J Cancer 2018; 9(5):851-860. doi:10.7150/jca.23039 This issue

Research Paper

Cancer survival in patients from a hospital-based cancer registry, China

Jian-Guo Chen 1,2✉, Hai-Zhen Chen 1, Jian Zhu 2, Yan-Lei Yang3, Yong-Hui Zhang2, Pei-Xin Huang3, Yong-Sheng Chen2, Chao-Yong Zhu1, Li-Ping Yang1, Kang Shen1, Fu-Lin Qiang1, Gao-Ren Wang1

1. Nantong University Tumor Hospital / Institute, 226361 Nantong, China
2. Qidong Liver Cancer Institute, 226200 Qidong, China
3. Haimen City Center for Disease Control and Prevention, 226100 Haimen, China.

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Chen JG, Chen HZ, Zhu J, Yang YL, Zhang YH, Huang PX, Chen YS, Zhu CY, Yang LP, Shen K, Qiang FL, Wang GR. Cancer survival in patients from a hospital-based cancer registry, China. J Cancer 2018; 9(5):851-860. doi:10.7150/jca.23039. Available from https://www.jcancer.org/v09p0851.htm

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Purpose: There are few reports on survival rate analysis from hospital-based cancer registries (HBCR) in China, although the National Center of Cancer Registry of China has launched such an effort with the mission to expand the scope of registration and follow-up. Our study aimed to evaluate survival and outcomes of cancer patients from a HBCR in eastern China.

Methods: Active and passive follow-up methods were used to obtain information on survival status for all patients from Qidong City and Haimen City in the databases of our hospital-based registrations from 2002 to 2014. Censor time for survival was 31st March, 2016. Survival probability was estimated using the life-table method with SPSS Statistics software, and comparison of significant differences in survival rates was tested by Wilcoxon (Gehan) statistic.

Results: The outcomes of 5010 patients were identified in the follow-up for 5244 cases from Qidong and Haimen, with a follow-up rate of 95.65%, and a rate of lost to follow-up of 4.35%. The 1-, 3-, 5-, and 10-year observed survival (OS) rate in all-combined cancer sites were 59.80%, 37.70%, 30.82%, and 22.60%, respectively. The top 10 cancer sites in rank were cancers of lung, esophagus, liver, cervix, stomach, breast, colon-rectum, non-Hodgkin's lymphoma, nasopharynx, and ovary, with 5-year OS rates of 12.63%, 19.62%, 11.69%, 66.61%, 21.35%, 59.43%, 36.36%, 37.03%, 48.95% and 36.17%, respectively. Females experienced better survival than males for lung, esophageal, liver, nasopharyngeal and pancreatic cancers (P<0.05), but not for other sites (P>0.05). A significant difference was also found between males and females when all-sites were combined (P<0.01). There are significant differences (P<0.05) between the 2015 patients (from Qidong) and the 3001 patients (from Haimen) with 5-year OS rates of 32.72% vs 29.57%; no significant differences were found for 5-year OS rates for individual cancer sites (P>0.05) except for liver (P=0.0005) and ovary (P=0.0460) between the two cities. Younger patients had better prognosis, but significance was only seen in cervical (P=0.0102) and nasopharyngeal (P=0.0305) cancers.

Conclusion: The survival rates of each site or of all sites-combined in this setting are consistent with those elsewhere in China and abroad. Discrepancies in overall survival could be affected by the proportion of sites with or without better prognosis. Hospital-based cancer survival is a better index to evaluate outcomes that reflect the levels of comprehensive treatment and improvement of medical and health services.

Keywords: Neoplasms, cancer registration (hospital-based), follow-up, survival (life-table method)