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用于估计短期和长期结直肠癌生存率的混合治愈模型。

Mixture cure model for estimating short-term and long-term colorectal cancer survival.

作者信息

Amanpour Farzaneh, Akbari Setareh, Azizmohammad Looha Mehdi, Abdehagh Mohammad, Pourhoseingholi Mohamad Amin

机构信息

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2019;12(Suppl1):S37-S43.

Abstract

AIM

We used mixture cure mode to separately investigate the risk factors for long-term and short-term survival of colorectal cancer patients.

BACKGROUND

Colorectal cancer (CRC) is the second most common cancer worldwide. In cancer studies, patients' survival is the most important indicator of patients' status. Classical methods in analyzing the survival data usually apply Cox proportional hazard regression.

METHODS

The study was performed on 1121 patients diagnosed with colorectal cancer. Mixture cure model with Weibull distribution and logit link function was fitted to data.

RESULTS

Odds of long-term survival for rectum cancer patients were lower than for colon cancer patients (OR=0.29(0.09, 0.9)). Also, patients with the advanced stage of the disease had lower odds of long-term survival compared to early-stage patients (OR=0.24(0.06, 0.86)).In the short-term, the hazard of death for people with normal BMI was lower than the underweight group (HR=0.4(0.21, 0.76)). The short-term hazard of death for rectum cancer was about half of the short-term hazard for colon cancer (HR=0.49(0.29, 0.81)). Further, people with moderately (HR=2.11(1.26, 3.55)) and poorly (HR=4.04(2.03, 8.03)) differentiated tumor grade had a higher short-term hazard of death compared to people with well-differentiated grade.

CONCLUSION

Predictive variables of colorectal cancer survival showed different effects in short- and long -terms. Site topography was a prognosis for both long-term and short-term survival; BMI and tumor grade were short-term predictors of survival while stage was a long-term predictor of survival.

摘要

目的

我们采用混合治愈模型分别研究结直肠癌患者长期和短期生存的危险因素。

背景

结直肠癌(CRC)是全球第二大常见癌症。在癌症研究中,患者的生存是患者状况的最重要指标。分析生存数据的经典方法通常应用Cox比例风险回归。

方法

对1121例诊断为结直肠癌的患者进行了研究。将具有威布尔分布和logit链接函数的混合治愈模型拟合到数据中。

结果

直肠癌患者长期生存的几率低于结肠癌患者(OR = 0.29(0.09, 0.9))。此外,与早期患者相比,疾病晚期患者长期生存的几率较低(OR = 0.24(0.06, 0.86))。在短期内,BMI正常者的死亡风险低于体重过轻者(HR = 0.4(0.21, 0.76))。直肠癌的短期死亡风险约为结肠癌短期死亡风险的一半(HR = 0.49(0.29, 0.81))。此外,与高分化肿瘤分级的患者相比,中分化(HR = 2.11(1.26, 3.55))和低分化(HR = 4.04(2.03, 8.03))肿瘤分级的患者短期死亡风险更高。

结论

结直肠癌生存的预测变量在短期和长期显示出不同的影响。部位形态对长期和短期生存均为预后因素;BMI和肿瘤分级是短期生存的预测因素,而分期是长期生存的预测因素。

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