• Title/Summary/Keyword: Survival and hazard analysis

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Application of Cox and Parametric Survival Models to Assess Social Determinants of Health Affecting Three-Year Survival of Breast Cancer Patients

  • Mohseny, Maryam;Amanpour, Farzaneh;Mosavi-Jarrahi, Alireza;Jafari, Hossein;Moradi-Joo, Mohammad;Monfared, Esmat Davoudi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.311-316
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    • 2016
  • Breast cancer is one of the most common causes of cancer mortality in Iran. Social determinants of health are among the key factors affecting the pathogenesis of diseases. This cross-sectional study aimed to determine the social determinants of breast cancer survival time with parametric and semi-parametric regression models. It was conducted on male and female patients diagnosed with breast cancer presenting to the Cancer Research Center of Shohada-E-Tajrish Hospital from 2006 to 2010. The Cox proportional hazard model and parametric models including the Weibull, log normal and log-logistic models were applied to determine the social determinants of survival time of breast cancer patients. The Akaike information criterion (AIC) was used to assess the best fit. Statistical analysis was performed with STATA (version 11) software. This study was performed on 797 breast cancer patients, aged 25-93 years with a mean age of 54.7 (${\pm}11.9$) years. In both semi-parametric and parametric models, the three-year survival was related to level of education and municipal district of residence (P<0.05). The AIC suggested that log normal distribution was the best fit for the three-year survival time of breast cancer patients. Social determinants of health such as level of education and municipal district of residence affect the survival of breast cancer cases. Future studies must focus on the effect of childhood social class on the survival times of cancers, which have hitherto only been paid limited attention.

Accuracy of c-KIT in lung cancer prognosis; a systematic review protocol" instead of c-KIT Expression in Lung Cancer Prognostic Evaluation - a Systematic Review Protocol

  • Roudi, Raheleh;Kalantari, Elham;Keshtkar, Abbas;Madjd, Zahra
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.863-866
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    • 2016
  • Background: Extensive efforts have been made to investigate c-KIT expression in lung cancer specimens and its correlation with clinical outcomes, but the issue remains unresolved. Thus, this study will be conducted to clarify the prognostic value of c-KIT expression in lung cancer patients. Materials and Methods: We will search Pubmed, SCOPUS, and ISI web of sciences with no restriction of language. Studies with any design (except case reports or case series) evaluating correlations of c-KIT expression with survival or outcome in patients with lung cancer will be included. The outcome measures will include all types of survival indexes, including overall survival rate and disease free survival using Kaplan-Meier analysis and hazard ratios. Study selection and data extraction will be performed by two independent researchers. Quality assessment (assessment of risk of bias) and data synthesis will be implemented using Stata software version 11.1. Results: No ethical issues are predicted. These findings will be published in a peer-reviewed journal and presented at national and international conferences. Conclusions: This systematic review protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews, registration number = CRD42015023391.

Changing incidence and survival of intrahepatic cholangiocarcinoma based on Surveillance, Epidemiology, and End Results Database (2000-2017)

  • Hassam Ali;Brandon Tedder;Syed Hamza Waqar;Rana Mohamed;Edward Lawson Cate;Eslam Ali
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.235-243
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    • 2022
  • Backgrounds/Aims: Historically, the incidence and prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (ICC) have been inadequately understood. Survival analysis in ICC has yet to be investigated in a population-based study. Methods: We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program (SEER) 18 Registry. Risk ratios were estimated via Poisson regression. Hazard ratios for 5-year survival were estimated using hierarchical Cox regression models. Results: Males show a higher rate of age-adjusted ICC incidence. Blacks carried a decreased risk of ICC diagnosis than Whites, while Asians revealed a higher risk of ICC diagnosis when compared with Whites. The observed survival rates at 12, 36, and 60 months were 36.3%, 12.8%, and 8.1%, respectively. Compared with Whites, Blacks showed an increased risk of death (p < 0.01). Lymph node resection during surgery was associated with a 64.1% reduced risk of mortality (p < 0.01). A higher T stage at diagnosis was associated with poor survival (p < 0.01). Surgery combined with chemoradiotherapy, radiotherapy, or chemotherapy was associated with a reduced risk of mortality compared with nonsurgical interventions (p < 0.01). Conclusions: ICC incidence has been increasing since 2000, especially in White males. The risk of ICC rises with age. Lymph node removal is associated with better survival. In recent years, survival had worsened, and surgical intervention improved survival compared with nonsurgical management.

Panel attrition factors in Korean Labor and Income Panel Study (한국노동패널 탈락 분석)

  • Lee, Sang-Hyeop;Park, Chan-Yong;Hye-Mi, Sung-Suk Chung;Choi, Hye-Mi
    • Journal of the Korean Data and Information Science Society
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    • v.22 no.1
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    • pp.1-8
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    • 2011
  • In panel studies in which the same respondents are interviewed repeatedly over the long term, panel attrition may cause the problems in the reliability of the result and the representativeness of the sample in panel study. In this article, we explore the risk factors of sample attrition in the first 11 waves of the Korean Labor and Income Panel Study (KLIPS) data covering the years 1998-2008, for which the survival analysis techniques such as life-table method and Cox proportional hazard model based on the time to the attrition of each respondent as the survival time of the respondent are applied.

Prognostic Value of Matrix Metalloproteinase 9 Expression in Breast Cancer Patients: A Meta-analysis

  • Song, Jian;Su, Hong;Zhou, Yang-Yang;Guo, Liang-Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1615-1621
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    • 2013
  • Background: Matrix metalloproteinase 9 (MMP-9) is related to tumor invasion and metastasis. However, the role of MMP-9 expression in breast cancer survival remains controversial. The purpose of this study was to accomplish a more accurate estimation of the association between MMP-9 expression and survival results in breast cancer patients through meta-analysis. Methods: A meta-analysis of published studies investigating the effects of positive MMP-9 expression on both relapse free survival (RFS) and overall survival (OS) was performed. Relevant literature was confirmed by searching electronic databases including PubMed, Ovid, EMBASE and China National Knowledge Infrastructure (CNKI) before November 1, 2012. Individual hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled HRs with 95% CIs were used to evaluate the strength of the association between positive MMP-9 expression and survival results of breast cancer patients. Funnel plot and Egger's regression tests were used to evaluate publication bias. Heterogeneity and sensitivity analysis was also conducted. All the work was completed using STATA. Results: A total of 2,344 patients from 15 evaluative studies were finally included. Pooled HRs and 95% CIs suggested that MMP-9 overexpression had an unfavorable impact on both OS (HR: 1.70, 95% CI: 1.41-2.04) and RFS (HR: 1.54, 95% CI: 1.17-2.01) in breast cancer patients. There was no significant heterogeneity observed in the studies reported for OS (P=0.360, $I^2$=8.8%), but not RFS (P=0.002, $I^2$=67%). Publication bias was absent among the studies both in OS and RFS cases (t=-0.54, P=0.605 and t=1.71, P=0.131, respectively). Omission of any single study had little effect on the combined risk estimates on sensitivity analysis. Conclusion: The results of this meta-analysis suggest that positive MMP-9 expression confers a higher risk of relapse and a worse survival in patients with breast cancer. Larger prospective studies are now needed to evaluate the clinical utility of MMP-9 expression.

Bayesian Variable Selection in the Proportional Hazard Model with Application to Microarray Data

  • Lee, Kyeong-Eun;Mallick, Bani K.
    • Proceedings of the Korean Statistical Society Conference
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    • 2005.05a
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    • pp.17-23
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    • 2005
  • In this paper we consider the well-known semiparametric proportional hazards models for survival analysis. These models are usually used with few covariates and many observations (subjects). But, for a typical setting of gene expression data from DNA microarray, we need to consider the case where the number of covariates p exceeds the number of samples n. For a given vector of response values which are times to event (death or censored times) and p gene expressions(covariates), we address the issue of how to reduce the dimension by selecting the significant genes. This approach enables us to estimate the survival curve when n ${\ll}$p. In our approach, rather than fixing the number of selected genes, we will assign a prior distribution to this number. The approach creates additional flexibility by allowing the imposition of constraints, such as bounding the dimension via a prior, which in effect works as a penalty To implement our methodology, we use a Markov Chain Monte Carlo (MCMC) method. We demonstrate the use of the methodology to diffuse large B-cell lymphoma (DLBCL) complementary DNA (cDNA) data and Breast Carcinomas data.

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A comparison study of inverse censoring probability weighting in censored regression (중도절단 회귀모형에서 역절단확률가중 방법 간의 비교연구)

  • Shin, Jungmin;Kim, Hyungwoo;Shin, Seung Jun
    • The Korean Journal of Applied Statistics
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    • v.34 no.6
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    • pp.957-968
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    • 2021
  • Inverse censoring probability weighting (ICPW) is a popular technique in survival data analysis. In applications of the ICPW technique such as the censored regression, it is crucial to accurately estimate the censoring probability. A simulation study is undertaken in this article to see how censoring probability estimate influences model performance in censored regression using the ICPW scheme. We compare three censoring probability estimators, including Kaplan-Meier (KM) estimator, Cox proportional hazard model estimator, and local KM estimator. For the local KM estimator, we propose to reduce the predictor dimension to avoid the curse of dimensionality and consider two popular dimension reduction tools: principal component analysis and sliced inverse regression. Finally, we found that the Cox proportional hazard model estimator shows the best performance as a censoring probability estimator in both mean and median censored regressions.

Determinants of Termination of Anti-dumping Measures: The Case of Korea

  • Rhee, Jin Woo;Jang, Yong Joon
    • East Asian Economic Review
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    • v.26 no.2
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    • pp.95-117
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    • 2022
  • This paper empirically examines what factors affected the termination of anti-dumping measures in Korea during the 2006-2019 period. Employing a meticulous literature review, the paper investigates the WTO's and Korea's rules on the termination of anti-dumping measures and sets up the related variables in the Cox proportional hazards model. The empirical results show that the GDP growth rate, employment, and trade competitiveness in domestic industries had positive effects on the hazard of the termination of AD measures, while free trade agreements had negative effects. By industry, the hazard of the termination of AD measures was less prominent in the steel industry, while it was more prominent in the machinery industry. These results imply that AD measures in Korea had the properties of a proper trade remedy policy and, at the same time, a protectionism tool to sustain its domestic industries, depending on industrial characteristics and other trade policies.

Tissue factor expression is associated with recurrence in patients with non-metastatic colorectal cancer

  • Jung, Hee Jae;Kim, Hye Jin;Kaneko, Kensuke;Kazama, Yoshihiro;Kawai, Kazushige;Ishihara, Soichiro;Choi, Gyu-Seog
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.128-134
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    • 2018
  • Purpose: Previous studies have addressed the role of the hypercoagulable state in the pathogenesis of cancer progression and metastasis. In this study, we investigated the association between coagulation factors, including tissue factor (TF) expression, platelet count, and fibrinogen level, and disease recurrence in patients with non-metastatic colorectal cancer. Methods: Patients who underwent curative resection for stage II or III colorectal cancer between 2000 and 2007 were included in this study. Data from a prospectively maintained database were retrospectively reviewed. TF expression was determined by immunohistochemistry using an anti-TF monoclonal antibody. The Kaplan-Meier method was used to estimate 5-year disease-free survival. Results: TF was highly expressed in 257 of 297 patients (86.5%). TF expression was not significantly associated with the platelet counts (P=0.180) or fibrinogen level (P=0.281). The 5-year disease-free survival rate was lower in patients with high TF expression than in patients with low TF expression (72.3% vs. 83.9%, P=0.074). In Cox hazard analysis, high TF expression was an independent risk factor for tumor recurrence (hazard ratio [HR] 2.446; 95% confidence interval [CI], 1.054-5.674; P=0.037). Undifferentiated histologic type (HR, 2.911; 95% CI, 1.308-6.481; P=0.009), venous invasion (HR, 2.784; 95% CI, 1.431-5.417; P=0.003), and lymph node metastasis (HR, 2.497; 95% CI, 1.499-4.158; P<0.001), were also significantly associated with disease recurrence. Conclusion: TF expression is associated with a recurrence in patients with non-metastatic colorectal cancer. However, further studies are required to clarify the underlying mechanisms relating TF expression with oncologic outcomes and its potential role as a therapeutic target.

Prognostic Value of Serum Ferritin in Terminally Ill Cancer Patients (말기암환자에서 예후인자로서 혈청 Ferritin의 유용성)

  • Lee, Soo Hee;Choi, Youn Seon;Hwang, In Cheol;Yeom, Chang Hwan;Lee, June Yeong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.51-59
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    • 2015
  • Purpose: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. Methods: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. Results: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. Conclusion: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.