Conditional median survival of patients with advanced carcinoma - Surveillance, epidemiology, and end results data

Background. Conditional survival is clinically useful, particularly for pat ients with malignant disease who have a poor prognosis. However, there are no published data on the conditional median survival of patients with advan ced carcinoma on a population basis. Methods. Data on 217,573 patients with breast, colorectal, lung, or prostat e carcinoma who were newly diagnosed with distant disease between 1973 and 1995 and who were followed through the end of 1997 were extracted from the Surveillance, Epidemiology, and End Results (SEER) data base of the Nationa l Cancer Institute. The Kaplan-Meier method was employed to estimate condit ional median survival and 95% confidence intervals at 0-5 years after the i nitial diagnosis. Results. The conditional median survival increased as time elapsed after th e initial diagnosis. The increase was slowest and almost leveled off among patients with prostate carcinoma. The median survival of patients with brea st carcinoma increased relatively linearly with time, i.e., 5-6 months per year. Conversely, there was a rapid increase in the conditional median surv ival according to the amount of time since diagnosis for patients with lung and colorectal carcinoma. The trend was most pronounced for patients with colorectal carcinoma. At 5 years after the initial diagnosis, the remaining median survival was longest for patients with colorectal carcinoma, almost 6 years (71.5 months), followed by patients with lung carcinoma (52.5 mont hs), breast carcinoma (42.5 months), and prostate carcinoma (34.5 months). Although race was a correlate with initial survival, gender and age had mor e impact on late conditional survival. Conclusions. The conditional median survival provides useful and encouragin g information for patients who survive with advanced disease and for health care professionals who treat these patients. However, the information shoul d be used carefully, taking the limitations of these data into account. Can cer 2001;92:2211-9. (C) 2001 American Cancer Society.