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应用非混合治愈率模型分析乳腺癌患者的生存率

Application of a Non-Mixture Cure Rate Model for Analyzing Survival of Patients with Breast Cancer.

作者信息

Baghestani Ahmad Reza, Moghaddam Sahar Saeedi, Majd Hamid Alavi, Akbari Mohammad Esmaeil, Nafissi Nahid, Gohari Kimiya

机构信息

Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :

出版信息

Asian Pac J Cancer Prev. 2015;16(16):7359-63. doi: 10.7314/apjcp.2015.16.16.7359.

Abstract

BACKGROUND

As a result of significant progress made in treatment of many types of cancers during the last few decades, there have been an increased number of patients who do not experience mortality. We refer to these observations as cure or immune and models for survival data which include cure fraction are known as cure rate models or long-term survival models.

MATERIALS AND METHODS

In this study we used the data collected from 438 female patients with breast cancer registered in the Cancer Research Center in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The patients had been diagnosed from 1992 to 2012 and were followed up until October 2014. We had to exclude some because of incomplete information. Phone calls were made to confirm whether the patients were still alive or not. Deaths due to breast cancer were regarded as failure. To identify clinical, pathological, and biological characteristics of patients that might have had an effect on survival of the patients we used a non-mixture cure rate model; in addition, a Weibull distribution was proposed for the survival time. Analyses were performed using STATA version 14. The significance level was set at P ≤ 0.05.

RESULTS

A total of 75 patients (17.1%) died due to breast cancer during the study, up to the last follow-up. Numbers of metastatic lymph nodes and histologic grade were significant factors. The cure fraction was estimated to be 58%.

CONCLUSIONS

When a cure fraction is not available, the analysis will be changed to standard approaches of survival analysis; however when the data indicate that the cure fraction is available, we suggest analysis of survival data via cure models.

摘要

背景

在过去几十年中,多种癌症的治疗取得了显著进展,因此未经历死亡的患者数量有所增加。我们将这些观察结果称为治愈或免疫,而包含治愈比例的生存数据模型被称为治愈率模型或长期生存模型。

材料与方法

在本研究中,我们使用了从伊朗德黑兰沙希德·贝赫什提医科大学癌症研究中心登记的438名女性乳腺癌患者收集的数据。这些患者于1992年至2012年被诊断出来,并随访至2014年10月。由于信息不完整,我们不得不排除一些患者。通过电话确认患者是否仍然存活。将因乳腺癌死亡视为失败。为了确定可能对患者生存有影响的患者临床、病理和生物学特征,我们使用了非混合治愈率模型;此外,还为生存时间提出了威布尔分布。使用STATA 14版本进行分析。显著性水平设定为P≤0.05。

结果

在研究期间直至最后一次随访,共有75名患者(17.1%)因乳腺癌死亡。转移淋巴结数量和组织学分级是显著因素。估计治愈比例为58%。

结论

当无法获得治愈比例时,分析将改为生存分析的标准方法;然而,当数据表明可以获得治愈比例时,我们建议通过治愈率模型分析生存数据。

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