaplan-Meier method. A total of 90,927 patients (SEER cohort = 88,807, FUSCC cohort = 2,120) were enrolled. Our results suggest that hazards of other causes-related death were always higher than that of cancer-specific death in low-risk RCC patients, but lower in metastatic RCC patients. It exceeded that of cancer-specific death by 8 years in high-risk RCC patients. Only in metastatic RCC patients, the COS improved markedly with survivorship increasing. After surviving 1, 2, 3, 4, and 5 years, the 5 years COS increased by +10, +18, +23, +29, and 35% (the observed 5 years OS: 12%), respectively. COS can better help patients with metastatic RCC rather than other RCC patients. Additionally, COS brings optimism for metastatic RCC patients with expected poorer prognosis psychologically.
由于条件生存可在每次随访时提供更相关的预后信息，本研究旨在基于两个队列评估条件总生存（COS），并评估肾细胞癌（RCC）与其他原因导致的死亡风险。复旦大学附属肿瘤医院（FUSCC）和监测、流行病学与最终结果（SEER）数据库用作我们分析的数据来源。使用Kaplan-Meier方法评估COS和癌症特异性生存。共纳入90927例患者（SEER队列 = 88807例，FUSCC队列 = 2120例）。我们的结果表明，在低风险RCC患者中，其他原因相关死亡的风险始终高于癌症特异性死亡，但在转移性RCC患者中则较低。在高风险RCC患者中，该风险超过癌症特异性死亡风险达8年。仅在转移性RCC患者中，COS随生存期延长而显著改善。在生存1、2、3、4和5年后，5年COS分别增加了 +10%、+18%、+23%、+29%和35%（观察到的5年总生存：12%）。COS对转移性RCC患者的帮助大于其他RCC患者。此外，COS在心理上为预后预期较差的转移性RCC患者带来了乐观情绪。
