Survival Odds Rise for Cancer Patients as Years Pass

SAN FRANCISCO — The odds of surviving cancer improve with time, making prognosis a moving target for any individual patient, researchers noted at a symposium sponsored by the American Society of Clinical Oncology.

The concept of “conditional survival” drove investigators to begin formulating survival odds for patients who live beyond 1 year after a diagnosis with gastric or gallbladder adenocarcinoma.

They are working on conditional survival paradigms for other cancers as well.

Patients often ask, “Doc, what's my chance of survival now that I've survived a year?” recounted Dr. Samuel J. Wang of the department of radiation oncology at the University of Texas Health Science Center at San Antonio. “Clinicians are left making their best guess or estimate, based on 5− or 10-year survival data from the time of diagnosis,” he said. “It might be that a patient is ahead of the curve by having beaten the odds at 1 year.”

Dr. Wang and associates therefore used the Surveillance, Epidemiology, and End Results (SEER) database to compare survival of gastric cancer from the time of diagnosis to survival of patients who had already lived with the disease for 5 years.

Survival probability improved markedly over time for patients with any stage of the disease, they found. For example, the 5-year observed, conditional survival was 46% at the time of diagnosis for a patient with localized disease, but improved to 65% after 5 years. Patients whose cancer had spread to regional lymph nodes had a 27% chance of 5-year survival at diagnosis, but a 62% chance of survival after living 5 years.

Improvement in conditional survival was greatest for patients with distant disease and for those under age 65, Dr. Wang said.

Patients with distant disease had a 5-year observed conditional survival of 2% at the time of diagnosis, compared with 53% at 5 years post diagnosis. Conditional survival for patients under age 65 increased from 19% to 76% at 5 years.

A second study examined year-by-year conditional survival of gallbladder adenocarcinoma.

Led by Clifton D. Fuller, a medical student in the department of radiation oncology at the University of Texas Health Science Center at San Antonio, the team found “dismal 5-year survival at diagnosis,” but improving odds for patients who lived between 1 and 4 years, when conditional survival began to plateau. (See box.)

“Although the disease-free survival outcomes for patients with gallbladder adenocarcinoma remain low, for those patients surviving even 1 year post diagnosis, conditional survival estimates increase rapidly,” the authors reported in their poster presentation at the meeting, which also was sponsored by the American Gastroenterological Association, the American Society for Therapeutic Radiology and Oncology, and the Society of Surgical Oncology.

Conditional survival calculations can offer some encouragement to cancer patients and can help clinicians decide how aggressively they should work up survivors as the years pass after a cancer diagnosis, Dr. Wang said in an interview at the meeting.

Moreover, these calculations “offer answers to very practical questions patients always have,” he added.

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SAN FRANCISCO — The odds of surviving cancer improve with time, making prognosis a moving target for any individual patient, researchers noted at a symposium sponsored by the American Society of Clinical Oncology.

The concept of “conditional survival” drove investigators to begin formulating survival odds for patients who live beyond 1 year after a diagnosis with gastric or gallbladder adenocarcinoma.

They are working on conditional survival paradigms for other cancers as well.

Patients often ask, “Doc, what's my chance of survival now that I've survived a year?” recounted Dr. Samuel J. Wang of the department of radiation oncology at the University of Texas Health Science Center at San Antonio. “Clinicians are left making their best guess or estimate, based on 5− or 10-year survival data from the time of diagnosis,” he said. “It might be that a patient is ahead of the curve by having beaten the odds at 1 year.”

Dr. Wang and associates therefore used the Surveillance, Epidemiology, and End Results (SEER) database to compare survival of gastric cancer from the time of diagnosis to survival of patients who had already lived with the disease for 5 years.

Survival probability improved markedly over time for patients with any stage of the disease, they found. For example, the 5-year observed, conditional survival was 46% at the time of diagnosis for a patient with localized disease, but improved to 65% after 5 years. Patients whose cancer had spread to regional lymph nodes had a 27% chance of 5-year survival at diagnosis, but a 62% chance of survival after living 5 years.

Improvement in conditional survival was greatest for patients with distant disease and for those under age 65, Dr. Wang said.

Patients with distant disease had a 5-year observed conditional survival of 2% at the time of diagnosis, compared with 53% at 5 years post diagnosis. Conditional survival for patients under age 65 increased from 19% to 76% at 5 years.

A second study examined year-by-year conditional survival of gallbladder adenocarcinoma.

Led by Clifton D. Fuller, a medical student in the department of radiation oncology at the University of Texas Health Science Center at San Antonio, the team found “dismal 5-year survival at diagnosis,” but improving odds for patients who lived between 1 and 4 years, when conditional survival began to plateau. (See box.)

“Although the disease-free survival outcomes for patients with gallbladder adenocarcinoma remain low, for those patients surviving even 1 year post diagnosis, conditional survival estimates increase rapidly,” the authors reported in their poster presentation at the meeting, which also was sponsored by the American Gastroenterological Association, the American Society for Therapeutic Radiology and Oncology, and the Society of Surgical Oncology.

Conditional survival calculations can offer some encouragement to cancer patients and can help clinicians decide how aggressively they should work up survivors as the years pass after a cancer diagnosis, Dr. Wang said in an interview at the meeting.

Moreover, these calculations “offer answers to very practical questions patients always have,” he added.

ELSEVIER GLOBAL MEDICAL NEWS

SAN FRANCISCO — The odds of surviving cancer improve with time, making prognosis a moving target for any individual patient, researchers noted at a symposium sponsored by the American Society of Clinical Oncology.

The concept of “conditional survival” drove investigators to begin formulating survival odds for patients who live beyond 1 year after a diagnosis with gastric or gallbladder adenocarcinoma.

They are working on conditional survival paradigms for other cancers as well.

Patients often ask, “Doc, what's my chance of survival now that I've survived a year?” recounted Dr. Samuel J. Wang of the department of radiation oncology at the University of Texas Health Science Center at San Antonio. “Clinicians are left making their best guess or estimate, based on 5− or 10-year survival data from the time of diagnosis,” he said. “It might be that a patient is ahead of the curve by having beaten the odds at 1 year.”

Dr. Wang and associates therefore used the Surveillance, Epidemiology, and End Results (SEER) database to compare survival of gastric cancer from the time of diagnosis to survival of patients who had already lived with the disease for 5 years.

Survival probability improved markedly over time for patients with any stage of the disease, they found. For example, the 5-year observed, conditional survival was 46% at the time of diagnosis for a patient with localized disease, but improved to 65% after 5 years. Patients whose cancer had spread to regional lymph nodes had a 27% chance of 5-year survival at diagnosis, but a 62% chance of survival after living 5 years.

Improvement in conditional survival was greatest for patients with distant disease and for those under age 65, Dr. Wang said.

Patients with distant disease had a 5-year observed conditional survival of 2% at the time of diagnosis, compared with 53% at 5 years post diagnosis. Conditional survival for patients under age 65 increased from 19% to 76% at 5 years.

A second study examined year-by-year conditional survival of gallbladder adenocarcinoma.

Led by Clifton D. Fuller, a medical student in the department of radiation oncology at the University of Texas Health Science Center at San Antonio, the team found “dismal 5-year survival at diagnosis,” but improving odds for patients who lived between 1 and 4 years, when conditional survival began to plateau. (See box.)

“Although the disease-free survival outcomes for patients with gallbladder adenocarcinoma remain low, for those patients surviving even 1 year post diagnosis, conditional survival estimates increase rapidly,” the authors reported in their poster presentation at the meeting, which also was sponsored by the American Gastroenterological Association, the American Society for Therapeutic Radiology and Oncology, and the Society of Surgical Oncology.

Conditional survival calculations can offer some encouragement to cancer patients and can help clinicians decide how aggressively they should work up survivors as the years pass after a cancer diagnosis, Dr. Wang said in an interview at the meeting.

Moreover, these calculations “offer answers to very practical questions patients always have,” he added.

ELSEVIER GLOBAL MEDICAL NEWS