Conditional Survival Analysis of Patients With Locally Advanced Laryngeal Cancer: Construction of a Dynamic Risk Model and Clinical Nomogram

作     者：Sheu, Tommy Vock, David M. Mohamed, Abdallah S. R. Gross, Neil Mulcahy, Collin Zafereo, Mark Gunn, G. Brandon Garden, Adam S. Sevak, Parag Phan, Jack Lewin, Jan S. Frank, Steven J. Beadle, Beth M. Morrison, William H. Lai, Stephen Y. Hutcheson, Katherine Marai, G. Elisabeta Canahuate, Guadalupe M. Kies, Merrill El-Naggar, Adel Weber, Randal S. Rosenthal, David I. Fuller, Clifton D. 

作者机构：Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA Department of Clinical Oncology and Nuclear Medicine University of Alexandria Alexandria Egypt Division of Biostatistics University of Minnesota School of Public Health Minneapolis Minnesota USA Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas USA Department of Radiation Oncology Henry Ford Hospital Detroit MI USA Department of Computer Science University of Illinois at Chicago Chicago Illinois USA Department of Electrical & Computer Engineering University of Iowa Iowa City IA USA Department of Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA Department of Pathology The University of Texas MD Anderson Cancer Center Houston Texas USA 

出 版 物：《SCIENTIFIC REPORTS》 (科学报告)

年 卷 期：2017年第7卷第1期

页      面：43928-43928页

核心收录：

学科分类：12[管理学] 1201[管理学-管理科学与工程(可授管理学、工学学位)] 08[工学] 

基　　金：Division Of Mathematical Sciences Direct For Mathematical & Physical Scien Funding Source: National Science Foundation 

摘      要：Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3-and 6-year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65-72%) and 49% (CI 45-53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65-74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention.