欢迎访问《中国癌症杂志》官方网站，今天是
图片表格检索 高级检索

中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (1): 11-19.doi: 10.19401/j.cnki.1007-3639.2021.01.002

• 专家述评与论著 • 上一篇    下一篇

以大型单中心医院登记为基础的2万例癌症转移患者的转移特征及生存分析

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

  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. 上海众访信息技术有限公司，上海 200092 ；
    3. 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 ；
    4. 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
  • 出版日期:2021-01-30 发布日期:2021-02-20
  • 通信作者: 郭小毛 E-mail: guoxm1800@126.com；郑　莹 E-mail: zhengying@fudan.edu.cn

Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database

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

  1. 1. Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Shanghai Zhongfang Information Technology Co., Ltd., Shanghai 200092, China; 3. Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 4. Department of Radiotherapy, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2021-01-30 Online:2021-02-20
  • Contact: GUO Xiaomao E-mail: guoxm1800@126.com; ZHENG Ying E-mail: zhengying@fudan.edu.cn

PDF

1279

摘要： 背景与目的：恶性肿瘤患者90%的死亡原因为发生远处转移，通过分析以医院登记为基础的2万余例发生转移的恶性肿瘤患者的转移部位分布和转移后生存状况，为恶性肿瘤患者的治疗和生存管理提供真实世界数据支持。方法：基于复旦大学附属肿瘤医院2008—2017年住院就诊的恶性肿瘤患者，纳入20 067例初诊或复诊过程中发生转移的恶性肿瘤患者。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。随访起始时间为转移发生时间，随访统计时间截至2020年11月1日。应用Kaplan-Meier法估计各个病种转移后的1、3和5年总生存（overall survival，OS）率。结果：随访中位时间为46.7个月，随访期间全死因死亡13 170例。60.05%为单一部位转移，39.95%为多发转移，在所有可转移部位中，转移至肝的比例为33.82%，肺为26.25%，骨为26.22%，脑为9.22%。单癌种中，肺癌患者发生脑转移的比例在所有癌种中最高，为31.14%；胰腺癌患者最易发生肝转移（77.85%），前列腺癌患者最易发生骨转移（83.20%）。分性别来看，男性肝转移占比高于女性（35.46% vs 31.89%，P<0.001），但是转移至肺、骨和脑的比例低于女性（24.96% vs 27.76%，25.26% vs 27.34%，8.34% vs 10.25%，P<0.001）。发生转移后，总体恶性肿瘤的1、3和5年OS率分别为65.59%（95% CI: 64.90~66.27）、33.42%（95% CI: 32.69~34.16）和21.12%（95% CI: 20.39~21.84）。结论：各癌种转移发生的部位倾向性不同，且存在性别异质性，转移发生后的生存率较差，未来可与临床治疗方案结合进行深入研究，以改善晚期恶性肿瘤患者的预后。

关键词: 恶性肿瘤, 转移, 生存率, 医院登记

Abstract: Background and purpose: Metastasis remains the cause of 90% of death from cancer. By analyzing the distribution of metastatic sites and survival status of 20 000 metastatic cancer patients from a hospital-based cancer registry database, this study provides the real-world data for the cancer treatment and survival management in China. Methods: A total of 20 067 cancer patients who were diagnosed as having metastatic caner or developed metastasis during the follow-up in Fudan University Shanghai Cancer Center from 2008 to 2017 were included in this study. Medical records review, telephone visits and death registry data linkage were applied in collecting endpoint data. The first follow-up date was the diagnosis date of metastasis, and the last follow-up date was November 1, 2020. Kaplan-Meier method was applied in evaluating the 1-, 3- and 5-year overall survival (OS) rates for overall cancer and site-specific cancer patients. Results: The median follow-up time was 46.7 months, 13 170 cases died during the follow- up, 60.05% was single-site metastasis, and 39.95% was multiple-site metastasis. Among all metastable sites, the proportion of metastasis to liver was 33.82%, 26.25% to lung, 26.22% to bone, and 9.22% to brain. The incidence of brain metastasis was the highest in lung cancer patients among all cancer types (31.14%). Liver was the most frequent metastatic site in pancreatic cancer (77.85%), and bone was the most frequent metastatic site in patients with prostate cancer (83.20%). Subgroup analysis showed that liver metastasis was easier to be observed in males than in females (35.46% vs 31.89%, P<0.001), whereas lung, bone and brain metastases were more frequently to be observed in females (24.96% vs 27.76%, 25.26% vs 27.34%, 8.34% vs 10.25, P<0.001). After metastasis, the 1-, 3- and 5-year OS rates of overall cancer were 65.59% (95% CI: 64.90-66.27), 33.42% (95% CI: 32.69-34.16) and 21.12% (95% CI: 20.39-21.84), respectively. Conclusion: The metastasis patterns for different cancer sites are different, and there is sex heterogeneity. Currently, the survival rate after metastasis is poor, and the future research combining with treatment strategies is required to improve the survival of advanced-stage cancer patients.

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

沪公网安备 31010402003527号

沪ICP备12009617号

地址：上海市徐汇区东安路270号复旦大学附属肿瘤医院10号楼415室

邮编：200032 电话：021-64188274 E-mail：zgazzz@china-oncology.com

访问总数:; 今日访问总数:; 当前在线人数:

本系统由北京玛格泰克科技发展有限公司设计开发 技术支持：support@magtech.com.cn