Umberto I Hospital, Siracusa, Italy.
New York University Medical School, New York, NY, USA.
Eur J Cancer Care (Engl). 2019 Nov;28(6):e13139. doi: 10.1111/ecc.13139. Epub 2019 Aug 22.
This review aimed to classify major patterns of cancer cure and discuss clinical implications. Patterns of cancer cure were identified, in terms of long-term survival and life expectancy, by means of two recently estimated indicators: cure fraction (CF) and time to cure (TTC).
We considered population-based studies reporting results for some cancer types on CF, defined as the proportion of patients who will reach the same life expectancy of the general population, or/and TTC, the time span necessary to experience a negligible excess mortality. TTC is obtained using conditional relative survival, which indicates the probability of surviving an additional y number of years, given that patients already survived x number of years.
Four major patterns of cancer types emerged from published studies: (a) cancers with a CF > 60% and a TTC < 5 years (e.g., testicular, thyroid); (b) cancers with a CF between 20% and 50% and a TTC < 10 years (colon, rectum); (c) cancers showing a CF of approximately 50% and TTC > 10 years (breast, prostate and bladder); (d) cancers with a CF < 20% and uncertain TTC (lung or pancreas).
Clinical and social impact of "cancer cure" categorisation are discussed in details. Recognising a cancer patient as cured represents an opportunity to improve their quality of life.
本综述旨在对癌症治愈的主要模式进行分类,并讨论其临床意义。通过最近估计的两个指标:治愈分数(CF)和治愈时间(TTC),从长期生存和预期寿命的角度来确定癌症的治愈模式。
我们考虑了基于人群的研究,这些研究报告了某些癌症类型的 CF 结果,CF 定义为达到与普通人群相同预期寿命的患者比例,或/和 TTC,即经历微不足道的超额死亡率所需的时间跨度。TTC 使用条件相对生存率来获得,它表示在已经存活 x 年的情况下,再存活 y 年的概率。
从已发表的研究中得出了四种主要的癌症类型模式:(a)CF > 60%且 TTC < 5 年的癌症(例如睾丸、甲状腺);(b)CF 在 20%至 50%之间且 TTC < 10 年的癌症(结肠、直肠);(c)CF 约为 50%且 TTC > 10 年的癌症(乳腺、前列腺和膀胱);(d)CF < 20%且 TTC 不确定的癌症(肺或胰腺)。
详细讨论了“癌症治愈”分类的临床和社会影响。将癌症患者视为治愈患者是提高其生活质量的机会。