Nordic Market Access AB, 113 59, Stockholm, Sweden.
Novartis Sverige AB, 164 28, Kista, Sweden.
BMC Public Health. 2022 Oct 14;22(1):1913. doi: 10.1186/s12889-022-14255-w.
Consistent improvements for overall survival (OS) have been reported for individuals with metastatic cancer. Swedish population-based registers allow national coverage and long follow-up time. The aim of this study was to estimate and explore long-term OS of individuals diagnosed with metastatic cancer using Swedish nationwide health registers.
Individuals with metastatic breast (MBC), non-small cell lung (MNSCLC), ovary (MOC) or colorectal cancer (MCRC) or metastatic malignant melanoma (MMM) were identified in the Swedish national cancer register and national patient registers. Survival was estimated and stratified by available variables. Potential cure fractions were estimated using mixture cure models.
In total, approximately 69,000 individuals were identified. The most common cancers were MCRC (36.2%) and MNSCLC (29.5%). Men were more frequently diagnosed with MNSCLC, MCRC, and MMM compared to women. Except for MOC, about 50% of individuals were 70 years or older at diagnosis. Throughout the study period survival differed across cancers. The longest median OS was observed for individuals with MOC and MBC. At 10 years of follow-up, the survival curves flatten at a survival rate of approximately 10% for all cancers except MNSCLC. The youngest age groups had the longest median OS. Increased survival was also observed for individuals diagnosed in 2015 and 2018 compared to individuals diagnosed during earlier years. The estimated cure fractions were 4% for MBC, 1.5% for MNSCLC, 6.8% for MCRC, 8.6% for MOC and MMM.
Long-term survival has been assessed across all indications except for NSCLC.. The findings may be relevant for healthcare planning to meet the needs of future patients and potential long-term survivors.
转移性癌症患者的总生存期（OS）持续改善。瑞典基于人群的登记处可实现全国性覆盖和长期随访。本研究旨在使用瑞典全国健康登记处估计和探讨诊断为转移性癌症患者的长期 OS。
在瑞典国家癌症登记处和国家患者登记处中确定患有转移性乳腺癌（MBC）、非小细胞肺癌（MNSCLC）、卵巢癌（MOC）或结直肠癌（MCRC）或转移性恶性黑色素瘤（MMM）的个体。根据可用变量估计生存率并进行分层。使用混合治愈模型估计潜在治愈分数。
共确定了约 69000 名个体。最常见的癌症是 MCRC（36.2%）和 MNSCLC（29.5%）。与女性相比，男性更常被诊断出患有 MNSCLC、MCRC 和 MMM。除了 MOC，大约 50%的个体在诊断时年龄为 70 岁或以上。在整个研究期间，癌症之间的生存率存在差异。MOC 和 MBC 患者的中位 OS 最长。在 10 年的随访中，除 MNSCLC 外，所有癌症的生存率曲线在生存率约为 10%时趋于平稳。年龄最小的组中位 OS 最长。与早期诊断的个体相比，2015 年和 2018 年诊断的个体的生存率也有所提高。估计的治愈分数分别为 MBC 4%、MNSCLC 1.5%、MCRC 6.8%、MOC 和 MMM 8.6%。
除 NSCLC 外，已经评估了所有适应证的长期生存情况。这些发现可能与医疗保健计划相关，以满足未来患者和潜在长期幸存者的需求。
