重庆市九龙坡区2008—2013年主要恶性肿瘤生存率分析

目的：对重庆市九龙坡区2008--2013年全人群登记的恶性肿瘤患者进行生存率分析,为评价肿瘤预后提供依据。方法：对来自九龙坡区肿瘤登记的8746例患者进行观察随访,观察截至2013—05—31,去除660例只有死亡医学证明书（death certificate only,DCO）的患者后,实际有8086例纳入分析。应用suRV3．01软件计算l～5年观察生存率（0S）,用Log—rank检验对男性和女性的总体恶性肿瘤观察生存率进行比较。结果：九龙坡区恶性肿瘤1年观察生存率为62．50％,2年为48．27％,3年为41．42％,4年为33．46％,5年为30．30％。发病居前10位的恶性肿瘤中,肝癌的5年观察生存率最低,为7．37％,其次是胰腺癌（9．69％）和肺癌（10．38％）,并且这3种肿瘤男性和女性生存率均比较低。与前述3种肿瘤相比,结直肠肛门癌的5年观察生存率男性为38．16％,女性为39．87％,均较高。主要发生于女性的恶性肿瘤中,乳腺癌的5年观察生存率最高,为70．87％,其次是子宫癌（37．64％）、卵巢癌（37．45％）和宫颈癌（35．32％）。男性和女性总体恶性肿瘤的观察生存率差异具有统计学意义,x2=8．89,P〈0．01。结论：主要恶性肿瘤中,肝癌、胰腺癌和肺癌是九龙坡区预后较差的肿瘤,结直肠肛门癌、女性乳腺癌、子宫癌、卵巢癌和宫颈癌是相对预后较好的肿瘤。九龙坡区女性恶性肿瘤患者总体生存率高于男性。     

北京城区女性乳腺癌发病死亡和生存情况20年监测分析

目的 探讨北京城区乳腺癌发病率、死亡率及生存率的变化特点,为乳腺癌的预防与控制提供依据。方法 利用1982-2001年北京城区肿瘤登记报告资料,并结合1982年1月1日至1983年12月30日和1987年1月1日至1988年12月30日两个时期新发病例的随访资料,对北京城区女性乳腺癌的发病率、死亡率、生存率进行比较分析。结果 1982-2001年北京城区女性乳腺癌发病率及世界标准人口标化率呈逐年上升趋势,平均每年递增4．6％和4．9％。其流行特征：（1）年龄别发病率呈现一条由低到高的双峰曲线;（2）20年间各年龄组发病率均呈增高趋势;（3）35～64岁截缩发病率高达95．3／10万;（4）1982-1983年和1987-1988年两个时期相比,5年观察生存率（OSR）从62．0％上升到68．7％,相对生存率（RSR）由66．3％增长到74．2％;（5）20年间,死亡率一直在8／10万～10／10万的水平上波动。结论 北京城区女性乳腺癌发病率呈逐年上升的流行趋势,死亡率呈平稳状态,5年生存率在不断提高。北京市乳腺癌的二级预防是有效果的。     

淮安市居民2010年新发恶性肿瘤患者生存率分析

目的：淮安地处淮河流域里下河下游地区,系全国恶性肿瘤高发区之一,肿瘤的高发生与死亡所致的疾病负担已成为当地一个严峻的公共卫生问题。研究淮安市居民2010年新发肿瘤患者的生存状况,为肿瘤的综合防治提供科学依据。方法收集淮安市恶性肿瘤随访登记系统2010-01-01－12-31新发10383例患者资料,并进行跟踪随访,随访截止日期为2015-12-31,采用 Life-table 过程计算观察生存率（observed survival rate,OS）与相对生存率（relative survival rate,RS）,不同性别、年龄组间肿瘤生存率比较采用 Log-rank 过程分析。结果全部肿瘤患者5年 OS 与 RS 分别为21．73％和25．12％。发病前5位恶性肿瘤为食管癌、肺癌、胃癌、肝癌和结直肠肛门癌,食管癌5年 RS 为26．95％,肺癌为12．01％,胃癌为27．73％,肝癌为8．41％,结直肠肛门癌为35．07％。男性肿瘤患者5年 OS 明显低于女性,χ2＝100．933,P ＜0．001;但发病前5位的恶性肿瘤患者5年 OS,男性与女性差异均无统计学意义,P ＞0．05。全部肿瘤病例、食管癌、肺癌、胃癌与结直肠肛门癌各年龄组的5年 OS,均随着年龄的增加而呈下降趋势,P 趋势＜0．001。结论在淮安市主要恶性肿瘤中,肝癌、肺癌、食管癌和胃癌的生存状况较差,结直肠肛门癌和女性乳腺癌生存状况相对较好,女性恶性肿瘤患者总体生存期高于男性。     

2011―2018年重庆多中心恶性肿瘤出院患者生存分析

摘 要：［目的］ 对重庆大学附属肿瘤医院牵头的8家医院2011至2018年出院的恶性肿瘤患者的生存情况进行统计分析。［方法］ 对所有恶性肿瘤患者进行随访,采用寿命表法计算主要恶性肿瘤的观察生存率。采用Log-rank检验比较不同年龄段、不同性别前10位恶性肿瘤的生存率。［结果］ 该次研究一共纳入60 088例恶性肿瘤患者,有效随访49 259例,有效随访率81.98%。主要恶性肿瘤患者１～５年生存率分别为76.55％、66.29％、59.88％、56.06％和52.97％。前10位恶性肿瘤患者中,5年生存率最高的是宫颈癌,达到90.70%,其次是乳腺癌,84.08%,生存率最低的是肝癌（14.66%）,其次是肺癌（20.43%）;经Log-rank检验,不同恶性肿瘤的不同年龄段生存率差异均有统计学意义（P<0.05）;不同恶性肿瘤的不同性别生存率相差较大,其中不同性别的肺癌、继发性恶性肿瘤、胃癌差异有统计学意义（P<0.05）,其他恶性肿瘤不同性别间的生存率差异均无统计学意义（P>0.05）。［结论］ 8家单位2011—2018出院的主要恶性肿瘤患者中,肝癌、肺癌、食管癌预后较差,宫颈癌、乳腺癌和鼻咽癌预后相对较好。     

双侧原发性乳腺癌的预后影响因素分析

目的：研究双侧原发性乳腺癌的预后及其影响因素。方法：对经病理证实的30例双侧原发性乳腺癌患者进行分析。结果：腋淋巴结无转移患者的5年生存率（64．7％）明显高于腋淋巴结转移的患者（30．8％）。肿瘤直径＜2cm的患者5年生存率（62．5％）明显高于肿瘤直径≥2cm的患者（45．5％）。ER受体阳性患者的5年生存率（66．7％）明显高于ER受体阴性患者（38．9％）。结论：双侧原发性乳腺癌的预后取决于腋窝淋巴结有无转移，肿瘤大小以及ER受体是否阳性。其中腋淋巴结有无转移是影响预后的一个重要指标。     

顺铂联合化疗治疗卵巢恶性生殖细胞肿瘤

目的：探讨卵巢恶性生殖细胞肿瘤的治疗疗效及复发患者二线治疗。方法：对我院1958年11月－1998年12月312例卵巢恶性肿瘤中的154例接受顺铂方案化疗的卵巢恶性生殖细胞肿瘤结果进行分析。结果：154例卵巢恶性生殖细胞肿瘤的总生存率为74．7％，初治患者（I－Ⅲ期）92例，5年生存率为92．2％，其中66例（71．7％）保留生育功能，19例已正常生育20次。复发转移62例，5年生存率51．1％，8例保留生育功能。结论：为了提高卵巢恶性生殖细胞肿瘤生存率，首次手术时应正确分期，术后及时采用当前标准BEP方案作为一线化疗，连续3－6疗程。对复发患者，根据以往治疗情况尽早选用有效的二线方案化疗，有利于提高生存率。     

启东市1972～2000年主要恶性肿瘤生存率分析

[目的]评价启东1972～2000年基于全人群的恶性肿瘤登记病例的预后。[方法]55496例登记病例的生存（死亡）情况随访截止于2001年12月31日，用Hakulinen等编制的SURV3．00bl软件计算5年观察生存率（OS）及5年相对生存率（RS）。[结果]女性乳腺癌的5年生存率最高（OS：55．92％，RS：58．44％），其次为宫颈癌（OS：39．06％，RS：42．40％）。原发性肝癌的5年生存率在男性（OS：3．26％，RS：3.46％）和女性（0S：4．11％，RS：4．31％）中均为最低。食管癌（OS：4．09％，RS：4．76％），肺癌（OS：4．79％，RS：5．48％），白血病（OS：5．48％，RS：5．79％）和胰腺癌（OS：6．56％．RS：7．45％）的预后也较差。与1972～1976年的生存率比较，男性胃癌、肝癌、前列腺癌等，以及女性鼻咽癌、直肠癌、肝癌、膀胱癌等生存率有所改善。[结论]启东市癌症总体生存率较低．与国内大城市相比有较大的葺距．与国外发达国家相比差距更大。     

北京乳腺癌流行特征及趋势预测

北京乳腺癌流行特征及趋势预测王启俊，祝伟星，袁光亮，邢秀梅北京市肿瘤防治研究所（北京１０００３４）乳腺癌是当今世界女性最多发的恶性肿瘤，列为女性癌症的首位，并居世界上两个性别癌症发病数第三位，仅次于肺癌、胃癌发病数。值得注意的是乳腺癌主要集中在世界发...     

54例25岁以下女性乳腺癌的临床特征和预后分析

背景与目的：25岁以下女性乳腺癌非常少见，目前缺乏这部分患者的预后报道，对其生物学特点和临床特征认识亦非常有限。本研究回顾性分析肿瘤研究所收治的年轻乳腺癌患者的临床表现和病理学特点和影响预后的因素。方法：收集1980年1月-2005年12月收治的54例25岁以下女性乳腺癌患者的临床资料，观察长期生存率，分析其临床特点及影响预后的因素。结果：54例患者占同期收治乳腺癌的0．48％，其中浸润性导管癌42例（77．8％），均无乳腺癌及卵巢癌家族史。Ⅰ、Ⅱ期患者占68．5％，淋巴结转移率为53．7％，肿瘤大小T1、T2占79．6％。根据生物学特点，ER和PR的阳性率较低（分别为29．6％和36．0％），HER-2阳性率较高（22．2％）。有8例患者存在脉管瘤栓。38例患者接受辅助化疗。化疗可以明显改善淋巴结阳性患者的5年总生存率（OS）（P=0．007）。有26例患者死亡。5年无病生存率（DFS）和OS分别为54．3％和55．5％。诊断延迟3个月以上（P=0．019）、临床分期（P=0．000）、肿瘤大小（P=0．007）、腋淋巴结转移（P=0．000）及脉管瘤栓（P=0．011）是预后相关的因素。多因素分析显示诊断延迟3个月以上（P=0．034）和淋巴结转移（P=0．027）是独立预后因素。结论：25岁以下女性浸润性乳腺癌有更强的侵袭性。诊断延迟3个月以上和淋巴结转移是不良预后因素。青少年和极年轻乳腺癌患者的治疗原则与一般乳腺癌相同，但是需要探索更为合理的个体化综合治疗。     

湖北某三甲综合医院2005年－2014年腹部常见恶性肿瘤疾病构成情况及死亡病例分析

目的：分析湖北某三甲综合医院腹部恶性肿瘤住院患者的疾病构成、病死率情况,为医院肿瘤防控工作及医疗质量管理提供依据。方法：回顾性分析2005年至2014年湖北省襄阳市中心医院6658例腹部恶性肿瘤住院患者及256例肿瘤住院死亡患者的临床资料,从性别、病种、死亡疾病构成、死因顺位等方面进行统计分析。结果：6658例腹部恶性肿瘤住院患者中,男性3822例（57．4％）,女性2836例（42．6％）,男女性别比1．35∶1。患者平均年龄（57．1±12．8）岁。腹部恶性肿瘤的疾病构成依次为：结直肠癌（36．3％）、肝癌（28．0％）、胃癌（24．2％）、胰腺癌（7．4％）、胆囊癌（4．1％）。男性腹部恶性肿瘤患者的前3位疾病构成为：肝癌、结直肠癌和胃癌,女性前3位疾病构成为：结直肠癌、胃癌、肝癌,第4、5位均为胰腺癌和胆囊癌。6658例腹部恶性肿瘤患者中,死亡256例,病死率为3．84％;2005年－2014年腹部恶性肿瘤住院患者呈逐年增加的趋势,2014年腹部恶性肿瘤住院人数为2005年的4．5倍,住院病死率从2005年的6．03％下降至2014年的2．35％,病死率随时间呈明显下降趋势（P ＜0．001）。对256例腹部恶性肿瘤死亡病例进行死因分析,结果显示,腹部恶性肿瘤的主要死因为：肝癌、结直肠癌、胃癌、胰腺癌、胆囊癌。男性的主要死因为肝癌、结直肠癌、胃癌、胰腺癌、胆囊癌;女性的主要死因为：胃癌、结直肠癌、肝癌、胰腺癌、胆囊癌。结论：腹部恶性肿瘤病例数逐年增加,中老年是主要发病人群,应当针对恶性肿瘤的构成特征、死亡构成有针对性的制定肿瘤防治策略。     

Analysis of the indicence and Survival of Female Breast Cancer Patients in Beijing Over a 20-Year Period

A bout 30-years of information concerning cancer morbidity and mortality has been collected by the Cancer Registration Office of Beijing since its establishment in 1976. The information suggested that lung cancer and female breast cancer (FBC) are relativ…     

Cancer Survival in Sweden During Three Decades, 1961-1991

Cancer survival in Sweden in 1961-1991 is presented as a comprehensive report from the Swedish Cancer Registry. The report shows both successes and failures, confirms some earlier published results and presents some new findings worth further analysis. Survival has increased for female breast cancer, malignant melanoma, cancers of the testis and thyroid gland, acute leukemia, and Hodgkin's disease. No improvements are found for multiple myeloma or cancers of the liver, gall bladder, and pancreas. Small increases are shown for colorectal cancer and cancers of the stomach, oesophagus, and kidney. Increases in postoperative survival are shown for sites dominated by histologically benign tumors, i.e., intracranial neurinoma, meningioma, and cancers of the endocrine glands such as parathyroid tumors. From 1970-1972 to 1980-1982 the 10-year relative survival rate (RSR) increased from 30% to 38% for males and from 44% to 51% for females. Hence, cancer survival for all cases combined has approached the survival of the general population somewhat. Most of the increases took place in the 1970's. Changes in the distribution of incidence towards cancer sites with better prognoses account for some 10-20% of the observed increases in RSR, whereas the aging of the cancer population reduces the upward trend in RSR for all cases combined by some 1-2%. Cancer patients have poorer survival than the population long after 5 years of follow-up. They reach the survival of the population after about 8-12 years for colorectal cancer, 10 years for cervical cancer, 7-10 years for malignant melanoma, 13-18 years for kidney cancer, and more than 19 years for female breast and prostate cancer. For patients diagnosed in 1970-1972 this occurred 16 years after diagnosis at 29% for males and 43% for females when all cancer cases were combined. The extended time until 'statistical cure' for most cancer forms clearly indicates the need to augment the commonly used 5-year RSR with other outcome measures. If cancers on average are discovered earlier today, the 5-year RSR gives an exaggerated impression of the improvement over time. In this case the change in the 10-year RSR is a less biased criterion.     

Global increases in kidney cancer incidence, 1973-1992.

Reports of increasing rates for kidney cancers in several count prompted this analysis of global incidence trends for total kidney cancers and by subsite. International incidence data for 5-year periods 1973-1977, 1978-1982, 1983-1987 and 1988-1992 were obtained from volumes IV to VII of Cancer Incidence in Five Continents published by the International Agency for Research on Cancer. The USA data for the same 5-year periods were obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Percentage changes in incidence rates were computed using the relative difference between the time periods 1973-1977 and 1988-1992, and annual percentage changes in incidence rates were computed using log linear regression. In 1988-1992, kidney cancer incidence rates (age-adjusted to the world-standard population) were highest in France (16.1/100,000 man-years and 7.3/100,000 woman-years) and lowest in India (2.0 and 0.9, respectively). Between 1973-1977 and 1988-1992, incidence rates rose among men and women in all regions and ethnic groups, with a few exceptions, mostly in Scandinavian countries. The largest percentage increase for men was in Japan (171%) and for women in Italy (107%). Rates for renal pelvis cancer were less than 1/100,000 person-years in almost all regions in both sexes, and the temporal trends were inconsistent. Incidence trends for renal parenchyma cancer tracked those for total kidney cancers, and appeared to result from increases in the prevalence of risk factors and in use of diagnostic imaging procedures.     

Cancer survival in Manila, Philippines, 1994-1995

The population-based cancer registry in Manila, Philippines, called the Philippine Cancer Society-Manila Cancer Registry, was established in 1983. Cancer registration is pursued by active methods. The registry contributed survival data on a random sample of total incident cancers of breast (500), cervix (500), colon and rectum (300) registered in 1994-1995. Follow-up has been carried out by passive and active methods, with median follow-up ranging between 15-33 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 78-88%; 74-83% of the total submitted cases were included for survival analysis. Complete follow-up at five years was available in 75-82% of cases. Five-year age-standardized relative survival rates was the highest for cancer of the breast (52%) followed by colon (49%), cervix (36%) and rectum (31%). Five-year relative survival by age group did not display any pattern or trend and was fluctuating. A decreasing survival with increasing extent of disease was noted for all cancers.     

Cancer survival in Khon Kaen, Thailand, 1993-1997

The Khon Kaen cancer registry was established in 1984 as a hospital-based cancer registry, and population-based cancer registration started in 1988 with retrospective data collection from 1985. Cancer registration is done by passive and active methods. Data on survival for 13 cancer sites or types registered during 1993-1997 were reported. Follow-up was done by active methods, with median follow-up ranging between 8-32 months for different cancers. The proportion with histologically verified diagnosis for various cancers ranged between 54-100%; death certificates only (DCOs) comprised 0-5%; 85-97% of total registered cases were included for survival analysis. Five-year follow-up ranged from 40-83%. Five-year age-standardized relative survival rates for common cancers were cervix (58%), breast (61%), colon (39%), ovary (43%), non-Hodgkin lymphoma (42%) and rectum (43%). Five-year relative survival by age group portrayed an inverse relationship or was fluctuating. Five-year survival was the highest for localized disease, followed by the regional and distant metastasis categories. Trends in 5-year relative survival in 1993-1997 compared to 1985-1992 showed a marked increase for cancers of the rectum, breast, ovary, Hodgkin and non-Hodgkin lymphomas and decrease for cancers of the lip and larynx.     

广东省四会市1987~2009年恶性肿瘤生存率分析

[目的]分析广东省四会市1987～2009年主要恶性肿瘤患者的生存状况,为肿瘤的预后评价和防控提供科学依据.[方法]收集并整理1987～2009年四会市全人群肿瘤登记数据共11 456例,随访截止日期为2014年12月31日.用Log-rank检验对各年龄组、性别组和各主要癌症不同确诊年份段的生存率进行比较.采用Cox回归模型进行多因素分析.[结果]23年间,四会市鼻咽癌、胃癌、结直肠癌、乳腺癌、肝癌、肺癌、宫颈癌、子宫体癌、甲状腺癌9种恶性肿瘤的5年OS有明显提高,差异有统计学意义(P＜0.05);而食道癌、膀胱癌、淋巴瘤、白血病的5年生存率在这3个年份阶段中的变化无统计学差异.各确诊年份段的女性生存率均高于男性,女性死亡风险是男性的0.77倍;≥70岁年龄组的死亡风险是＜40岁组的2.23倍;2007～2009年的死亡风险是1987～1996年的0.71倍.[结论]23年来,四会市全人群恶性肿瘤生存率有所提高,但与国外发达国家及国内其他地区比较仍处于较低水平,提示应重视其他主要癌症的早诊早治工作.     

Cancer survival in Barshi, India, 1993-2000

The rural cancer registry of Barshi, Paranda and Bhum, was the first of its kind in India and was established in 1987. Registration of cases is carried out entirely by active methods. Data on survival from 15 cancer sites or types registered during 1993-2000 are reported in this study. Follow-up has been carried out predominantly by active methods, with median follow-up time ranging between 2-49 months for different cancers. The proportion of histologically verified diagnosis for various cancers ranged between 73-98%; death certificates only (DCOs) comprised 0-2%; 98-100% of total registered cases were included for survival analysis. Complete follow-up at five years ranged between 96-100% for different cancers. The 5-year age-standardized relative survival rates for selected cancers were non-melanoma skin (86%), penis (63%), breast (61%), cervix (32%), mouth (23%), hypopharynx (11%) and oesophagus (4%). The 5-year relative survival by age group did not display any particular pattern. Five-year relative survival trend between 1988-1992 and 1993-2000 showed a marked decrease for cancers of the tongue, hypopharynx, stomach, rectum, larynx, lung and penis; but a notable increase for breast and non-Hodgkin lymphoma.     

Trends of cancer occurrence and survival in Japan, and in Osaka]

Recent improvements in cancer medical care in Osaka have resulted in the elevation of survival rates of cancer patients, except for the so-called "refractory" cancers. Five-year relative survival rates for reported patients diagnosed in 1981-1983 were higher than 60% for cancers of the breast, uterus and bladder, and around 40% for rectum, colon and stomach cancers. However, cancers of the liver, gallbladder, pancreas, and lung continued to show very low survival rates of less than 10%. In higher age-groups, advanced cases occupied a larger proportion while cases which received curative resection occupied a smaller proportion. Reflecting this, survival rates were lower in age-groups higher than 75, and the reduction of age-differences between younger and older groups was not observed during the decade. Cancer incidence for all sites in Japan was estimated by the Research Group for Population-based Cancer Registries to be 320,000 in 1985. The stomach, colorectal, lung, liver, and breast were the five leading cancer sites. According to the authors' studies, cancer incidence is projected to be 740,000 in Japan in 2015, of which 40% would be patients of "refractory" cancers and 62% would be aged patients in their upper than 70, though these were 19% and 32% in 1985. In order to combat this difficult situation in the near future, the following activities are urgently required: (1) Promotion of primary preventive measures for incurable cancers. (2) Development of specific therapy programs taking into account of QOL for aged patients as well as advanced patients. (3) Promotion of secondary preventive measures for aged people as well as younger people.     

Cancer survival is dependent on season of diagnosis and sunlight exposure

Sunlight is essential for the production of vitamin D in the body. Evidence exists to suggest that vitamin D metabolites may have a role in tumor growth suppression. In this large study, involving over a million cancer patients from the United Kingdom, we have analyzed the role of season of diagnosis and sunlight exposure in cancer survival for cancers of the breast, colorectum, lung, prostate and at all sites combined. We used population-based data from the Thames Cancer Registry to analyze cancer survival in periods 0-1 and 0-5 years after diagnosis. The analysis was performed using Cox proportional regression analysis adjusting for age and period at diagnosis and including season of diagnosis and sunlight exposure in the preceding months as factors in the analysis. We found evidence of substantial seasonality in cancer survival, with diagnosis in summer and autumn associated with improved survival compared with that in winter, especially in female breast cancer patients and both male and female lung cancer patients (hazard ratios 0.86 [95% CI 0.83-0.89], 0.95 [95% CI 0.92-0.97] and 0.95 [95% CI 0.93-0.98] respectively). Cumulative sunlight exposure in the months preceding diagnosis was also a predictor of subsequent survival, although season of diagnosis was a stronger predictor than cumulative sunlight exposure. We found seasonality in cancer survival to be stronger in women than in men. Our results add to a growing body of evidence that vitamin D metabolites play an important role in cancer survival.