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中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (2): 90-97.doi: 10.19401/j.cnki.1007-3639.2020.02.002

• 论著 • 上一篇    下一篇

以大型单中心的医院登记为基础的3.5万例乳腺癌患者长期生存报告

莫　淼 1 ，袁　晶 1 ，周昌明 1 ，沈　洁 1 ，王泽洲 1 ，余科达 2 ，柳光宇 2 ，吴　炅 2 ，沈镇宙 2 ，邵志敏 2 ，郑　莹 1   

  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:2020-02-29 发布日期:2020-03-06
  • 通信作者: 通信作者：郑　莹　E-mail: zhengying@fudan.edu.cn

Changing long-term survival of Chinese breast cancer patients—experience from a large single institution hospital based cancer registry with 35 thousand patients

MO Miao 1 , YUAN Jing 1 , ZHOU Changming 1 , SHEN Jie 1 , WANG Zezhou 1 , YU Keda 2 , LIU Guangyu 2 , WU Jiong 2 , SHEN Zhenzhou 2 , SHAO Zhimin 2 , ZHENG Ying 1   

  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 Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2020-02-29 Online:2020-03-06
  • Contact: ZHENG Ying E-mail: zhengying@fudan.edu.cn

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摘要： 背景与目的：基于医院登记为基础的3.5万例乳腺癌患者的随访资料，分析其5年和10年观察生存率与无病生存率，为了解我国乳腺癌患者长期生存提供真实世界研究证据。方法：研究纳入2003年1月1日—2017年12月31日在复旦大学附属肿瘤医院确诊为乳腺癌并接受住院治疗的患者共35 872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、5和10年总生存率（overall survival，OS）和无病生存率（disease-free survival，DFS），根据年龄组、性别、首次治疗时期各亚组分别描述。结果：所有患者经中位4.7年随访后，5和10年OS分别为92.5%和83.0%，相应DFS分别为86.6%、77.0%。不同年龄段患者OS和DFS的差异有统计学意义，不同性别患者OS和DFS的差异无统计学意义。2003—2005年、2006—2008年、2009—2011年、2012—2014年、2015—2017年各时期患者5年OS和DFS分别为85.8%、92.0%、92.1%、92.9%、93.8% 和70.2%、84.7%、86.0%、87.8%、90.1%；2003—2005年、2006—2008年患者10年OS分别为71.0%、82.6%，DFS分别为56.0%、75.2%，后3年相比前3年分别提升了11.6%和19.2%。结论：首次报告国内乳腺癌患者的10年长期生存结果，发现2003—2017年乳腺癌患者OS和DFS呈明显的增长趋势，预后和长期生存正在不断改善，可能与筛查应用早诊早治以及临床治疗方法的进步有关。35岁以下年轻乳腺癌患者预后稍差，值得关注。

关键词: 乳腺癌, 总生存率, 无病生存率, 医院登记

Abstract: Background and purpose: The study described 5- and 10-year observed survival and disease-free survival (DFS) of over 35 thousand breast cancer patients from a hospital-based cancer registry database, aiming to provide real world evidence of long-term survival among Chinese breast cancer patients. Methods: A total of 35 872 hospitalized breast cancer patients in Fudan University Shanghai Cancer Center (FUSCC) from Jan. 1, 2003 to Dec. 31, 2017 were included in the analysis. Medical records review, telephone visits and death registry data linkage were carried out for collecting endpoint data. The last follow-up date was Nov. 30, 2019. Kaplan-Meier method was uesd to evaluate the 1-year, 3-year, 5-year and 10-year overall survival (OS) and DFS rate for all, and data were stratified by age group, gender and calendar periods. Results: With a median follow-up time of 4.7 years, the 5-year and 10-year OS of all patients was 92.5% and 83.0%, while DFS was 86.6% and 77.0% respectively. OS and DFS among different age groups were significantly different, while no significant difference existed between females and males. The 5-year OS and DFS for patients diagnosed during the five periods of 2003-2005, 2006-2008, 2009-2011, 2012-2014, 2015-2017 were 85.8%, 92.0%, 92.1%, 92.9%, 93.8% and 70.2%, 84.7%, 86.0%, 87.8%, 90.1%, respectively. The 10-year OS for patients during 2003-2005 and 2006-2008 was 71.0% and 82.6%, while DFS was 56.0% and 75.2%, showing an improvement of 11.6% on OS and 19.2% on DFS in 2006-2008 compared with in 2003-2005, respectively. Conclusion: It is the first report on survival up to 10 years among Chinese breast cancer patients, showing that the patients have experienced significant improvement on OS and DFS during consecutive calendar periods between 2003 and 2017, which might be contributed to early diagnosis from cancer screening and novel treatments. Besides, patients younger than 35 experience poor survival and need more concern in the future.

Key words: Breast cancer, Overall survival, Disease-free survival, Hospital-based registry

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