Survival rate
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Survival rateis a part ofsurvival analysis.It is the proportion of people in a study or treatment group still alive at a given period of time after diagnosis. It is a method of describingprognosisin certain disease conditions, and can be used for the assessment of standards of therapy. The survival period is usually reckoned from date of diagnosis or start of treatment. Survival rates are based on the population as a whole and cannot be applied directly to an individual.[1]There are various types of survival rates (discussed below). They often serve asendpoints of clinical trialsand should not be confused withmortality rates,a population metric.
Overall survival
[edit]Patientswith a certaindisease(for example,colorectal cancer) can die directly from that disease or from an unrelated cause (for example, acar accident). When the precisecause of deathis not specified, this is called theoverall survival rateorobserved survival rate.Doctors often use mean overall survival rates to estimate the patient's prognosis. This is often expressed over standard time periods, like one, five, and ten years. For example,prostate cancerhas a much higher one-year overall survival rate thanpancreatic cancer,and thus has a better prognosis.
Sometimes the overall survival is reported as a death rate (%) without specifying the period the % applies to (possibly one year) or the period it is averaged over (possibly five years), e.g.Obinutuzumab: A Novel Anti-CD20 Monoclonal Antibody for Chronic Lymphocytic Leukemia.
Net survival rate
[edit]When someone is interested in how survival is affected by the disease, there is also thenet survival rate,which filters out the effect of mortality from other causes than the disease. The two main ways to calculate net survival arerelative survivalandcause-specific survivalordisease-specific survival.
Relative survival has the advantage that it does not depend on accuracy of the reported cause of death; cause specific survival has the advantage that it does not depend on the ability to find a similar population of people without the disease.
Relative survival
[edit]Relative survivalis calculated by dividing the overall survival after diagnosis of a disease by the survival as observed in a similar population that was not diagnosed with that disease.[2]A similar population is composed of individuals with at least age and gender similar to those diagnosed with the disease.
Cause-specific survival and disease-specific survival
[edit]Disease-specific survival rate refers to "the percentage of people in a study or treatment group who have not died from a specific disease in a defined period of time. The time period usually begins at the time of diagnosis or at the start of treatment and ends at the time of death. Patients who died from causes other than the disease being studied are not counted in this measurement."[3]
Median survival
[edit]Mediansurvival, or "median overall survival" is also commonly used to express survival rates. This is the amount of time after which 50% of the patients have died and 50% have survived. In ongoing settings such asclinical trials,the median has the advantage that it can be calculated once 50% of subjects have reached theclinical endpointof the trial, whereas calculation of anarithmetical meancan only be done after all subjects have reached the endpoint.[4]
The median overall survival is frequently used by the U.S.Food and Drug Administrationto evaluate the effectiveness of a novel cancer treatment. Studies find that new cancer drugs approved by the U.S.Food and Drug Administrationimprove overall survival by a median of 2 to 3 months depending on the sample and analyzed time period: 2.1 months,[5]2.4 months,[6]2.8 months.[7]
Five-year survival
[edit]Five-year survival ratemeasures survival at five years after diagnosis.
Disease-free survival, progression-free survival, and metastasis-free survival
[edit]Incancer research,various types of survival rate can be relevant, depending on thecancertype andstage.These include thedisease-free survival(DFS) (the period after curative treatment [disease eliminated] when no disease can be detected), theprogression-free survival(PFS) (the period after treatment when disease [which could not be eliminated] remains stable, that is, does not progress), and themetastasis-free survival(MFS) ordistant metastasis–free survival(DMFS) (the period untilmetastasisis detected). Progression can be categorized as local progression, regional progression, locoregional progression, and metastatic progression.
See also
[edit]- Progression-free survival
- Response Evaluation Criteria in Solid Tumors(RECIST)
- Surveillance, Epidemiology, and End Results database(SEER)
References
[edit]- ^"NCI Dictionary of Cancer Terms".National Cancer Institute.2011-02-02.Retrieved2016-04-22.
- ^Mariotto AB, Noone AM, Howlader N (November 2014)."Cancer Survival: An Overview of Measures, Uses, and Interpretation".JNCI Monographs.2014(49): 145–186.doi:10.1093/jncimonographs/lgu024.PMC4829054.PMID25417231.
- ^Definition: disease-specific survival rate
- ^"median overall survival".NCI Dictionary of Cancer Terms.National Cancere Institute. 2011-02-02.Retrieved4 December2014.
- ^Fojo T, Mailankody S, Lo A (2014). "Unintended Consequences of Expensive Cancer Therapeutics—The Pursuit of Marginal Indications and a Me-Too Mentality That Stifles Innovation and Creativity: The John Conley Lecture".JAMA Otolaryngol Head Neck Surg.140(12): 1225–1236.doi:10.1001/jamaoto.2014.1570.PMID25068501.
- ^Ladanie A, Schmitt AM, Speich B, Naudet F, Agarwal A, Pereira TV, Sclafani F, Herbrand AK, Briel M, Martin-Liberal J, Schmid T, Ewald H, Ioannidis JP, Bucher HC, Kasenda B, Hemkens LG (2020)."Clinical Trial Evidence Supporting US Food and Drug Administration Approval of Novel Cancer Therapies Between 2000 and 2016".JAMA Netw Open.3(11): e2024406.doi:10.1001/jamanetworkopen.2020.24406.PMC7656288.PMID33170262.
- ^Michaeli DT, Michaeli T (2022). "Overall Survival, Progression-Free Survival, and Tumor Response Benefit Supporting Initial US Food and Drug Administration Approval and Indication Extension of New Cancer Drugs, 2003-2021".Journal of Clinical Oncology.40(35): 4095–4106.doi:10.1200/JCO.22.00535.PMID35921606.S2CID251317641.