Graf W, Påhlman L, Bergström R, Glimelius B
Department of Surgery, Akademiska Sjukhuset, Uppsala, Sweden.
Br J Cancer. 1994 Sep;70(3):559-63. doi: 10.1038/bjc.1994.345.
This analysis was conducted to evaluate the independent relationship between survival and response to chemotherapy in advanced colorectal cancer. In order to correct for the guarantee time effect, patients dying before the response evaluation were excluded from the analyses. A previously constructed prognostic model containing 11 variables was applied to 324 patients. When the response categories were analysed together with the prognostic variables, it was found that a response was associated with a definite survival advantage (P < 0.001), whereas the influence of all the other variables decreased. The corrected survival advantage (relative progressive disease) was 11 months after a complete response, 6 months after a partial response and 4 months after stable disease. The survival advantage was of a similar magnitude when the analyses were repeated in an independent population comprising 198 patients in whom the prognostic model was extended to include also a set of laboratory values. The results show that a response to chemotherapy is associated with a longer survival also after correction for the guarantee time effect and the distribution of prognostic variables.
进行该分析是为了评估晚期结直肠癌患者生存与化疗反应之间的独立关系。为校正保证时间效应，在分析中排除了在反应评估前死亡的患者。将先前构建的包含11个变量的预后模型应用于324例患者。当将反应类别与预后变量一起分析时，发现反应与明确的生存优势相关（P < 0.001），而所有其他变量的影响则降低。完全缓解后的校正生存优势（相对于疾病进展）为11个月，部分缓解后为6个月，疾病稳定后为4个月。当在一个独立人群（包括198例患者，其中预后模型扩展到还包括一组实验室值）中重复进行分析时，生存优势的幅度相似。结果表明，校正保证时间效应和预后变量分布后，化疗反应与更长的生存期相关。
