ЗЛОКАЧЕСТВЕННЫЕ НОВООБРАЗОВАНИЯ КОСТЕЙ. ЗАБОЛЕВАЕМОСТЬ, СМЕРТНОСТЬ, ДОСТОВЕРНОСТЬ УЧЕТА, ВЫЖИВАЕМОСТЬ БОЛЬНЫХ С УЧЕТОМ ГИСТОЛОГИЧЕСКИХ ФОРМ

Introduction. Standardized (world standard) incidence of malignant tumors of bones (S40,41) does not have has significant fluctuations. According to IARC among male population the most common incidence rates range from 1 to 2 cases per 100.000 and among female population – from 0.5 to 1.0 among women.  Purpose of study. To study dynamics of morbidity and mortality from malignant tumors of bones, the quality of estimation, observed and relative survival of patients according to histological forms. The work of this level is held in Russia for the first time. Material and methods of study. There were used an open world and domestic sources to estimate the prevalence of malignant tumors of bones, databases of population-based cancer registers, classical methods of population-based estimation of the prevalence of malignant tumors of bones. results of study. The basis of this work is data from the Population-based Cancer Registry of St. Petersburg and special studies being held before its establishing in 1993. Annually in St. Petersburg there are registered 40–60 primary cases of malignant tumors of bones (S40, 41). The level of morphological verification of these malignancies in Russia is 82.1 %, in St. Petersburg – 84.9 %. There is a high rate of undefined stage: in Russia – 19.7 %, in St. Petersburg – 24.5 %, in Moscow – 23.5 %. During the first year of observation 27.3 % of patients die in Russia, 21.7 % in St. Petersburg, and 11.1 % in Moscow. In comparison with the average data (Eurocare program) the relative survival of patients in St. Petersburg is significantly lower: in men (St. Petersburg – 42.2–48.2 %, (Eurocare-3,4 – 55–58 %), in women (St. Petersburg – 32.2–54.6 % (Eurocare – 59–63 %). conclusion. Thus, in this work for the first time in Russia it is showed dynamics of absolute and relative incidence rates of malignant tumors of bones since 1980 by sex and age-specific indicators. It is presented a set of analytical indicators, the level of morphological verification, one-year mortality as well as observed and relative survival. For the first time it is provided dynamics of a 5-year survival of patients with malignant tumors of bone in accordance with the histological forms. There is marked a growth of a 5-year survival rates of patients with chondrosarcoma and osteosarcoma.Введение. Стандартизованный (мировой стандарт) показатель заболеваемости населения злокачественными новообразованиеми костей (С40, 41) не имеет значительных колебаний. По данным Международного агентства по изучению рака, уровни заболеваемости колеблются от 1 до 2 случаев на 100 000 мужского и от 0,5 до 1,0 на 100 000 женского населения. Цель исследования. Изучить динамику заболеваемости и смертности населения от злокачественных новообразований костей, качество учета, наблюдаемую и относительную выживаемость больных с учетом гистологических форм опухолей. Материал и методы. Основой работы являются данные Популяционного ракового регистра г. Санкт-Петербурга и проводимых до его создания в 1993 г. исследований. Использованы открытые мировые и отечественные источники для оценки распространенности злокачественных новообразований костей, базы данных Популяционных раковых регистров, классические методы популяционной оценки распространенности злокачественных новообразований костей. результаты исследования. В г. Санкт-Петербурге ежегодно регистрируется 40–60 первичных случаев злокачественных новообразований костей (С40, 41). Уровень морфологической верификации ЗНО костей по России – 82,1 %, в г. Санкт-Петербурге – 84,9 %. Высок процент по России числа больных с неуточненной стадией заболевания – 19,7 %, в г. Санкт-Петербурге он еще выше – 24,5 %, в г. Москве – 23,5 %. На первом году наблюдения в России погибают 27,3 % больных, в г. Санкт-Петербурге – 21,7 %, в г. Москве – 11,1 %. В сравнении со среднеевропейскими данными (программа Eurocare- 3,4, 2003 г.), относительная выживаемость больных в г. Санкт-Петербурге (1994–1997, 1998–2001 гг.) существенно ниже: мужчин 42,2–48,2 %, (Eurocare-3, 4 – 55–58 %); женщин 32,2–54,6 % (Eurocare – 59–63 %). заключение. В данной работе впервые в России представлена динамика абсолютных и относительных показателей заболеваемости населения злокачественными новообразованиями костей с 1980 г. с учетом пола и повозрастных показателей. Представлен комплекс аналитических показателей, уровень морфологической верификации, одногодичная летальность, наблюдаемая и относительная выживаемость. Впервые представлена динамика 5-летней выживаемости больных ЗНО костей с учетом гистологических форм опухолей. Отмечен рост показателей 5-летней выживаемости больных с хондросаркомой и остеосаркомой

ЭПИДЕМИОЛОГИЯ И ВЫЖИВАЕМОСТЬ БОЛЬНЫХ ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ ПОЛОСТИ НОСА, СРЕДНЕГО УХА И ПРИДАТОЧНЫХ ПАЗУХ С УЧЕТОМ СТАДИИ ЗАБОЛЕВАНИЯ И ГИСТОЛОГИЧЕСКОЙ СТРУКТУРЫ ОПУХОЛИ

Introduction. The population-level survival analysis for cancer patients was not carried out in Russia due to the absence of population-based cancer registries, meeting the requirements of international Agency for Research on Cancer. This opportunity has appeared only with the establishment of the population-based cancer registry in St. Petersburg. Cancer survival estimation is possible only under conditions of strict adherence to the principles of the study. Analysis of survival of cancer patients is the main criterion of the objective assessment of the effectiveness of anticancer therapy. Malignant tumors of the nasal cavity, middle ear and accessory sinuses are classified by two ICD-10 diagnosis codes: С30 and С31 (С30: malignant tumors of the nasal cavity and middle ear; C31: malignant tumors of accessory sinuses). Database of the population-based cancer registry promotes the study of survival by any parameter including the fourth character of the ICD-10 code and histological type of the tumor.Purposes and objectives. To estimate the observed and relative survival rates in patients with malignant tumors of the nasal cavity, middle ear and accessory sinuses and to compare the results obtained with the EU average (according to the EuroCare program), as well as to estimate survival of this group of patients according to sex, age, stage of disease and histological type of the tumor.Material and methods. Between 1994 and 2009, 565 cases with malignant tumors of the nasal cavity, middle ear and accessory sinuses were selected from the population-based cancer registry. There were used the observed and relative survival rates calculated according to the international standards.Results. We estimated the 5-year observed and relative survival rates in patients with cancers of the nasal cavity, middle ear and sinuses, using ICD-10 codes С30 and 31 and taking into account sex, age, stage of disease and histological structure of tumors. A clear trend toward increase in the 5-year observed and relative survival rates in patients with malignant tumors of the nasal cavity, middle ear and accessory sinuses was observed.Введение. Расчеты выживаемости больных злокачественными новообразованиями (ЗНО) на популяционном уровне в России не проводились в связи с отсутствием системы популяционных раковых регистров (ПРР), работающих по международным стандартам. Такая возможность появилась только с созданием ПРР в г. Санкт-Петербурге. Расчет показателей выживаемости больных ЗНО возможен только при условии строгого соблюдения всех правил проведения исследования. Анализ выживаемости больных является основным критерием объективной характеристики эффективности проводимых противораковых мероприятий. ЗНО полости носа, среднего уха и придаточных пазух при расчетах заболеваемости рассматриваются вместе по двум рубрикам МКБ-10: С30 и 31 (С30 – ЗНО полости носа и среднего уха, С31 – ЗНО придаточных пазух). БД ПРР предоставляет возможность исследования выживаемости больных по любому параметру, в том числе и по четвертому знаку МКБ-10 и гистологическому типу опухоли.Цель исследования – исчислить показатели наблюдаемой и относительной выживаемости больных раком носа, среднего уха и придаточных пазух, сравнить полученные данные со среднеевропейскими показателями (по программе Eurocare). Провести расчеты выживаемости данной группы больных по полу, возрасту, стадии заболевания и гистологическому типу опухоли.Материал и методы. Для проведения исследования из БД ПРР отобрано 565 случаев ЗНО полости носа, среднего уха и придаточных пазух среди мужского и женского населения г. Санкт-Петербурга за 1994–2009 гг. Для расчета использованы показатели наблюдаемой и относительной выживаемости, исчисленные по международным стандартам (Eurocare).Результаты. Исчислен показатель наблюдаемой и относительной 5-летней выживаемости больных ЗНО по рубрикам МКБ-10 С30,31 с учетом пола, возраста, стадии заболевания и гистологической структуры опухолей. Установлен прогресс в динамике 5-летней наблюдаемой и относительной выживаемости больных ЗНО данной группы и сближение с аналогичными среднеевропейскими показателями.

EPIDEMIOLOGY OF MALIGNANT TUMORS OF LARGE SALIVARY GLANDS (POPULATION-BASED STUDY)

Introduction. Malignant tumors of large salivary glands are a relatively rare malignancy. In 2014 as a whole in Russia 1236 cases of these diseases were registered. According to the latest data of the Interna- tional Agency for Research on Cancer (Volume X) the most common standardized incidence rate in various countries ranges from 0.6-0.9 per 100,000 men and 0.4-0.6 per 100,000 women. aim of study. The aim of this study is to carry out for the first time in Russia an estimation of a complex of analytical rates including an evaluation of observed and relative survival rates to assess the effectiveness of cancer control related to patients with a diagnosis of malignant tumors of large salivary glands. material and methods. An estimation of a complex of analytical rates was conducted in accordance with database of the Population-based Cancer Registry of St. Petersburg. There were selected 896 patients with a diagnosis of malignant tumors of large salivary glands from 1994 to 2013. Results. It was found that the most frequent value of the standardized incidence rates of malignant tumors of large salivary glands in different countries of the world community for the male population was 0.6-0.9 per 100,000 population and 0.4-0.6 for the female. These values were 0000 equal to 0.7 and 0.4 0/ in Russia (2014), and 0.6 and 0.5 0/ in St. Petersburg (2014). The vast majority 0000 of recorded cases of malignant tumors of large salivary glands were for S07.9 - of malignant tumors of large salivary glands undefined. 46.6 % of primary patients had early stages (I + II). A relative 5-year survival rate was 61.9 % for men and 69.9 % for women, which was slightly less than the European average (Eurocare). Conclusion. This study for the first time in Russia allowed estimating series of analytical rates character- izing the effectiveness of cancer control related to patients with malignant tumors of large salivary glands in St. Petersburg including estimations of a 5-year relative survival of patients

EPIDEMIOLOGY OF LIVER CANCER. MORBIDITY, MORTALITY, DYNAMICS OF HISTOLOGICAL STRUCTURE

Primary liver cancer is the ICD-10 category C22 (malignant tumors of the liver and intrahepatic bile ducts). This is one of the most severe forms of cancer. According to database (DB) of the Population-based Cancer Registry of St. Petersburg for the past 15 years the median of cumulative observed survival of liver cancer patients of all histological forms (excluding postmortem diagnosed patients) both for men and women was no more than 3.3 months from the moment of diagnosis. On the majority of administrative territories of Russia mortality from liver cancer exceeds the level of morbidity that indicates a significant underestimation of primary patients. Even mortality («rude» rate) for Russia in the whole for men in 2012 exceeded the level of morbidity. St. Petersburg (Leningrad) is the single territory of Russia where the dynamics of the population liver cancer incidence can be analyzed since 1980. Dynamics of histological structure of liver cancer, recorded in St. Petersburg, shows a sharp decline in the proportion of tumors of the liver without a specific histological type and the significant increase in hepatocellular carcinoma and cholangiocarcinoma. Purpose of the study. To study the prevalence of liver cancer in the world and Russia, to produce in-depth development of material based on DB of the Population-based Cancer Registry of St. Petersburg. Material and methods. For the study there were taken by international data of the program «Cancer in 5 continents», statistical materials on Russia, 3893 cases from DB of the Population-based Cancer Registry of St. Petersburg, estimated analytical indices, index accuracy. Results of the study. Liver cancer is the most severe form of cancer. It is practically not detected in stage I and II of disease, index of accuracy in the most administrative territories exceeds 1.0. Conclusion. Thus liver cancer is not only one of tumors with the highest lethality and the lowest median of survival but also has a significant underestimation of the primary cases. Since the introduction in public reporting data on deaths from liver cancer in 1999 the standardized mortality rate in St. Petersburg decreased by 17.2 % in men and 16.0 % women

EPIDEMIOLOGY AND SURVIVAL OF PATIENTS WITH MALIGNANT TUMORS OF CONNECTIVE AND SOFT TISSUE

Introduction. Malignant tumors of connective and soft tissue are met relatively rare, although in general in Russia each year more than 1.500 new cases are registered. On five administrative territories of Russia during a year there are recorded less than 5 new cases of malignant tumors of connective and soft tissue (Yamal-Nenets A.R. – 4; Tuva Republic – 0, Magadan Region – 3; Chukotka A.R. – 0; Jewish A.R. – 4. More seldom data on these patients’ survival are published. Purpose of study. To estimate dynamics of incidence of malignant tumors of connective and soft tissue on the basis of public reporting, to calculate the index accuracy and observed and relative survival rates by histological forms, including sarcomas. Material and methods. To perform a detailed study there were selected, for two periods of observation, respectively 1054 patients (1995–2001) and 919 patients (2002–2008). Estimation of survival was carried out using software, which had been developed together with Ltd. «Novel» (Director – T.L.Tsvetkova, Ph.D.). results of study. The most typical incidence rate for of malignant tumors of connective and soft tissue (S47, 49) that are presented by  cancer registries of different countries is from 1.5 to 2.5 0/   in men and 1.5–2.0 0/   in women. Dynamics  of morbidity of the Russian population, Moscow and St. Petersburg indicates that the level of standardized  incidence rates is in the range of 2.0 0/   in men and within 1.5 0/   in women. The mortality rate in 2013  was respectively for men and women in Russia in total 1.7 0/   and 1.13 0/   , in Moscow – 1.42 0/   and  1.24 0/   , in St. Petersburg – 1.88 0/   and 1.26 0/   . The index accuracy for both sexes in Russia is 0.88,  in Moscow – 1.2; in St. Petersburg – 1.4. This index should be used for the site of these diseases with high fatality. According to official data a one-year lethality of patients with tumors of connective and soft tissue in 2013 was 20.1 %, and for all malignant tumors – 25.3 %, however the index accuracy for all malignant tumors was equal to 0.72, and for malignant tumors of connective and soft tissue – 0.88. That is in 5 of 8 federal districts the index accuracy is 1 or more, testifies significant undercount of patients with malignant tumors of connective and soft tissue. conclusion. The study allowed determining, despite relatively low rates of morbidity and mortality from malignant tumors of connective and soft tissue, there was revealed a significant undercount of primary cases. In a number of federal districts morbidity exceeds morbidity. Kaposi’s sarcoma is a tiny fraction of this group of tumors. The main part of patients with malignant tumors of connective and soft tissue is for C49 column «Malignant tumors of other types of connective and soft tissue». In basic part of patients with malignant tumors of connective and soft tissue there has been established positive dynamics of a 5-year observed and relative survival but this level is lower than the European average. Among sarcomas all malignant tumors of connective and soft tissue the best indicator of survival is for liposarcoma (>70 %), then for leiomyosarcoma (>40 %), and the least for sarcoma with undefined diagnosis

DYNAMICS OF OBSERVED AND RELATIVE SURVIVAL OF PATIENTS WITH PRIMARY LIVER CANCER ON THE POPULATION LEVEL ACCORDING TO DISEASE STAGE AND HISTOLOGICAL STRUCTURE

Introduction. Liver cancer relates to serious cancer pathology. The study of risk factors for liver cancer is the subject of many publications including experimental research. Of 16 countries, which presented data on estimation of relative oneand five-year survival of patients with liver cancer (both sexes) in the European countries (the program Eurocare-4), only in five countries a 5-year relative survival exceeded 10 %. The European average rate of a 5-year relative survival (for both sexes) was 8.7 %. For men it was equal to 8.9 % and for women 8.4 %. Purpose. To provide for the first time in Russia on the population level an analysis of dynamics of survival of liver cancer patients in accordance with database of the Population-Based Cancer Registry of St. Petersburg, the first in Russia working on international standards, in comparison with the programs Eurocare-3 and 4. Also it was necessary to estimate a number of analytical indicators, which reflect the state of problem. Material and methods. To solve this purpose there were studied the state of problem in European registries, data on state reporting of Russia and primary materials of the Population-Based Cancer Registry of St. Petersburg. The total number of observations according to the Population-Based Cancer Registry of St. Petersburg was 4003 cases of primary liver cancer including 2218 cases among men and 1785 among women. For the estimation of observed and relative survival rates there were used estimations of rates, modified by us, of the programs Eurocar-3 and 4. Results. There has been established the level, close to the European average, of observed and relative 5-year survival of liver cancer patients, both men and women of St. Petersburg. Throughout the whole period of observation it was revealed an extremely low level in median survival. Coding of histological forms of malignant tumors of the liver was significantly improved. The proportion of ICD codes 8000/3 and 8010/3 decreased among men from 71.6 % to 8.2 %, among women with 48.48 % to 6.38 %. Conclusion. Malignant tumors of the liver are severe pathology in oncology. It is required not only an improvement of the primary estimation but also more accurate coding and providing timely medical care to patients

MALIGNANT TUMORS OF BONES. MORBIDITY, MORTALITY, INDEX ACCURACY, SURVIVAL OF PATIENTS ACCORDING TO HISTOLOGICAL FORMS

Introduction. Standardized (world standard) incidence of malignant tumors of bones (S40,41) does not have has significant fluctuations. According to IARC among male population the most common incidence rates range from 1 to 2 cases per 100.000 and among female population – from 0.5 to 1.0 among women.  Purpose of study. To study dynamics of morbidity and mortality from malignant tumors of bones, the quality of estimation, observed and relative survival of patients according to histological forms. The work of this level is held in Russia for the first time. Material and methods of study. There were used an open world and domestic sources to estimate the prevalence of malignant tumors of bones, databases of population-based cancer registers, classical methods of population-based estimation of the prevalence of malignant tumors of bones. results of study. The basis of this work is data from the Population-based Cancer Registry of St. Petersburg and special studies being held before its establishing in 1993. Annually in St. Petersburg there are registered 40–60 primary cases of malignant tumors of bones (S40, 41). The level of morphological verification of these malignancies in Russia is 82.1 %, in St. Petersburg – 84.9 %. There is a high rate of undefined stage: in Russia – 19.7 %, in St. Petersburg – 24.5 %, in Moscow – 23.5 %. During the first year of observation 27.3 % of patients die in Russia, 21.7 % in St. Petersburg, and 11.1 % in Moscow. In comparison with the average data (Eurocare program) the relative survival of patients in St. Petersburg is significantly lower: in men (St. Petersburg – 42.2–48.2 %, (Eurocare-3,4 – 55–58 %), in women (St. Petersburg – 32.2–54.6 % (Eurocare – 59–63 %). conclusion. Thus, in this work for the first time in Russia it is showed dynamics of absolute and relative incidence rates of malignant tumors of bones since 1980 by sex and age-specific indicators. It is presented a set of analytical indicators, the level of morphological verification, one-year mortality as well as observed and relative survival. For the first time it is provided dynamics of a 5-year survival of patients with malignant tumors of bone in accordance with the histological forms. There is marked a growth of a 5-year survival rates of patients with chondrosarcoma and osteosarcoma