启东市2001年-2007年肺癌生存率分析

背景与目的生存率研究是反映癌症预后的一个重要指标。本研究旨在对启东2001年-2007年全人群肺癌登记病例进行生存率分析,为预后评价及防治提供依据。方法 4,451例登记病例的生存(死亡)情况随访截止于2009年12月31日;剔除只有死亡医学证明书(death certificate only,DCO)病例,实际纳入分析4,382例。用SURV 3.01软件计算观察生存率(observed survival,OS)及相对生存率(relative survival,RS),并应用Hakulinen氏似然比检验法进行统计学检验。结果肺癌1年、3年、5年OS分别为23.73%、11.89%和10.01%,1年、3年、5年RS分别为24.86%、13.69%和12.73%。其中男性1年、3年、5年RS分别为23.70%、12.58%和11.73%,女性1年、3年、5年RS分别为27.89%、16.53%和15.21%,女性生存率高于男性,两组之间的差异具有统计学意义(χ2=13.77,P=0.032)。15岁-34岁、35岁-44岁、45岁-54岁、55岁-64岁、65岁-74岁及75+岁各年龄组的5年RS分别为35...     

启东市2001-2007年肝癌生存率分析

目的:对启东2001-2007年全人群肝癌登记病例进行生存率分析,为预后评价及防治提供依据。方法:6 217例登记病例的生存(死亡)情况随访截止于2009-12-31;剔除"死亡报告"或"死亡医学证明"(DCO)病例,实际纳入分析6 104例。SURV 3.01软件计算5年观察生存率(OS)及5年相对生存率(RS)。结果:肝癌1、3和5年OS分别为18.68%、10.85%和8.94%,1、3和5年RS分别为19.11%、11.61%和10.00%。其中男性1、3和5年RS分别为19.73%、11.69%和9.84%,女性为17.24%、11.39%和10.55%,男女性生存率差异无统计学意义,P>0.05。15～34、>34～44、>44～54、>54～64、>64～74及>74岁各年龄组的5年RS分别为12.88%、8.50%、10.57%、9.20%、10.52%及13.05%。5年RS比启东1972-1981及1982-1991年时的2.2%及2.3%有较大的提高。结论:启东市全人群肝癌登记病例总体生存率有较大的提高,但与国外发达国家相比尚有差距。我国肝癌的总体治疗水平亟待提高。     

上海人群结直肠癌生存率分析

背景与目的：中国结直肠癌的发病率和死亡率逐年上升,该研究分析了结直肠癌生存率资料,以促进结直肠癌的防治。方法：根据上海市肿瘤登记处收集的2002—2006年结直肠癌登记和生存随访报告资料,采用寿命表法和Ederer Ⅱ法对结直肠癌患者的观察生存率(observed survival,OS)和相对生存率(relative survival,RS)及其相关人口学和疾病状况特征资料进行分析,以反映上海地区人群结直肠癌的生存现况。结果：纳入分析的上海市2002—2006年诊断的结肠癌和直肠癌病例分别为16682例和11906例,5年OS分别为48.84%和51.65%,5年RS分别为70.50%和71.31%。各种不同诊断时期别间的生存率差异有统计学意义(P<0.05)。Ⅰ期患者的生存率明显高于Ⅲ期和Ⅳ期。不同性别、年龄、肿瘤组织学类型和居住区域的结直肠癌患者生存情况差异有统计学意义(P<0.05)。女性生存率较男性高,>44~54岁年龄段患者生存率高于其他年龄组,上皮型肿瘤的结肠癌患者生存率高于其他组织学类型的结肠癌患者,非上皮型肿瘤的直肠癌患者生存率高于其他组织学类型的直肠癌患者。过去30年来,上海地区结直肠癌的5年OS和RS都有明显改善。结论：上海市结直肠癌患者的生存水平较高,接近发达国家水平。不同特征人群结直肠癌生存的差异为进一步改善早期筛查和临床诊治提供了发展方向。     

启东市2001-2007年胃癌生存率分析

目的:分析启东市2001年-2007年全人群胃癌患者的观察生存率和相对生存率。方法:2839例胃癌登记病例的生存(死亡)情况随访截止于2009年12月31日;剔除DCO(death certificate only)病例,实际纳入分析2824例。用SURV3.01软件计算观察生存率(OS)及相对生存率(RS)。结果:启东胃癌1、3、5年OS分别为41.86%、27.59%和24.41%,1、3、5年RS分别为43.82%、31.68%和30.88%。其中男性1、3、5年OS分别为44.04%、31.00%、29.99%,女性1、3、5年RS分别为43.45%、32.86%、32.42%,男女性生存率差别无显著意义(P>0.05)。15-34岁、35-44岁、45-54岁、55-64岁、65-74岁及75岁以上各年龄组的5年RS分别为27.79%、37.91%、34.18%、29.41%、29.61%及29.85%,年龄组生存率差异有显著意义(P<0.001)。5年相对生存率与启东20世纪70年代相比,有了显著的提高。结论:启东市全人群胃癌生存率呈上升趋势,应当继续重视胃癌的生存率研究,为人群综合防治服务。     

启东市2001～2007年宫颈癌生存率分析

目的对启东2001~2007年全人群宫颈癌登记病例进行生存率分析,为预后评价及防治提供依据。方法 241例登记病例的生存（死亡）情况随访截止于2009年12月31日,用SURV3.01软件计算观察生存率（OS）及相对生存率（RS）。结果宫颈癌1,3,5年OS分别为64.32%、52.62%和50.69%;1,3,5年RS分别为65.34%、55.18%和54.99%。15~34岁、35~44岁、45~54岁、55~64岁、65~74岁及75岁以上各年龄组的5年OS分别为73.68%、70.20%、63.19%、39.64%、16.09%和20.00%;5年RS分别为73.86%、70.79%、64.51%、41.29%、18.42%和36.37%。年轻宫颈癌患者有较高的相对生存率,各年龄组生存率相比差异有显著性（P〈0.05）。启东2001~2007年宫颈癌5年OS、RS比1976~2000年各时期有了较大的提高。结论启东市20世纪70年代以来全人群宫颈癌登记病例的总体预后已有长足的进步,但与国外发达国家相比尚有差距。宫颈癌的防治任重道远。     

启东恶性肿瘤患者在某肿瘤医院住院诊治后生存率分析

摘 要：［目的］ 结合以人群为基础的癌症登记和以医院为基础的癌症登记资料进行随访及互核来研究患者的预后,为综合评估癌症患者住院后生存率提供依据。［方法］ 对2002~2014年启东籍首次住于某肿瘤医院恶性肿瘤患者（下称“医院登记患者”）开展生存结局的主动随访与被动随访,随访信息截止于2016年3月31日,剔除失访病例后列入统计。用寿命表法计算观察生存率,并与同期人群为基础的癌症患者（下称“人群登记患者”）生存率作比较分析。［结果］ 2002~2014年医院登记患者2156例,经随访获得生存结局信息的为2015例,失访141例,失访率为6.54%。所有患者的1年、3年、5年及10年观察生存率(OS)分别为63.37%、40.21%、32.75%及23.08%。医院登记患者中前10位癌症依次为肺癌、宫颈癌、食管癌、肝癌、乳腺癌、胃癌、非霍奇金淋巴瘤(NHL)、结直肠癌、鼻咽癌、卵巢癌,占全部恶性肿瘤的68.93%;5年观察生存率分别为11.78%、65.51%、17.19%、14.00%、55.76%、21.73%、39.85%、29.88%、49.16%及28.99%。所有癌症合计的5年生存率女性高于男性,有统计学意义（P<0.01）,分癌种中鼻咽癌5年生存率女性高于男性,有统计学意义（P<0.01）,而其它部位癌症5年生存率男女性间差异无统计学意义（P>0.05）。启东籍医院登记患者5年生存率（32.75%）远高于2003~2007年启东人群登记患者的5年生存率（16.82%）,差异有统计学意义（P<0.01）。分肿瘤比较显示医院登记患者中宫颈癌、食管癌、NHL、鼻咽癌的5年生存率高于启东人群登记患者中同类别癌症的5年生存率,差异有统计学意义（P<0.01）;肺癌、肝癌的生存率差异亦有统计学意义（P<0.05）;而医院登记患者中乳腺癌、胃癌、结直肠癌、卵巢癌与人群登记患者的生存率差异无统计学意义（P>0.05）。［结论］ 启东籍医院登记患者的生存率与国内外同类资料可比;与人群登记患者的生存率比较可反映肿瘤医院的专科特色及部位别肿瘤的诊治水平。     

以医院为基础的233例结直肠癌登记患者的生存率分析

摘 要：［目的］ 对南通市肿瘤医院2002~2014年以医院为基础的肿瘤登记结直肠癌病例做生存率分析,为制定结直肠癌患者防治策略提供可靠依据。 ［方法］ 对癌症登记数据库中启东、海门籍的结直肠癌住院患者开展主动与被动相结合的方法进行生存结局的随访。用寿命表法计算观察生存率,并用Wilcoxon统计分析比较生存率的差别。 ［结果］ 2002~2014年间南通市肿瘤医院共收治启东、海门籍结直肠癌患者237例,随访截止于2016年3月31日,共获得癌症生存结局信息233例,失访4例,随访率为98.31%。233例纳入病例中,男性136例,女性97例;结肠癌93例,直肠癌140例;首次入院平均年龄为（66.82±7.94）岁。在各年龄组中50~74岁共计175例,占75.11%。结直肠癌患者的1、3、5、10年总观察生存率分别为75.11%、48.60%、36.36%和28.14%,其中直肠癌住院患者的观察生存率优于结肠癌患者,两组比较总体生存率差异有统计学意义（Gehan=7.172,P=0.007）。在结直肠癌患者中男性1、3、5、10年观察生存率分别为72.79%、46.69%、34.04%和22.59%,而女性分别为78.35%、51.29%、40.18%和37.32%,两组比较差异无统计学意义 (Gehan=0.189,P=0.664) 。海门籍结直肠癌患者生存率与启东籍患者比较,差异无统计学意义（Gehan =1.083,P=0.298)。0~44岁、45~54岁、55~64岁、65~74岁及75岁以上各年龄组的5年生存率分别为7.33%、31.53%、43.17%、41.66%和24.31%（Gehan=3.194,P=0.526）。［结论］ 以医院为基础的肿瘤登记可作为肿瘤防治工作的基础,可为评估结直肠癌患者接受正规治疗后的综合效果和结局提供参考依据。     

启东市2001～2007年食管癌生存率分析

[目的]分析启东市2001~2007年全人群食管癌登记病例生存率,为预后评价及防治提供依据。[方法]929例食管癌登记病例的生存（死亡）情况随访截止于2009年12月31日;剔除只有死亡医学证明（DCO）病例,实际纳入分析916例。用SURV3.01软件计算5年观察生存率（OS）及5年相对生存率（RS）。[结果]食管癌1、3、5年OS分别为26.20%、12.79%、10.66%,1、3、5年RS分别为27.85%、15.33%和14.45%。其中男性1、3、5年RS分别为28.56%、15.65%、14.70%,女性1、3、5年RS分别为26.30%、14.63%、13.87%,男女性生存率差别无显著意义（P〉0.05）。15~34岁、35~44岁、45~54岁、55~64岁、65~74岁及75岁以上各年龄组的5年RS分别为33.44%、14.59%、19.07%、19.43%、11.11%及12.00%。男、女性食管癌5年RS（14.70%与13.87%）显著高于启东1972~2000年的4.38%与5.57%。[结论]过去几十年中启东市全人群食管癌登记病例总体生存率有较大的提高,相当于国内城市地区90年代的水平,与国外发达国家的差距也在缩小。     

启东市2001-2007年胃癌生存率分析

目的：分析启东市2001年-2007年全人群胃癌患者的观察生存率和相对生存率。方法：2839例胃癌登记病例的生存（死亡）情况随访截止于2009年12月31日;剔除DCO（death certificate only）病例,实际纳入分析2824例。用SURV3.01软件计算观察生存率（OS）及相对生存率（RS）。结果：启东胃癌1、3、5年OS分别为41.86%、27.59%和24.41%,1、3、5年RS分别为43.82%、31.68%和30.88%。其中男性1、3、5年OS分别为44.04%、31.00%、29.99%,女性1、3、5年RS分别为43.45%、32.86%、32.42%,男女性生存率差别无显著意义（P〉0.05）。15-34岁、35-44岁、45-54岁、55-64岁、65-74岁及75岁以上各年龄组的5年RS分别为27.79%、37.91%、34.18%、29.41%、29.61%及29.85%,年龄组生存率差异有显著意义（P〈0.001）。5年相对生存率与启东20世纪70年代相比,有了显著的提高。结论：启东市全人群胃癌生存率呈上升趋势,应当继续重视胃癌的生存率研究,为人群综合防治服务。     

以大型单中心医院登记为基础的1.37万例结直肠癌手术患者生存报告

背景与目的:基于医院登记为基础的结直肠癌手术患者的随访资料,分析其1、3和5年总生存率(overall survival,OS)与无病生存率(disease-free survival,DFS),为了解中国结直肠癌患者长期生存情况提供真实世界研究证据。方法:研究纳入2008年1月1日-2017年12月31日在复旦大学附属肿瘤医院接受手术治疗的结直肠癌患者共13 721例,通过查阅患者复诊病史、电话随访和死因数据链接等方式收集患者的生存随访资料,随访统计时间截至2019年11月30日。采用Kaplan-Meier法估计患者1、3和5年OS和DFS,根据年龄组、性别、治疗时期、肿瘤分期以及病理学特征、治疗方式各亚组分别描述。结果:结直肠癌手术患者经中位54.03个月随访后,5年OS和0~Ⅲ期患者5年DFS分别为73.87%和72.25%。0~Ⅰ、Ⅱ、Ⅲ和Ⅳ期结直肠癌手术患者5年OS分别为91.92%、87.15%、70.49%和27.70%,45岁以下年龄组患者5年OS为74.93%,差于45~64岁和65~74岁年龄组。不同组织学类型、分化程度、壁外血管侵犯、神经侵犯、环切缘情况患者的生存差异显著。结论:首次报告中国国内单中心超万人结直肠癌患者的5年长期生存结果,44岁及以下青年结直肠癌患者生存率较低,肿瘤分期是影响结直肠癌患者生存的重要可改变因素,应加强早诊早治,进一步提升患者生存率。     

Trends in Breast Cancer Mortality, Incidence, and Survival, and Mammographic screening in Tuscany, Italy

Objective: The study describes breast cancer mortality trends in Tuscany (period 1970–97), comparing Florence with the rest of Tuscany (Florence excluded), and, for Florence, incidence (period 1985–94) and survival (1985–86 versus 1991–92) trends, taking into account the diffusion of screening. Methods: Mortality and incidence rates, age-adjusted on the European population, and 95% confidence intervals (95% CI). Five-year relative survival rates and estimates of risk of dying provided by the Cox model. Results: Mammographic screening, started at the beginning of the 1970s in some municipalities, largely involved the Florence area after 1990 (mammograms/years: from 8000–9000 to 28,000–29,000, respectively, before and after 1990). In the same period no population-based screenings were ongoing in the rest of Tuscany. A significant mortality drop was observed in Tuscany (–3.7%/year), starting at the beginning of the 1990s and observed for ages 74 (especially ages 40–49: –11.2%/year). The drop was similar in Florence and in the rest of Tuscany. In ages 50–69, incidence, increasing between 1985–87 and 1988–90 (+6.5%), rose sharply in 1991–94 (+17.0%); it was stable in other ages. Local disease increased more markedly in ages 50–69 (globally: +88.3%), but also in other ages (+20–30%). Regional and metastatic cancers decreased. A significantly better 5-year survival was observed among cases diagnosed in 1991–92, persisting after adjustment by extent of disease. Conclusion: Even if the causes of breast cancer mortality trends are not easy to clarify in an observational study, our data suggest that the drop in mortality observed in Tuscany at the beginning of the 1990s could be largely explained by both earlier detection, outside of an organized screening program, and by better treatments. The increase in incidence and the shift in stage distribution that occurred before the enlargement of the screening area and in age groups not involved in the program, supports the role of a `spontaneous' widespread earlier detection. The better survival of the period 1991–92, only partly explained by the shift in stage at diagnosis, indirectly supports the role of improvement in therapy.     

Etoposide, dexamethasone, cytarabine, and cisplatin in vincristine, doxorubicin, and dexamethasone-refractory myeloma

Based on remarkable activity in refractory lymphomas, a combination of etoposide, cisplatin (both administered by 4-day continuous infusions), cytarabine (Ara-C), and dexamethasone (EDAP) was evaluated in 20 patients with advanced myeloma refractory to standard melphalan and prednisone (MP) and/or vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) and even to high doses of melphalan (HDM) (seven patients). Forty percent of patients responded regardless of previously recognized risk factors (eg, duration of drug resistance, tumor mass, and serum lactic dehydrogenase [LDH] level). While the median survival was only 4.5 months, patients with good performance (Zubrod less than 2) and low or intermediate tumor stage survived more than 14 months compared with only 2 months for the remaining group. EDAP could be readily administered in the outpatient clinic, but neutropenic fever prompted hospital admission in 80% of patients, half of whom developed penumonia and sepsis, a fatal outcome in four patients. Severe myelosuppression was of short duration, so that subsequent cycles could be administered every 3 to 4 weeks. No serious extramedullary toxicity, including renal toxicity, was encountered. Marrow toxicity and hence infectious complications may be reduced by elimination of Ara-C without compromising treatment efficacy. We conclude that the lack of cross-resistance with VAD and even HDM makes EDAP or a similar combination an attractive regiment to be formally explored in an alternating sequence with VAD in high-risk myeloma.     

Mate drinking, alcohol, tobacco, diet, and esophageal cancer in Uruguay

A case-control study was conducted in Uruguay to investigate the role of mate drinking, alcohol, tobacco, and certain dietary factors in the etiology of esophageal cancer. The study included 261 patients with squamous cell carcinoma of the esophagus and 522 hospital controls matched by sex and age. A strong association with a clear dose-response relationship was observed with the amount of mate drunk daily and duration of the habit. The relative risk for those drinking over 2.5 liters of mate per day was 12.2 (95% confidence interval, 3.8-39.6) after adjusting for the effects of age, area of residence, alcohol, and tobacco. Strong associations were also observed with tobacco smoking and alcohol drinking which appear to act in a multiplicative way. The relative risk for those who smoke and drink heavily compared to that of light smokers and drinkers was 22.6. The risk associated with black tobacco was about three times higher than that associated with blond tobacco. A clear protective effect was found for the consumption of fruits and vegetables but a dose-response relationship was present only for fruits. Finally, an increased risk was also found for those eating barbecued meat daily.     

Trends in cancer incidence in esophagus, stomach, colon, rectum and liver in males in India.

Time trends in cancers of the esophagus, stomach, colon, rectum and liver cancers among the male population in five Indian urban population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, and Bhopal) were examined over the period of the last two decades. The model applied fits data to the logarithm of Y=ABx. This Linear Regression method showed decreasing trends in age-adjusted incidence rates for cancers of the stomach and esophagus, especially in Bjopal, and increasing trends for colon and rectum and liver, throughout the entire period of observation in most of the registries. The five cancers together constitute more than 80% of the total gastro intestinal cancers and are serious diseases in both sexes. To understand the etiology of these cancers in depth, analytic epidemiological studies should be planned in the near future on a priority basis.     

Socio-demographic variation in stage at diagnosis of breast,bladder, colon,endometrial, lung,melanoma, prostate,rectal, renal and ovarian cancer in England and its population impact

Background Stage at diagnosis strongly predicts cancer survival and understanding related inequalities could guide interventions.Methods We analysed incident cases diagnosed with 10 solid tumours included in the UK government target of 75% of patients diagnosed in TNM stage I/II by 2028. We examined socio-demographic differences in diagnosis at stage III/IV vs. I/II. Multiple imputation was used for missing stage at diagnosis (9% of tumours).Results Of the 202,001 cases, 57% were diagnosed in stage I/II (an absolute 18% ‘gap’ from the 75% target). The likelihood of diagnosis at stage III/IV increased in older age, though variably by cancer site, being strongest for prostate and endometrial cancer. Increasing level of deprivation was associated with advanced stage at diagnosis for all sites except lung and renal cancer. There were, inconsistent in direction, sex inequalities for four cancers. Eliminating socio-demographic inequalities would translate to 61% of patients with the 10 studied cancers being diagnosed at stage I/II, reducing the gap from target to 14%.Conclusions Potential elimination of socio-demographic inequalities in stage at diagnosis would make a substantial, though partial, contribution to achieving stage shift targets. Earlier diagnosis strategies should additionally focus on the whole population and not only the high-risk socio-demographic groups.Subject terms: Oncology, Health policy