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; 周昌明; 莫　淼; 袁　晶; 沈　洁; 王泽洲; 张志红; 秦一雨; 吴　炅; 郑　莹; 郭小毛

doi:10.19401/j.cnki.1007-3639.2021.01.002

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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

专家述评与论著 | 更新时间：2026-01-27

- 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
- Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database
- 中国癌症杂志 2021年31卷第1期页码：11-19
- 作者机构：
  
  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
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2021.01.002
  中图分类号： R730.1
- 网络出版：2021-02-20，
  
  纸质出版：2021-02-20
- 稿件说明：
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冯小双, 周昌明, 莫　淼, 袁　晶, 沈　洁, 王泽洲, 张志红, 秦一雨, 吴　炅, 郑　莹, 郭小毛 . 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[J]. 中国癌症杂志, 2021, 31(1): 11-19.

冯小双, 周昌明, 莫　淼, et al. Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database[J]. China Oncology, 2021, 31(1): 11-19.
冯小双, 周昌明, 莫　淼, 袁　晶, 沈　洁, 王泽洲, 张志红, 秦一雨, 吴　炅, 郑　莹, 郭小毛 . 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[J]. 中国癌症杂志, 2021, 31(1): 11-19. DOI： 10.19401/j.cnki.1007-3639.2021.01.002.

冯小双, 周昌明, 莫　淼, et al. Metastasis patterns and survival analysis of 20 000 patients with metastasis from a hospital-based cancer registry database[J]. China Oncology, 2021, 31(1): 11-19. DOI： 10.19401/j.cnki.1007-3639.2021.01.002.

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%，P0.001），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%，P0.001）。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。

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%

P0.001)

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

P0.001). 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.

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