| Objective:Bladder cancer is a common malignant tumor of the urinary system and brings a heavy disease burden to the country.This study aims to compare the changes of 5-year survival rate of urban bladder cancer patients in Liaoning Province during the two periods,discuss the prognostic factors and propose reference,so as to improve the survival rate of bladder cancer patients and provide a scientific basis for the formulation of bladder cancer detection and prevention strategies in Liaoning Province.Methods:Utilizing the Liaoning Cancer Incidence Reporting System,bladder cancer patients diagnosed between 2000-2002 and 2008-2009 among urban residents in Shenyang,Anshan and Benxi were extracted.The basic conditions,clinical information and survival status of patients with bladder cancer were retrospectively investigated by using the selfcompiled follow-up sheets,which investigate the diagnosis and treatment and survival status of bladder cancer patients.Two groups of confirmed cases were followed for 5 years with deadlines of 31 December 2007 and 31 December 2014,respectively.After exclusion according to strict selection criteria,1049 patients with bladder cancer were included.Epidata 3.1 software was used for questionnaire entry and SPSS 25.0 software was used for statistical analysis of data,and the significance test level was α = 0.05.The Observed Survival Rate(OSR)was calculated by the Kaplan-Meier method,the Expected survival rate(ESR)was calculated by Ederer II,the Relative Survival Rate(RSR)was calculated using OSR and ESR.The 5-year survival rate was compared with the z-test,and the survival curve was estimated by the Kaplan-Meier method.The survival rate of bladder cancer patients in different groups was compared by log-rank test.The Cox proportional hazards model was used for univariate and multivariate analysis.Results: 1049 patients with bladder cancer were included in the analysis,including 433 cases in 2000-2002 and 616 cases in 2008-2009.The patients’ 5-year OSR was 55.20%and 61.85% in 2000-2002 and 2008-2009.From 2000 to 2002,the 1,2,3,4 and 5-year RSR of patients respectively were 84.17%,76.84%,70.72%,67.85% and 65.21%.From2008 to 2009,the 1,2,3,4 and 5-year RSR patients respectively were 89.54%,81.65%,78.66%,75.24% and 73.74%.The increase rates of 1,2,3,4 and 5-year RSR in the two groups respectively were 5.37%(P = 0.034),4.81%(P = 0.108),7.94%(P = 0.021),7.39%(P = 0.043)and 8.54%(P = 0.026),and the increases of 1,3,4 and 5-year RSR were statistically significant.The 5-year RSR increases of male,≥ 75-year-old,stage III and IV,and all surgical patients respectively were 8.72%(P = 0.030),20.37%(P = 0.042),28.60%(P = 0.035),24.56%(P = 0.035)and 13.75%(P= 0.001),and the increases were statistically significant.The results of univariate Cox model analysis showed that age,clinical stage,surgery and surgical mode were the prognostic factors of bladder cancer patients from 2000 to 2002.Age,clinical stage,and surgery were the prognostic factors of bladder cancer patients from 2008 to 2009.The analysis results of the multivariate Cox proportional risk model hypothesis test showed that age,clinical stage,and whether surgery was met were all influencing factors for the prognosis of bladder cancer(P < 0.05).Conclusion: The five-year RSR of urban bladder cancer patients in Liaoning Province from 2008 to 2009 was improved compared with 2000-2002,and the survival rate level and trend of the two periods are relatively close to the domestic average level during the same period.Advanced age,high clinical,and no surgery are risk factors for prognosis of bladder cancer patients,and radical resection is a protective factor for the prognosis of bladder cancer patients.Therefore,in order to improve the long-term survival rate of bladder cancer patients in our province and improve the quality of life of bladder cancer patients,we should advocate early diagnosis and early treatment,and using surgical treatment as much as possible,especially radical resection treatment. |
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