Relative mortality in soft tissue sarcoma patients: a Danish population-based cohort study

BMC Cancer

Alma B Pedersen²  Steen Baerentzen¹  Akmal Safwat⁵  Johnny Keller⁴  Ninna Aggerholm-Pedersen⁵  Katja Maretty-Nielsen³ 

[1]Department of Pathology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark

[2]Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark

[3]Department of Experimental Clinical Oncology, Aarhus University Hospital, Noerrebrogade 44, building 5, 8000 Aarhus C, Denmark

[4]Department of Orthopaedic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark

[5]Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark

关键词: Comorbidity;    Cancer-specific survival;    Prognosis;    Relative survival;    Soft tissue sarcoma;   

Others  :  1121059
DOI  :  10.1186/1471-2407-14-682

 received in 2013-12-10, accepted in 2014-09-15,  发布年份 2014

【 摘 要 】

Background

Cancer-specific survival estimates rely on precise and correct data on the cause of death; however, these data can be difficult to acquire, particularly in elderly patients where comorbidity is common. Furthermore, while some deaths are directly related to cancer, others are more complex, with cancer merely contributing. Another, more precise, method is to assess the relative mortality, i.e., mortality in patients compared to the general population. The aims of this study were to describe the relative mortality in soft tissue sarcoma, and to compare the relative mortality with the cancer-specific mortality.

Methods

We included 1246 patients treated for soft tissue sarcoma and 6230 individually age- and sex-matched individuals from the general population. The relative mortality was estimated as rates, and rate ratios adjusted for comorbidity. Mortality rate ratios were computed using the Cox proportional hazard model for 0–5 years and 5–10 years, according to age, sex and level of comorbidity. The cancer-specific mortality was compared to the corresponding relative mortality.

Results

The overall 5- and 10-year relative mortality was 32.8% and 36.0%. Patients with low-grade soft tissue sarcoma did not have increased mortality compared with the general population. Soft tissue sarcoma patients had a 4.4 times higher risk of dying within the first five years after diagnosis and a 1.6 times higher risk between five and ten years compared with the general comparison cohort. The relative mortality varied according to age, grade, stage at diagnosis, and level of comorbidity, being highest in younger patients and in patients without comorbidity. The overall 5- and 10-year cancer-specific mortality was underestimated by 1.5 and overestimated by 0.7 percentage points compared to the relative mortality, respectively. No statistical significant difference between the relative and the cancer-specific mortality was found.

Conclusion

The relative mortality provides an unbiased and accurate method to differentiate between cancer-specific and non-cancer-specific deaths. However, when data on the cause of death is of a sufficient quality, there is no difference between relative mortality and disease-specific mortality based on death certificates.

【 授权许可】

   
2014 Maretty-Nielsen et al.; licensee BioMed Central Ltd.

【 图 表 】

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