Major patterns of cancer cure: Clinical implications

Abstract

Introduction This review aimed to classify major patterns of cancer cure and discuss clinical implications. Patterns of cancer cure were identified, in terms of long‐term survival and life expectancy, by means of two recently estimated indicators: cure fraction (CF) and time to cure (TTC). Methods We considered population‐based studies reporting results for some cancer types on CF, defined as the proportion of patients who will reach the same life expectancy of the general population, or/and TTC, the time span necessary to experience a negligible excess mortality. TTC is obtained using conditional relative survival, which indicates the probability of surviving an additional y number of years, given that patients already survived x number of years. Results Four major patterns of cancer types emerged from published studies: (a) cancers with a CF > 60% and a TTC < 5 years (e.g., testicular, thyroid); (b) cancers with a CF between 20% and 50% and a TTC < 10 years (colon, rectum); (c) cancers showing a CF of approximately 50% and TTC > 10 years (breast, prostate and bladder); (d) cancers with a CF < 20% and uncertain TTC (lung or pancreas). Conclusion Clinical and social impact of “cancer cure” categorisation are discussed in details. Recognising a cancer patient as cured represents an opportunity to improve their quality of life.

Comparing Quality of Life in Breast Cancer Patients Who Underwent Mastectomy Versus Breast-Conserving Surgery: A Meta-Analysis

“…Numerous studies have been done to compare the survival outcomes between the two surgical techniques [2][3][4], as well as the impact on psychological health such as depression [5]. Due to better survival outcomes for breast cancer patients over the past decades [6], an aspect that is becoming increasingly important is the quality of life (QoL) of these patients after surgery. QoL is defined by the World Health Organisation as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns" [7].…”

What is the Definition of Cure in Non-small Cell Lung Cancer?

“…Statistical cure is used in epidemiology and public health to consider the outcome of the [1,7]. It occurs when the mortality rate of cancer patients returns to the baseline level of the general age-matched population.…”

“…However, defining 'cure' is not as easy as it might first seem and has generated a great deal of discussion and debate. A common definition of cure in cancer is difficult to give, because the public, patients, clinicians and policymakers use the concept in different ways [1]. The first attempt to define 'cure' was in 1963, and referred to a group of disease-free survivors whose annual mortality was equal to that of the general population [2].…”

“…Statistical cure is used in epidemiology and public health to consider the outcome of the whole population of cancer patients. It is useful to policymakers for standardising care across different settings, such as follow-up time [ 1 , 7 ]. It occurs when the mortality rate of cancer patients returns to the baseline level of the general age-matched population.…”

“…The time point from diagnosis to when this occurs is called the cure point, or time to cure [ 7 , 8 ]. The proportion of patients still alive is the cure fraction [ 1 ]. Figure 1 illustrates these points.…”