Overall survival estimates from diagnosis are valuable for guiding treatment, but do not consider the years already survived. Conditional survival (CS) provides dynamic survival predictions over time. This study was conducted to estimate CS at 1–8 years from diagnosis and the impact of baseline prognostic factors on CS in multiple myeloma (MM) patients. This is a retrospective study including 2556 MM patients diagnosed between 2004 and 2019. CS (t | s) was defined as the probability of surviving t years given survival of s years. Median age was 64 years. Median follow-up was 6.2 years and median overall survival from diagnosis was 7.5 years. The 5-year CS estimates at s = 0, 1, 2, 3, and 5 years were 0.64, 0.61, 0.61, 0.61, and 0.58, respectively. On multivariate analysis, age ≥ 65 and proteasome inhibitor+immunomodulatory-based induction were associated with decreased survival and increased survival, respectively, retained at 5 years. The adverse impact of 1q gain/amplification, high-risk IgH translocation, and ISS-3 was significant at 1 and 3 years but not 5 years. Chromosome 17 abnormality was associated with decreased survival only at 1 year. Among MM patients, 5-year CS was stable at 1–5 years from diagnosis. The prognostic impact of high-risk cytogenetic factors decreased with additional years survived.
从诊断时算起的总体生存率估算对指导治疗具有重要价值，但未考虑患者已存活的年限。条件生存率能够提供随时间变化的动态生存预测。本研究旨在估算多发性骨髓瘤患者诊断后1-8年的条件生存率，并评估基线预后因素对其影响。这项回顾性研究纳入了2004年至2019年间确诊的2556例多发性骨髓瘤患者。条件生存率（t|s）定义为在已存活s年的前提下继续存活t年的概率。患者中位年龄为64岁，中位随访时间6.2年，诊断后中位总生存期为7.5年。当s=0、1、2、3、5年时，对应的5年条件生存率估计值分别为0.64、0.61、0.61、0.61和0.58。多变量分析显示，年龄≥65岁与蛋白酶体抑制剂+免疫调节剂为基础的诱导治疗分别持续至5年时仍保持与生存率降低和升高的相关性。1q增益/扩增、高危IgH易位及ISS-3期的不良影响在第1年和第3年显著，但在第5年不再显著。17号染色体异常仅在第1年与生存率降低相关。在多发性骨髓瘤患者中，诊断后1-5年的5年条件生存率保持稳定。高危细胞遗传学因素的预后影响随存活年限增加而减弱。
Conditional survival in multiple myeloma and impact of prognostic factors over time
肿瘤(癌症)患者之家