启东恶性肿瘤患者在某肿瘤医院住院诊治后生存率分析

Survival Analysis of Hospital Registered Cancer Patients in Qidong

[目的]结合以人群为基础的癌症登记和以医院为基础的癌症登记资料进行随访及互核来研究患者的预后,为综合评估癌症患者住院后生存率提供依据。[方法]对2002~2014年启东籍首次住于某肿瘤医院恶性肿瘤患者(下称"医院登记患者")开展生存结局的主动随访与被动随访,随访信息截止于2016年3月31日,剔除失访病例后列入统计。用寿命表法计算观察生存率,并与同期人群为基础的癌症患者(下称"人群登记患者")生存率作比较分析。[结果 ]2002~2014年医院登记患者2156例,经随访获得生存结局信息的为2015例,失访141例,失访率为6.54%。所有患者的1年、3年、5年及10年观察生存率(OS)分别为63.37%、40.21%、32.75%及23.08%。医院登记患者中前10位癌症依次为肺癌、宫颈癌、食管癌、肝癌、乳腺癌、胃癌、非霍奇金淋巴瘤(NHL)、结直肠癌、鼻咽癌、卵巢癌,占全部恶性肿瘤的68.93%;5年观察生存率分别为11.78%、65.51%、17.19%、14.00%、55.76%、21.73%、39.85%、29.88%、49.16%及28.99%。所有癌症合计的5年生存率女性高于男性,有统计学意义(P<0.01),分癌种中鼻咽癌5年生存率女性高于男性,有统计学意义(P<0.01),而其它部位癌症5年生存率男女性间差异无统计学意义(P>0.05)。启东籍医院登记患者5年生存率(32.75%)远高于2003~2007年启东人群登记患者的5年生存率(16.82%),差异有统计学意义(P<0.01)。分肿瘤比较显示医院登记患者中宫颈癌、食管癌、NHL、鼻咽癌的5年生存率高于启东人群登记患者中同类别癌症的5年生存率,差异有统计学意义(P<0.01);肺癌、肝癌的生存率差异亦有统计学意义(P<0.05);而医院登记患者中乳腺癌、胃癌、结直肠癌、卵巢癌与人群登记患者的生存率差异无统计学意义(P>0.05)。[结论]启东籍医院登记患者的生存率与国内外同类资料可比;与人群登记患者的生存率比较可反映肿瘤医院的专科特色及部位别肿瘤的诊治水平。

[Purpose] To analyze the survival of cancer patients admitted in a Qidong cancer hospital by follow-up and cross-check data from a hospital-based cancer registry and a population-based registry. [Methods] Active follow-up and passive follow-up methods were used to obtain the information on survival for all patients from Qidong city who were registered in a hospital-based cancer registry in 2002 to 2014 （hospital registered patients,HRP）. Censored time for survivors was the 31st March,2016. After eliminating the lost-to-follow-up cases,survival probability was estimated by using the life-table method,and comparison was made. [Results] The outcomes of 2015 patients were identified in the follow-up for 2156 HRP cases with a rate of lost-to-follow-up of 6.54%. The 1-,3-,5-,and 10-year overall survival（OS） rate in all-combined cancer sites were 63.37%,40.21%,32.75%,and 23.08%,respectively. The top 10 cancer sites were lung,cervix,esophagus,liver,breast,stomach,non-Hodgkin’s lymphoma,colorectum,nasopharynx,and ovary,which accounted for 68.93% of all sites. The 5-year OS rates of the top 10 cancers were 11.78%,65.51%,17.19%,14.00%,55.76%,21.73%,39.85%,29.88%,49.16% and 28.99%,respectively. Females had better survival than males for the all-combined cancer and the site of nasopharynx（P〈0.01）,but didn’t for other sites（P〉0.05）. There were statistical significances in 5-year OS rate between the HRPs（2002～2014） and patients from our population-based registry（2003～2007） （32.75% vs 16.82%,P〈0.01）. The HRPs had better survival than the patients from populationbased registry for the sites of cervix,esophagus,NHL,and nasopharynx（P〈0.01）,and also for the sites of lung and liver（P〈0.05）,but no statistical significances were found for 5-year OS rates for the sites of breast,stomach,colorectum,and ovary cancers（P〉0.05）. [Conclusion] The survival rate in Qidong cancer patients admitted in a local tumor hospital is consistent with that in settings from home and abroad. Compared with the survival of patients from population-based registration,the survival of hospital registered patients can reflect the special characteristic and level in the diagnosis and treatment of a tumor hospital.