中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (1): 11-24.doi: 10.19401/j.cnki.1007-3639.2020.01.002

• 论著 • 上一篇    下一篇

以医院登记为基础的20万例恶性肿瘤患者生存报告

周昌明 1 ,莫 淼 1 ,袁 晶 1 ,沈 洁 1 ,王泽洲 1 ,张志红 1 ,朱 骥 2 ,秦一雨 3 ,郑 莹 1 ,吴 炅 4 ,郭小毛 2   

  1. 1. 复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海 200032 ;
    2. 复旦大学附属肿瘤医院肿瘤放疗科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    3. 上海众访信息技术有限公司,上海 200092 ;
    4. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2020-01-30 发布日期:2020-01-17
  • 通信作者: 郭小毛 E-mail: guoxm1800@126.com

Report on 200 thousand cancer patients’ survival from a hospital-based cancer registry database

ZHOU Changming 1 , MO Miao 1 , YUAN Jing 1 , SHEN Jie 1 , WANG Zezhou 1 , ZHANG Zhihong 1 , ZHU Ji 2 , QIN Yiyu 3 , ZHENG Ying 1 , WU Jiong 4 , GUO Xiaomao 2   

  1. 1. Department of Cancer Prevention Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Department of Radiotherapy, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Shanghai Zhongfang Information Technology Co, Ltd., Shanghai 200092, China; 4. Department of Breast Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2020-01-30 Online:2020-01-17
  • Contact: GUO Xiaomao E-mail: guoxm1800@126.com

摘要: 背景与目的:恶性肿瘤是全球重大的公共健康问题,患者生存率是评价恶性肿瘤诊治水平的重要指标。通过描述以医院登记为基础的20万例恶性肿瘤患者的生存情况,以真实世界数据从一个侧面反映我国恶性肿瘤的治疗效果。法:纳入2008年1月1日—2017年12月31日之间在复旦大学附属肿瘤医院确诊为恶性肿瘤并接受住院治疗的患者共计202 542例。通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存随访信息,随访统计时间截至2019年11月30日。应用寿命表法估计各个病种1年、3年和5年总生存率(overall survival,OS),以性别、年龄组、首次治疗时间分层。采用Kaplan-Meier生存曲线绘制各病种的总体生存曲线。结果:患者总体的1年、3年、5年OS分别为89.8%、77.4%和71.0%;男性患者5年OS为58.8%,女性患者为78.7%。在常见的恶性肿瘤中,甲状腺癌患者的5年OS最高,为98.6%;胰腺癌患者最低,为11.4%。2013—2017年首次治疗的乳腺癌、肺癌和肾癌患者5年OS分别为90.0%、55.9%和80.7%,显著高于2008—2012年首次治疗患者,其他肿瘤未见显著上升。结论:大部分恶性肿瘤患者经规范诊治可以获得较为理想的预后,女性生存情况显著优于男性,乳腺癌和肺癌患者的生存改善可能归功于新的临床治疗和早诊手段。

关键词: 恶性肿瘤, 生存率, 医院登记

Abstract: Background and purpose: Cancer is a global major public health concern, and survival rate is a key indicator in evaluating the treatment effect of cancer. This study described the survival of over 200 thousand cancer patients from a hospital-based cancer registry database, aiming to reflect current cancer treatment effect somehow with real world data. Methods: A total of 202 542 hospitalized patients in Fudan University Shanghai Cancer Center from Jan. 1 2008 to Dec. 31 2017 were included in the analysis. Medical records review, telephone visits and death registry data linkage were applied in collecting endpoint data. The last follow-up date was Nov. 30 2019. Life table was applied in evaluating the 1-year, 3-year and 5-year overall survival (OS) rate for all and stratified by gender, age group and periods. Kaplan-Meier method was applied in plotting the survival curves. Results: The 1-year, 3 year and 5-year OS of cancer patients were 89.8%, 77.4% and 71.0%. The 5-year OS of males and females were 58.8% and 78.7% respectively. Among common cancers, thyroid cancer held the highest 5-year survival rate 98.6% while pancreatic cancer the lowest, 11.4%. The 5-year survival rates of breast, lung and kidney cancer in 2013—2017 were 90.0%, 55.9% and 80.7% respectively, significantly higher than those in 2008—2012. No significant improvement was observed in other cancers. Conclusion: Most cancer patients can have a relatively better prognosis after standardized treatment. The survival of female is superior to male. The improvement of the survival of breast cancer and lung cancer could be contributed to novel treatment methods and early diagnosis.

Key words: Cancer, Survival rate, Hospital-based registry