Baghestani Ahmad Reza, Moghaddam Sahar Saeedi, Majd Hamid Alavi, Akbari Mohammad Esmaeil, Nafissi Nahid, Gohari Kimiya
Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
Asian Pac J Cancer Prev. 2015;16(18):8567-71. doi: 10.7314/apjcp.2015.16.18.8567.
The Cox model is known as one of the most frequently-used methods for analyzing survival data. However, in some situations parametric methods may provide better estimates. In this study, a Weibull parametric model was employed to assess possible prognostic factors that may affect the survival of patients with breast cancer.
We studied 438 patients with breast cancer who visited and were treated at the Cancer Research Center in Shahid Beheshti University of Medical Sciences during 1992 to 2012; the patients were followed up until October 2014. Patients or family members were contacted via telephone calls to confirm whether they were still alive. Clinical, pathological, and biological variables as potential prognostic factors were entered in univariate and multivariate analyses. The log-rank test and the Weibull parametric model with a forward approach, respectively, were used for univariate and multivariate analyses. All analyses were performed using STATA version 11. A P-value lower than 0.05 was defined as significant.
On univariate analysis, age at diagnosis, level of education, type of surgery, lymph node status, tumor size, stage, histologic grade, estrogen receptor, progesterone receptor, and lymphovascular invasion had a statistically significant effect on survival time. On multivariate analysis, lymph node status, stage, histologic grade, and lymphovascular invasion were statistically significant. The one-year overall survival rate was 98%.
Based on these data and using Weibull parametric model with a forward approach, we found out that patients with lymphovascular invasion were at 2.13 times greater risk of death due to breast cancer.
Cox模型是分析生存数据最常用的方法之一。然而,在某些情况下,参数方法可能能提供更好的估计。在本研究中,采用威布尔参数模型来评估可能影响乳腺癌患者生存的预后因素。
我们研究了1992年至2012年期间在沙希德·贝赫什提医科大学癌症研究中心就诊并接受治疗的438例乳腺癌患者;对患者进行随访直至2014年10月。通过电话联系患者或其家属以确认他们是否仍然存活。将临床、病理和生物学变量作为潜在的预后因素纳入单因素和多因素分析。单因素分析采用对数秩检验,多因素分析采用向前逐步法的威布尔参数模型。所有分析均使用STATA 11版软件进行。P值低于0.05被定义为具有统计学意义。
单因素分析显示,诊断时年龄、教育程度、手术类型、淋巴结状态、肿瘤大小、分期、组织学分级、雌激素受体、孕激素受体和淋巴管侵犯对生存时间有统计学显著影响。多因素分析显示,淋巴结状态、分期、组织学分级和淋巴管侵犯具有统计学意义。一年总生存率为98%。
基于这些数据并使用向前逐步法的威布尔参数模型,我们发现有淋巴管侵犯的患者死于乳腺癌的风险高出2.13倍。