Conditional survival after a diagnosis of malignant brain tumour in Canada: 2000-2008.

Y Yuan,F G Davis,Q Shi,J Ross

doi:10.3747/co.24.3579

Abstract

"Conditional survival probability" is defined as the probability that a patient will survive an additional time, given that the patient has already survived a defined period of time after diagnosis. Such estimates might be more relevant for clinicians and patients during post-diagnosis care, because survival probability projections are based on the patient's survival to date. Here, we provides the first population-based estimates of conditional survival probabilities by histology for brain cancer in Canada. Canadian Cancer Registry data were accessed for patients diagnosed with primary brain cancers during 2000-2008. Kaplan-Meier survival probabilities were estimated by histology. Conditional survival probabilities at 6 months (short-term, denoted scs) and 2 years (long-term, denoted lcs) were derived from the Kaplan-Meier survival estimates for a range of time periods. Among the 20,875 patients who met the study criteria, scs increased by a margin of 16-18 percentage points from 6-month survivors to 2-year survivors for the three most aggressive brain cancers. The lcs for 2-year survivors was 66% or greater for all tumour groups except glioblastoma. The lcs for 4-year survivors was 62% or greater for all histologies. For glioblastoma and diffuse astrocytoma, the lcs increased each year after diagnosis. For all other histologies, the lcs first increased and then plateaued from 2 years after diagnosis. The lcs and scs both worsened with increasing older age at diagnosis. We report histologically specific conditional survival probabilities that can have value for clinicians practicing in Canada as they plan the course of follow-up for individual patients with brain cancer.

Highlights

Survival probabilities for malignant brain tumours by histology in Canada have only recently been described[1]
Summary We report histologically specific conditional survival probabilities that can have value for clinicians practicing in Canada as they plan the course of follow-up for individual patients with brain cancer
The number of incidents and deaths were tabulated by sex, age group at diagnosis, region, selected histology groups, and microscopically confirmed (MC) status

Summary

Introduction

Survival probabilities for malignant brain tumours by histology in Canada have only recently been described[1]. Those estimates reflect observed survival from the time of diagnosis and are useful for group comparisons; those common statistics have a time origin at the date of diagnosis and do not accurately describe prognosis for individuals who continue to survive for months or years after diagnosis. Conditional survival probabilities are clinically relevant and provide more informative estimates for surviving patient populations, because the probability of survival changes with increasing survival time[2,3]. Estimates of conditional survival probabilities have a straightforward interpretation and are easy to understand both for clinicians and for patients seeking relevant prognostic information at the population level.

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Discussion

Conclusion