ESMO 2018: When is a Cancer Patient Cured?
First, it is critical that we learn and standardize how we define a cured patient. Unfortunately, a widely accepted epidemiological measurable definition of “cured patients” is lacking. At a population level, a patient can be considered cured when they reach the same mortality rate (life expectancy) of the general population of the same sex and age. At the individual level, a measurable excess risk may remain after the elimination of all “detectable” malignant cells (complete remission).
Some important question that needs to be answered include how many years will a patient need to wait to consider himself cured? How many patients will he/she be cured of the disease? How many patients are already cured of the disease? What is the life expectancy of cancer patients?
Dr. Dal Maso next described a study assessing 0.8 million Italian cancer patients with 18-28 years of follow-up diagnosed after the year 1976. Validated statistical methods were used to estimate population-based indicators of cancer cure, by cancer type, gender, age, and time-period. Conditional relative survival (the cumulative probability of surviving an additional five years, given that the patients already survived a certain number of years) was also demonstrated.
For this study, patients had to be stopped being recruited several years ago, so that a long enough follow-up would exist on each patient. Cancer types of different organs have various cure rates and varying time to cure.
The limitations of this study include the fact that the definition of time to cure is still questionable, and there was no information on histology, stage, and treatment. Lastly, estimates can vary over time and in various countries. In summary, a reliable and accurate answer to the question when is a cancer patient cured can be found, making the lives of patients easier.
Presented by: Luigino Dal Maso, Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy.
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 European Society for Medical Oncology Congress (#ESMO18), October 19-23, 2018, Munich Germany