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32 种癌症的癌症治愈方法:来自 EUROCARE-5 研究的结果。

Cancer cure for 32 cancer types: results from the EUROCARE-5 study.

机构信息

Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy.

National Center for Prevention and Health Promotion, Italian National Institute of Health (ISS), Rome, Italy.

出版信息

Int J Epidemiol. 2020 Oct 1;49(5):1517-1525. doi: 10.1093/ije/dyaa128.

Abstract

BACKGROUND

Few studies have estimated the probability of being cured for cancer patients. This study aims to estimate population-based indicators of cancer cure in Europe by type, sex, age and period.

METHODS

7.2 million cancer patients (42 population-based cancer registries in 17 European countries) diagnosed at ages 15-74 years in 1990-2007 with follow-up to 2008 were selected from the EUROCARE-5 dataset. Mixture-cure models were used to estimate: (i) life expectancy of fatal cases (LEF); (ii) cure fraction (CF) as proportion of patients with same death rates as the general population; (iii) time to cure (TTC) as time to reach 5-year conditional relative survival (CRS) >95%.

RESULTS

LEF ranged from 10 years for chronic lymphocytic leukaemia patients to <6 months for those with liver, pancreas, brain, gallbladder and lung cancers. It was 7.7 years for patients with prostate cancer at age 65-74 years and >5 years for women with breast cancer. The CF was 94% for testis, 87% for thyroid cancer in women and 70% in men, 86% for skin melanoma in women and 76% in men, 66% for breast, 63% for prostate and <10% for liver, lung and pancreatic cancers. TTC was <5 years for testis and thyroid cancer patients diagnosed below age 55 years, and <10 years for stomach, colorectal, corpus uteri and melanoma patients of all ages. For breast and prostate cancers, a small excess (CRS < 95%) remained for at least 15 years.

CONCLUSIONS

Estimates from this analysis should help to reduce unneeded medicalization and costs. They represent an opportunity to improve patients' quality of life.

摘要

背景

很少有研究估计癌症患者治愈的概率。本研究旨在通过类型、性别、年龄和时期来估计欧洲基于人群的癌症治愈指标。

方法

从 EUROCARE-5 数据集中选择了 1990-2007 年间年龄在 15-74 岁之间、随访至 2008 年的 720 万例癌症患者(来自欧洲 17 个国家的 42 个基于人群的癌症登记处)。使用混合治愈模型来估计:(i)致命病例的预期寿命(LEF);(ii)治愈分数(CF),即与普通人群死亡率相同的患者比例;(iii)治愈时间(TTC),即达到 5 年条件相对生存率(CRS)>95%的时间。

结果

LEF 范围从慢性淋巴细胞白血病患者的 10 年到肝癌、胰腺癌、脑癌、胆囊癌和肺癌患者的<6 个月。65-74 岁前列腺癌患者的 LEF 为 7.7 年,乳腺癌女性患者的 LEF 超过 5 年。睾丸癌的 CF 为 94%,女性甲状腺癌的 CF 为 87%,男性甲状腺癌的 CF 为 70%,女性皮肤黑色素瘤的 CF 为 86%,男性皮肤黑色素瘤的 CF 为 76%,乳腺癌的 CF 为 66%,前列腺癌的 CF 为 63%,肝癌、肺癌和胰腺癌的 CF <10%。诊断年龄<55 岁的睾丸癌和甲状腺癌患者的 TTC<5 年,所有年龄段的胃癌、结直肠癌、子宫体癌和黑色素瘤患者的 TTC<10 年。对于乳腺癌和前列腺癌,至少有 15 年的时间仍存在微小的超额(CRS<95%)。

结论

本分析的估计值应该有助于减少不必要的医疗化和成本。它们为改善患者的生活质量提供了机会。

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