Department of Cancer Strategy, Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka Prefecture 541-8567, Japan.
Inequalities in Cancer Outcome Network, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
Cancer Epidemiol. 2022 Aug;79:102170. doi: 10.1016/j.canep.2022.102170. Epub 2022 May 4.
The burden of stomach cancer remains high, particularly among Asian countries. Although Japan is known to achieve high survival from stomach cancer, little is known regarding the survival trends for recent years and survival by subsite and stage. We report age-standardised 1-, 3-, 5- and 10-year net survival for patients diagnosed with stomach cancer in Osaka, Japan.
We analysed patients diagnosed with primary stomach cancer and registered in the population-based cancer registry in Osaka Prefecture between 2001 and 2014. We used the non-parametric Pohar Perme method to derive net survival for each year. Both cohort and period approaches were used. Age was standardised using weights of the external population of the International Cancer Survival Standard. Multiple imputation was applied to handle missing information on subsite and stage before estimating age-standardised net survival by subsite (cardia and non-cardia) and stage (localised, regional and distant metastasis). We then examined general trends in the cohort-based survival estimates, as well as by subsite and stage, using linear regression.
A total of 97,276 patients were included in the analysis. Age-standardised net survival improved steadily (mean annual absolute change ≥1.2%). Net survival for both subsites improved, but cardia cancer showed 7-23% lower survival than non-cardia cancer throughout the study period. Five-year net survival remained high (≥80%) in the localised stage from the beginning of this study. Net survival increased steeply (≥1.4% per year) in the regional stage. Although 1-year net survival increased by 14% in the distant stage, 5-year and 10-year net survival remained below 10%.
Age-standardised net survival for stomach cancer in Japan improved during the study period owing to an increase in the number of patients with localised stage at diagnosis and improved treatment. Monitoring both short- and long-term survival should be continued as management of stomach cancer progresses.
胃癌负担仍然很高，特别是在亚洲国家。尽管日本在胃癌生存率方面较高，但对于近年来的生存率趋势以及亚部位和分期的生存率知之甚少。我们报告了在日本大阪诊断为胃癌的患者的年龄标准化 1 年、3 年、5 年和 10 年净生存率。
我们分析了 2001 年至 2014 年间在大阪府癌症登记处登记的原发性胃癌患者。我们使用非参数 Pohar Perme 方法为每年得出净生存率。使用国际癌症生存标准外部人群的权重对年龄进行标准化。在估计亚部位（贲门和非贲门）和分期（局部、区域和远处转移）的年龄标准化净生存率之前，应用多重插补处理亚部位和分期的缺失信息。然后，我们使用线性回归检查基于队列的生存估计的总体趋势，以及基于亚部位和分期的趋势。
共有 97276 名患者纳入分析。年龄标准化净生存率稳步提高（平均每年绝对变化≥1.2%）。两个亚部位的净生存率都有所提高，但在整个研究期间，贲门癌的生存率比非贲门癌低 7-23%。局部阶段的 5 年净生存率一直很高（≥80%）。区域阶段的净生存率急剧增加（每年≥1.4%）。尽管远处阶段的 1 年净生存率增加了 14%，但 5 年和 10 年的净生存率仍低于 10%。
由于诊断时局部阶段患者数量的增加和治疗效果的提高，日本胃癌的年龄标准化净生存率在研究期间有所提高。随着胃癌管理的进展，应继续监测短期和长期生存率。
