Background: Chronic lymphocytic leukemia (CLL) is a common hematological malignancy with highly variable clinical presentation. Many patients never require any treatment but for the others, chemotherapy, immunochemotherapy, and newer targeted therapies have changed the treatment landscape. Diagnostic age influences the applied treatment, and we thus wanted to analyze age-specific survival trends through 50 years up to 2020s. Methods: We used 1- and 5-year relative survival from the NORDCAN database, with data from Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE). Because of the variable presentation of CLL, we also considered incidence and mortality trends. For comparison, US SEER data were used. Results: The large age-specific survival differences in 1972–76 almost disappeared by 2017–21. While 5-year survival in younger patients exceeded 90%, for those diagnosed at age 80–89 years, survival reached 90% in DK and SE women, 80% in NO and SE men, but only 50% in FI. DK 5-year overall survival for men was 92.4%, and for women, it was 96.3%. These survival figures were higher than age-group-specific US survival data. Conclusions: The DK data are probably global top figures for national survival which could be achieved by boosting survival even among the oldest patients. The qualification to these figures and international comparisons is that survival needs to be considered in terms of incidence, which is high in DK and NO. Low survival of the FI 80–89-year-old patients, even in the first year after diagnosis, may suggest delayed diagnosis, which should call for a closer national scrutiny.
背景：慢性淋巴细胞白血病（CLL）是一种临床表现高度异质性的常见血液系统恶性肿瘤。许多患者终生无需治疗，但对于其他患者，化疗、免疫化疗及新型靶向疗法已显著改变了治疗格局。诊断年龄影响治疗方案选择，因此我们旨在分析截至2020年代跨越50年的年龄特异性生存趋势。 方法：我们采用NORDCAN数据库中丹麦（DK）、芬兰（FI）、挪威（NO）和瑞典（SE）的1年及5年相对生存率数据。鉴于CLL临床表现的多样性，同时考虑了发病率与死亡率趋势。采用美国SEER数据进行对比分析。 结果：1972-1976年间显著的年龄特异性生存差异至2017-2021年已基本消失。年轻患者5年生存率超过90%，而80-89岁诊断患者的生存率在丹麦和瑞典女性中达90%，挪威和瑞典男性中为80%，芬兰患者仅为50%。丹麦男性5年总生存率为92.4%，女性达96.3%，这些数据均高于美国同年龄组生存率。 结论：丹麦数据可能代表了国家层面生存率的全球最高水平，这得益于其对高龄患者生存率的显著提升。需结合发病率解读这些数据及国际比较结果——丹麦和挪威的高发病率需纳入考量。芬兰80-89岁患者（包括诊断后第一年）生存率偏低，可能提示诊断延迟问题，值得开展更深入的全国性调查。
肿瘤(癌症)患者之家