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根据患者年龄和肿瘤组织学类型分层的原发性恶性脑肿瘤患者生存率:基于监测、流行病学和最终结果(SEER)数据的分析,1973 - 1991年

Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991.

作者信息

Davis F G, Freels S, Grutsch J, Barlas S, Brem S

机构信息

Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 60612-7260, USA.

出版信息

J Neurosurg. 1998 Jan;88(1):1-10. doi: 10.3171/jns.1998.88.1.0001.

Abstract

OBJECT

The authors present population-based survival rate estimates for patients with malignant primary brain tumors based on an analysis of 18 years of data obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute.

METHODS

Estimates of survival rates at 2 and 5 years after diagnosis for patients with specific histological tumor types were categorized by patient's age at diagnosis (< or = 20 years, 21-64 years, and 65 years or older) and by the time period in which the patients were diagnosed (1973-1980, 1981-1985, 1986-1991). Where appropriate, survival estimates were adjusted for changing patterns in the mean age at diagnosis.

CONCLUSIONS

The authors observed a pattern of declining survival rates in patients with increasing age of the patient at diagnosis for most histological groups and overall improvements in survival rates of patients across these time periods adjusting for age at diagnosis. There were improvements in 2- and 5-year survival rates over the three time periods for children and adults with medulloblastoma and for adults with astrocytoma and oligodendroglioma. Improvements in survival rates for pediatric patients with medulloblastoma have leveled off in the most recent time period, and gender differences in survival rates for patients with this tumor, which were present in the 1970s, have disappeared. Clinically significant improvements in survival rates were not apparent in patients aged 65 years and older. Changes in diagnostic and treatment procedures since the mid-1970s have resulted in improved survival rates for patients diagnosed as having medulloblastoma, oligodendroglioma, and astrocytoma, controlling for age at diagnosis. Glioblastoma multiforme continues to be the most intractable brain tumor.

摘要

目的

作者基于对美国国立癌症研究所监测、流行病学和最终结果(SEER)项目18年数据的分析,给出了恶性原发性脑肿瘤患者基于人群的生存率估计。

方法

特定组织学肿瘤类型患者诊断后2年和5年的生存率估计,按诊断时患者年龄(≤20岁、21 - 64岁、65岁及以上)以及患者诊断所处时间段(1973 - 1980年、1981 - 1985年、1986 - 1991年)进行分类。在适当情况下,对生存率估计进行调整以适应诊断时平均年龄的变化模式。

结论

作者观察到,对于大多数组织学组,随着诊断时患者年龄增加,生存率呈下降模式;在调整诊断时年龄后,这些时间段内患者的总体生存率有所提高。在三个时间段中,髓母细胞瘤患儿和成人以及星形细胞瘤和少突胶质细胞瘤成人患者的2年和5年生存率均有所提高。髓母细胞瘤儿科患者的生存率在最近时间段趋于平稳,该肿瘤患者在20世纪70年代存在的生存率性别差异已消失。65岁及以上患者的生存率没有明显的临床显著改善。自20世纪70年代中期以来诊断和治疗程序的变化导致诊断为髓母细胞瘤、少突胶质细胞瘤和星形细胞瘤的患者生存率提高,同时控制了诊断时的年龄。多形性胶质母细胞瘤仍然是最难治疗的脑肿瘤。

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