Conditional survival of patients with hepatocellular carcinoma: results from the Surveillance, Epidemiology, and End Results registry

Background: Compared with overall survival, conditional survival is a more relevant measure of prognosis in surviving patients over time. The aim of this study was to describe the conditional survival of patients with hepatocellular carcinoma according to different prognostic variables through an analysis of a national population-based cancer registry. Methods: We analyzed data from 3,082 hepatocellular carcinoma patients who were diagnosed between 2004 and 2014. Results: The conditional overall and cause-specific survival improved from 37.6% to 68.9% and 45% to 79.1%, respectively, in the entire study population. The conditional overall and cause-specific survival improved from 32.6% to 69.3% and 40.1% to 74.8%, respectively, in patients aged 65 to 74 years. The conditional overall and cause-specific survival improved from 8.4% to 44.1% and 12.1% to 66.1%, respectively, in the stage IVB group. The conditional overall and cause-specific survival improved from 32.8% to 71.4% and 40.3% to 78.4%, respectively, in the positive/elevated AFP group. Conclusions: Conditional survival exhibited an improved prognosis over time. For hepatocellular carcinoma patients who survived for a specific period of time after diagnosis, more dramatic improvements occurred in patients aged 65–74 years, patients with AJCC stage IVB, and patients with a positive/elevated AFP value.

背景：相较于总生存期，条件生存率是评估随时间存活患者预后的更具临床相关性的指标。本研究旨在通过分析全国基于人群的癌症登记数据库数据，描述不同预后变量分层下肝细胞癌患者的条件生存特征。方法：本研究纳入2004年至2014年间确诊的3082例肝细胞癌患者数据进行分析。结果：在全部研究队列中，条件总生存率与病因特异性生存率分别从37.6%提升至68.9%、从45%提升至79.1%。在65至74岁患者亚组中，条件总生存率与病因特异性生存率分别从32.6%提升至69.3%、从40.1%提升至74.8%。在AJCC ⅣB期患者亚组中，条件总生存率与病因特异性生存率分别从8.4%提升至44.1%、从12.1%提升至66.1%。在甲胎蛋白（AFP）阳性或升高的患者亚组中，条件总生存率与病因特异性生存率分别从32.8%提升至71.4%、从40.3%提升至78.4%。结论：肝细胞癌患者的条件生存预后随生存时间延长而逐步改善。对于确诊后已存活特定时长的肝细胞癌患者，65~74岁亚组、AJCC ⅣB期亚组以及甲胎蛋白阳性/升高亚组的预后改善更为显著。