摘要
背景与目的:基于医院登记为基础的结直肠癌手术患者的随访资料,分析其1、3和5年总生存率(overall survival,OS)与无病生存率(disease-free survival,DFS),为了解中国结直肠癌患者长期生存情况提供真实世界研究证据。方法:研究纳入2008年1月1日-2017年12月31日在复旦大学附属肿瘤医院接受手术治疗的结直肠癌患者共13 721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和5年OS和DFS,根据年龄组、性别、治疗时期、肿瘤分期以及病理学特征、治疗方式各亚组分别描述。结果:结直肠癌手术患者经中位54.03个月随访后,5年OS和0~Ⅲ期患者5年DFS分别为73.87%和72.25%。0~Ⅰ、Ⅱ、Ⅲ和Ⅳ期结直肠癌手术患者5年OS分别为91.92%、87.15%、70.49%和27.70%,45岁以下年龄组患者5年OS为74.93%,差于45~64岁和65~74岁年龄组。不同组织学类型、分化程度、壁外血管侵犯、神经侵犯、环切缘情况患者的生存差异显著。结论:首次报告中国国内单中心超万人结直肠癌患者的5年长期生存结果,44岁及以下青年结直肠癌患者生存率较低,肿瘤分期是影响结直肠癌患者生存的重要可改变因素,应加强早诊早治,进一步提升患者生存率。
Background and purpose: The study analyzed 1-, 3-and 5-year observed overall survival(OS) and disease-free survival(DFS), providing real world evidence of long-term survival among Chinese surgical colorectal cancer patients. Methods: A total of 13 721 colorectal cancer patients undergoing surgery in Fudan University Shanghai Cancer Center(FUSCC) from Jan. 1, 2008 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 used to evaluate the1-, 3-, and 5-year OS and DFS, and data were stratified by age group, gender, staging, calendar period, pathological characteristics and treatment approaches. Results: With a median follow-up time of 54.03 months, the 5-year OS of all patients and DFS of 0-Ⅲ stage surgical colorectal cancer patients were 73.87% and 72.25%, respectively. The 5-year OS of stage 0-Ⅰ,Ⅱ,Ⅲ and Ⅳ colorectal cancer patients were 91.92%, 87.15%, 70.49% and 27.70%, respectively. The OS of patients aged less than 45 years was 74.93%, poorer than 45-64 and 65-74 age category. There were significant difference in OS and DFS among different histology types, differentiation, extermural vascular invasion, perineural invasion and circumferential radial margin. Conclusion: It is the first single institutional long term survival report of over 10 thousand colorectal cancer patients. Young patients aged less than 45 years had a poor prognosis. Staging is an important modifiable factor, which implies that enhancing screening and early diagnosis has important meaning to further improve the patients’ survival.
作者
周昌明
郭天安
莫淼
袁晶
沈洁
王泽洲
黄丹
朱骥
李心翔
蔡国响
徐烨
蔡三军
郑莹
ZHOU Changming;GUO Tianan;MO Miao;YUAN Jing;SHEN Jie;WANG Zezhou;HUANG Dan;ZHU Ji;LI Xinxiang;CAI Guoxiang;XU Ye;CAI Sanjun;ZHENG Ying(Department of Cancer Prevention,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Colorectal Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Pathology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Radiotherapy,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2020年第4期246-253,共8页
China Oncology
基金
中国癌症基金会项目(NH2018001)。
关键词
大肠癌
总生存率
无病生存率
医院登记
Colorectal cancer
Overall survival
Disease-free survival
Hospital-based registry