Martus P, Birkenhake S, Sauer R
Institut für Medizinische Statistik und Dokumentation, Universität Erlangen-Nürnberg.
Strahlenther Onkol. 1998 Jan;174(1):1-6. doi: 10.1007/BF03038220.
Survival of elder oncological patients may depend on the tumor disease, on reasons not related to the underlying disease or simply on patient's age. Therefore patient' age has to be taken into account if the objective of an oncological study is the disease-related survival. Basically, there are 3 different approaches: multivariate statistical modelling, estimation of disease-related survival after censoring of cases with cause of death not due to the tumor disease, and consideration of demographical data in the general population.
Our paper deals with the age correction using the data from the 1986/88 census in Germany. We have written a computer program based on SPSSWIN, which allows an automated age correction. Using clinical data of radiotherapy after surgical therapy of bladder cancer, we illustrate the method.
The estimated 5-year-survival using the age correction was--dependent on patient's age in the sample--10% up to 15% higher than the uncorrected rate. In the whole sample of 333 unselected patients, 5-year-survival was corrected from 47% to 59%. In the normal population adjusted for age- and sex-distribution, the expected survival rate was 80%.
The age correction has substantial influence on survival analysis of male patients elder than 60 years and female patients elder than 70 years. It should therefore be used in oncological studies investigating long-term survival of patients in these age-groups.
老年肿瘤患者的生存情况可能取决于肿瘤疾病本身、与基础疾病无关的因素或者仅仅取决于患者年龄。因此，如果肿瘤学研究的目标是疾病相关生存率，就必须考虑患者年龄。基本上有三种不同的方法：多变量统计建模、对死因并非肿瘤疾病的病例进行删失后估计疾病相关生存率，以及考虑一般人群的人口统计学数据。
我们的论文利用德国1986/88年人口普查数据进行年龄校正。我们编写了一个基于SPSSWIN的计算机程序，可实现自动年龄校正。我们以膀胱癌手术治疗后放疗的临床数据为例来说明该方法。
使用年龄校正后的估计5年生存率——取决于样本中的患者年龄——比未校正率高10%至15%。在333例未经过筛选的患者的整个样本中，5年生存率从47%校正至59%。在根据年龄和性别分布进行调整的正常人群中，预期生存率为80%。
年龄校正对60岁以上男性患者和70岁以上女性患者的生存分析有重大影响。因此，在研究这些年龄组患者长期生存情况的肿瘤学研究中应采用年龄校正。
