Transcript 中山大学肿瘤防治中心

Trends in the survival of patients with
nasopharyngeal carcinoma
1976-2005 in Sihui city, Guangdong province, P.R. of China:
a population-based study
Qing Liu, Jinou Chen, Qihong Huang, Yanhua Li
Cancer Center, Sun Yat-sen University
Sihui Cancer Institute
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
NPC Epidemiological Charateristics in Sihui
Incidence rate of NPC: 30.9 in male and 13.0 in female
Mortality rate of NPC: 22.0 in male and 7.7 in female
Incidence rates and mortality rates of NPC kept stable
Comparing to the reduction in HK, TW, LA in USA
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Trend of NPC incidence 1988-2002 in HK
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Trend of NPC incidence 1978-2002 in Sihui
40
men
35
women
25
20
15
10
5
20
01
19
99
19
97
19
95
19
93
19
91
19
89
19
87
19
85
19
83
19
81
0
19
79
发病率(/10万)
30
年份
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Materials and methods
Cancer registry system since 1973 in Sihui
Follow up system for NPC cases since 1978
1761 incidence cases of NPC were chose during 1976-2005
Follow up to the end of 2006 , Max follow up year=30.4
1239 (70.3%) cases with pathological evidence
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Materials and methods
Kaplan–Meier estimate for survival rates
Cox proportional hazards regression for risk factor screening
Risk factors: gender,age,period of diagnosis,clinical stage,
pathological status,diagnosis medical unit were analyzed
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Materials and methods
Relative survival probabilities for NPC were assessed by
matched sex, age group, period of diagnosis with general
population
Age-specific death rates and life table of Sihui general
population was available based on death registry system
SURV3 was used for relative survival rate estimation
SAS 9.2 for other statistical analyses
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Results
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Characteristics of patients with NPC 1976-2005
Gender
Male
Female
N
%
1189
67.5
572
32.5
Age at diagnosis
<40
498
28.2
40-
545
30.9
50-
414
23.5
60+
304
17.3
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Characteristics of patients with NPC 1976-2005
Clinical stage
N
I
107
II
546
III
467
IV
119
Unknown
522
Pathological diagnosis
WHO I
159
WHO II/III
1080
Unknown
522
中山大学肿瘤防治中心
%
6.1
31.0
26.5
6.8
29.6
9.0
61.3
29.6
SUN YAT-SEN UNIVERSITY CANCER CENTER
Characteristics of patients with NPC 1976-2005
Period diagnosed
N
%
1976-
409
23.2
1986-
472
26.8
1993-
534
30.3
2000-
346
19.6
1076
61.1
685
38.9
Diagnostic hospital
CC
Other
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Five year survival of NPC patients in Sihui
MTS
OS(95%CI)
5.1
50.5(48.1-52.9)
RS(95%CI)
60.3(57.5-63.1)
48.4(45.5-51.3)
54.5(50.4-58.7)
59.3(55.8-62.8)
62.2(57.6-66.8)
56.4(51.9-60.9)
53.9(49.6-58.1)
48.7(43.8-53.6)
36.4(30.8-41.9)
59.4(54.7-64.1)
60.1(55.4-64.8)
62.5(56.3-68.6)
59.1(50.5-67.6)
All cases
Gender
Male
4.5
Female
6.2
Age at diagnosis
<40
8.7
405.9
504.8
60+
2.8
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Five year survival of NPC patients in Sihui
MTS
Clinical Stages
I
14.4
II
6.3
III
2.8
IV
2.3
Unknown
6.1
Path
WHO I
5.1
WHO II/III 5.5
Unknown
4.2
OS(95%CI)
RS(95%CI)
73.7(65.3-82.1)
57.4(53.1-61.7)
38.3(33.8-42.8)
31.5(22.8-40.2)
52.8(48.4-57.2)
85.2(75.8-94.5)
69.4(64.5-74.3)
44.7(39.5-50.0)
37.9(27.6-48.2)
64.4(59.2-69.6)
49.8(41.1-58.6)
52.1(49.1-55.1)
46.4(42.0-50.9)
56.9(52.3-61.5)
62.3(58.8-65.8)
58.8(53.5-64.1)
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Five year survival of NPC patients in Sihui
MTS
Period diagnosed
1976-1985
3.8
1986-1992
4.0
1993-1999
5.5
2000-2005
Diagnostic Hospital
CC
5.5
Others
4.3
OS(95%CI)
RS(95%CI)
42.5(37.8-47.3)
43.4(39.0-47.9)
52.1(47.8-56.3)
69.8(64.1-75.4)
51.8(46.2-57.4)
51.1(45.9-56.3)
62.5(57.5-67.6)
84.8(79.1-90.6)
52.3(49.3-55.3)
47.4(43.5-51.2)
62.3(58.8-65.8)
56.9(52.3-61.5)
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Risk factors related to death from NPC by Multivariate Cox Regression
Gender Male
Female
Age
<40
405060+
Stage
I
II
III
IV
Histo
WHOII/III
WHO I
Period 1976-1985
1986-1992
1993-1999
2000-2005
HR
1.00
0.76
1.00
1.21
1.51
2.22
1.00
1.61
2.61
3.41
1.00
1.28
1.00
0.76
0.55
0.28
95%CI
0.65-0.90
0.99-1.49
1.22-1.88
1.73-2.84
1.17-2.22
1.89-3.60
2.34-4.99
1.00-1.64
0.63-0.91
0.45-0.68
0.20-0.40
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Observed and relative survival (95%CI) of NPC in Sihui 1976-2005
OSR
RSR
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
0
2
4
6
8
10
year after diagnosis
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Relative survival of NPC, stage I and II
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Relative survival of NPC, stage III and IV
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
Conclusion
Significant improvement of NPC survival
No change of proportion of stage of NPC cases
Improved radiotherapy might contribute to survival of NPC
Screening for NPC will definitely increase survival of NPC
May predict a reduction of mortality rates of NPC in Sihui
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER
screening
中山大学肿瘤防治中心
SUN YAT-SEN UNIVERSITY CANCER CENTER