启东市1972-2011年膀胱癌生存率长期趋势分析

背景与目的：我国鲜见有以人群为基础的超过40年的膀胱癌生存率的报道。该研究对启东1972—2011年全人群膀胱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：1619例登记病例的生存(死亡)情况随访截止于2012年4月。用SURV 3.01软件计算观察生存率(observed survival rate，OS)和相对生存率(relative survival rate，RS)。结果：膀胱癌1、3、5、10、15、20及30年OS分别为59.91%、43.49%、35.98%、26.91%、21.30%、18.37%及12.24%，1、3、5、10、15、20及30年RS分别为64.07%、53.02%、50.06%、52.42%、59.59%、76.39%及115.75%。其中男性1、3、5、10、15、20及30年OS分别为60.84%、43.91%、36.95%、27.31%、21.49%、18.29%及12.59%，1、3、5、10、15、20及30年RS分别为65.23%、53.95%、52.02%、54.57%、62.59%、79.12%及117.07%；女性1、3、5、10、15、20及30年OS分别为56.61%、42.03%、32.44%、25.65%、20.78%、18.80%及0%，1、3、5、10、15、20及30年RS分别为59.99%、49.91%、43.37%、45.86%、51.21%、69.02%及0%，男性、女性生存率差异无统计学意义(P=0.256)。15~34岁、35~44岁、45~54岁、55~64岁、65~74岁及大于75岁各年龄组的5年RS分别为49.10%、67.53%、62.77%、53.92%、46.59%和39.85%；10年RS分别为49.79%、61.23%、52.99%、48.21%、54.94%和51.21%。20世纪80年代以来，膀胱癌5、10和15年RS均有上升趋势。结论：启东市全人群膀胱癌登记病例总体生存率在逐步提高，早期诊断和治疗方法的进步可能是膀胱癌生存率提高的影响因素。与发达国家相比，膀胱癌生存率的差距正在缩小，但仍有提高的空间。

Long-term survival trends of bladder cancer from 1972 to 2011 in Qidong

Background and purpose:There are few studies referring to population-based cancer survival of bladder cancer for more than forty years in China. This paper was to offer basis for assessing long-term survival trends of bladder cancer and the prognosis of this cancer through analysis of the survival rates based on cancer report documents from 1972 to 2011 in Qidong.Methods:The deadline of the last follow-up for survival status of the 1 619 registered cases was Apr. 2012. Cumulative observed survival rate (OS) and relative survival rate (RS) were calculated using Hakulinen’s method performed by the SURV3.01 Software which is developed by Finnish Cancer Registry.Results:The one-, three-, five-, ten-, fifteen-, twenty-, and thirty-year OS rates were 59.91%, 43.49%, 35.98%, 26.91%, 21.30%, 18.37% and 12.24%; and the one-, three-, five-, ten-, fifteen-, twenty-, and thirty-year RS rates were 64.07%, 53.02%, 50.06%, 52.42%, 59.59%, 76.39% and 115.75%, respectively. For males, these OS rates were 60.84%, 43.91%, 36.95%, 27.31%, 21.49%, 18.29% and 12.59%, and RS rates were 65.23%, 53.95%, 52.02%, 54.57%, 62.59%, 79.12% and 117.07%, respectively; For females, these OS rates were 56.61%, 42.03%, 32.44%, 25.65%, 20.78%, 18.80% and 0%, and RS rates, 59.99%, 49.91%, 43.37%, 45.86%, 51.21%, 69.02% and 0%, respectively. There were no statistical differences couldbe found between both sexes (P=0.256). Five-year RS rates of age groups 15-34, 35-44, 45-54, 55-64, 65-74, and more than 75 were 49.10%, 67.53%, 62.77%, 53.92%, 46.59% and 39.85%, and 10-year RS rates, 49.79%, 61.23%, 52.99%, 48.21%, 54.94% and 51.21%, respectively. Remarkable improvement could be seen for the five-, ten-, and fifteen-year RS rates in this setting since 1980’s.Conclusion:The survival outcome from Qidong registered cases with bladder cancer shows gradual progress during the past 2 decades. Early detection and improvement of therapies may be the factors affecting the prognosis of bladder cancer. Although the disparities in survival rates between Qidong and the developed countries are getting narrower, potential for survival improvement still exists.