• Title/Summary/Keyword: Cure fraction

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Application of a Non-Mixture Cure Rate Model for Analyzing Survival of Patients with Breast Cancer

  • Baghestani, Ahmad Reza;Moghaddam, Sahar Saeedi;Majd, Hamid Alavi;Akbari, Mohammad Esmaeil;Nafissi, Nahid;Gohari, Kimiya
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7359-7363
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    • 2015
  • Background: As a result of significant progress made in treatment of many types of cancers during the last few decades, there have been an increased number of patients who do not experience mortality. We refer to these observations as cure or immune and models for survival data which include cure fraction are known as cure rate models or long-term survival models. Materials and Methods: In this study we used the data collected from 438 female patients with breast cancer registered in the Cancer Research Center in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The patients had been diagnosed from 1992 to 2012 and were followed up until October 2014. We had to exclude some because of incomplete information. Phone calls were made to confirm whether the patients were still alive or not. Deaths due to breast cancer were regarded as failure. To identify clinical, pathological, and biological characteristics of patients that might have had an effect on survival of the patients we used a non-mixture cure rate model; in addition, a Weibull distribution was proposed for the survival time. Analyses were performed using STATA version 14. The significance level was set at $P{\leq}0.05$. Results: A total of 75 patients (17.1%) died due to breast cancer during the study, up to the last follow-up. Numbers of metastatic lymph nodes and histologic grade were significant factors. The cure fraction was estimated to be 58%. Conclusions: When a cure fraction is not available, the analysis will be changed to standard approaches of survival analysis; however when the data indicate that the cure fraction is available, we suggest analysis of survival data via cure models.

Fitting Cure Rate Model to Breast Cancer Data of Cancer Research Center

  • Baghestani, Ahmad Reza;Zayeri, Farid;Akbari, Mohammad Esmaeil;Shojaee, Leyla;Khadembashi, Naghmeh;Shahmirzalou, Parviz
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7923-7927
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    • 2015
  • Background: The Cox PH model is one of the most significant statistical models in studying survival of patients. But, in the case of patients with long-term survival, it may not be the most appropriate. In such cases, a cure rate model seems more suitable. The purpose of this study was to determine clinical factors associated with cure rate of patients with breast cancer. Materials and Methods: In order to find factors affecting cure rate (response), a non-mixed cure rate model with negative binomial distribution for latent variable was used. Variables selected were recurrence cancer, status for HER2, estrogen receptor (ER) and progesterone receptor (PR), size of tumor, grade of cancer, stage of cancer, type of surgery, age at the diagnosis time and number of removed positive lymph nodes. All analyses were performed using PROC MCMC processes in the SAS 9.2 program. Results: The mean (SD) age of patients was equal to 48.9 (11.1) months. For these patients, 1, 5 and 10-year survival rates were 95, 79 and 50 percent respectively. All of the mentioned variables were effective in cure fraction. Kaplan-Meier curve showed cure model's use competence. Conclusions: Unlike other variables, existence of ER and PR positivity will increase probability of cure in patients. In the present study, Weibull distribution was used for the purpose of analysing survival times. Model fitness with other distributions such as log-N and log-logistic and other distributions for latent variable is recommended.

Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

  • Byungje Bae;Keera Kang;Sung Kyu Song;Chul-Woon Chung;Yongkeun Park
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.47-57
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    • 2022
  • Backgrounds/Aims: It is challenging to assess the efficacy of partial hepatectomy (PH) as a treatment option for patients with hepatocellular carcinoma (HCC) accompanied by cirrhosis. This study aimed to determine the cure fraction of PH for HCC accompanied by cirrhosis compared to that for HCC without cirrhosis. Methods: A systematic review was performed on outcomes of previous studies that compared recurrence-free survival (RFS) after PH in patients with HCC with or without cirrhosis. A meta-analysis was conducted to obtain the cumulative hazard ratio for two patient groups: cirrhosis and non-cirrhosis. Cure fractions after PH in both groups were determined using a cure model analysis. Results: A total of 18 studies were eligible for meta-analysis and 13 studies were selected for the cure model analysis. The cumulative hazard ratio for RFS of the cirrhosis group compared to that of the non-cirrhosis group was 1.66 (95% confidence interval [CI], 1.43-1.93). Survival data of 3,512 patients in both groups were reconstructed from survival curves of original articles for cure model analysis. The probability of being statistically cured after PH for HCC was 14.1% (95% CI, 10.6%-18.1%) in the cirrhosis group lower than that (32.5%) in the non-cirrhosis group (95% CI, 28.6%-36.4%). Conclusions: The prognosis after PH for HCC accompanied by cirrhosis is inferior to that for HCC without cirrhosis. However, a cure can be expected for one-seventh of patients with HCC accompanied by cirrhosis after PH.

A new extended Birnbaum-Saunders model with cure fraction: classical and Bayesian approach

  • Ortega, Edwin M.M.;Cordeiro, Gauss M.;Suzuki, Adriano K.;Ramires, Thiago G.
    • Communications for Statistical Applications and Methods
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    • v.24 no.4
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    • pp.397-419
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    • 2017
  • A four-parameter extended fatigue lifetime model called the odd Birnbaum-Saunders geometric distribution is proposed. This model extends the odd Birnbaum-Saunders and Birnbaum-Saunders distributions. We derive some properties of the new distribution that include expressions for the ordinary moments and generating and quantile functions. The method of maximum likelihood and a Bayesian approach are adopted to estimate the model parameters; in addition, various simulations are performed for different parameter settings and sample sizes. We propose two new models with a cure rate called the odd Birnbaum-Saunders mixture and odd Birnbaum-Saunders geometric models by assuming that the number of competing causes for the event of interest has a geometric distribution. The applicability of the new models are illustrated by means of ethylene data and melanoma data with cure fraction.

Cure Rate Model with Clustered Interval Censored Data (군집화된 구간 중도절단자료에 대한 치유율 모형의 적용)

  • Kim, Yang-Jin
    • The Korean Journal of Applied Statistics
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    • v.27 no.1
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    • pp.21-30
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    • 2014
  • Ordinary survival analysis cannot be applied when a significant fraction of patients may be cured. A cure rate model is the combination of cure fraction and survival model and can be applied to several types of cancer. In this article, the cure rate model is considered in the interval censored data with a cluster effect. A shared frailty model is introduced to characterize the cluster effect and an EM algorithm is used to estimate parameters. A simulation study is done to evaluate the performance of estimates. The proposed approach is applied to the smoking cessation study in which the event of interest is a smoking relapse. Several covariates (including intensive care) are evaluated to be effective for both the occurrence of relapse and the smoke quitting duration.

Studies on the Crosslinking Density and Reinforcement of Rubber Compounds by Cure System (가황조건별 배합고무의 가교밀도와 고무보강성에 관한 연구)

  • Park, Nam-Cook;Lee, Seog
    • Elastomers and Composites
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    • v.33 no.5
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    • pp.315-323
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    • 1998
  • The purpose of this study was to investigate the crosslinking density and reinforcement of rubber compounds with various carbon black loadings, cure systems and cure temperatures. Bound rubber content increased with volume fraction of carbon black in rubber compounds, but total crosslinking density decreased with increasing the bound rubber content. Rate constant of cure reaction was changed significantly by cure system and cure temperature, especially it showed strong dependence on the cure temperature. High activation energys of cure reaction were shown in the rubber compound with high loading of carbon black under EC system and in the rubber compound with low loading of carbon black under CC system. High total crosslinking density of vulcanized compounds appeared in the rubber compound with low loading of carbon black and CC system among cure systems. Typical change of total crosslinking density by EC system was not shown. The highest elastic constant by Mooney-Rivlin equation was shown in the rubber compound with low loading of carbon black and SEC system. Modulus increased as increasing the loading of carbon black in the rubber compounds and showed the order of SEC, CC, and EC system for cure system.

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Stromal vascular fraction injection to treat intractable radiation-induced rectovaginal fistula

  • Kim, Mijung;Lew, Dae Hyun;Roh, Tai Suk;Song, Seung Yong
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.127-130
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    • 2021
  • Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.

Effects of Artemisia Capillaris Fructus on Fas-FasL-induced Apoptosis in Hepatocye (인진호(茵蔯蒿)가 Fas-FasL 매개형 간세포 Apoptosis에 미치는 영향)

  • Kim, Hyeong-Hwan;An, Joong-Hwan;Kim, Jong-Dae;Kim, Cheorl-Ho;Kim, Seon-Kang
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.353-360
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    • 2001
  • Objectives: Recently, it was known that the major cause of hepatitis is apoptosis reaction mediated by Fas-FasL. Since Artemisia Capillaris Fructus has long been applied to cure the jaundice in oriental medicine. Therefore, this study was carried out to examine the effect of fractions of Artemisia Capillaris Fructus on Fas-FasL-mediated apoptosis in hepatocytes. Methods: This study employed propidium iodide negative cell count assay and some the other biochemical assays. Results : This study confirms that hepatitis has been occured by apoptosis mediated by Fas-FasL in cultured hepatocyte and fractions of Artemisia Capillaris Fructus restrain apoptosis induced Fas-FasL. Conclusions : Water-extracted fraction, methanol extracts, ether-soluble fraction, and buthanol-soluble fractions of Artemisia Capillaris Fructus restrain Fas-FasL-mediated apoptosis in hepatocyte. Silica gel chromatograph of Buthanol-soluble fraction of Artemisia Capillaris Fructus restrain Fas-FasL-mediated apoptosis in hepatocyte. Artemisia Capillaris Fructus could be applied to cure hepatitis.

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Simulation Study for Statistical Methods in Comparing Cure Rates between Two Groups (모의실험을 통한 두 처리군간 치료율 비교방법 연구)

  • 박미라;이재원;진서훈
    • The Korean Journal of Applied Statistics
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    • v.17 no.2
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    • pp.253-267
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    • 2004
  • In some clinical trials, one may see that a significant fraction of patients are cured and their original disease does not recur even after termination of treatment and pro-longed follow-up. This situation occurs frequently in pediatric cancer trials where there are excellent therapeutic results. In such cases, interest concentrated on the difference of cure rates rather than other types of differences in failure distributions. Various authors have investigated the parametric and nonparametric methods for testing the difference of cure rates. In this study, we compare by simulation the power and size of a parametric test and five nonparametric tests in a various range of the alternatives, censoring rates and cure rates. Our objectives are to determine if any test was preferable on the basis of size and power in various situation, and to investigate the effect of the model misspecification.

Cure rate proportional odds models with spatial frailties for interval-censored data

  • Yiqi, Bao;Cancho, Vicente Garibay;Louzada, Francisco;Suzuki, Adriano Kamimura
    • Communications for Statistical Applications and Methods
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    • v.24 no.6
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    • pp.605-625
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    • 2017
  • This paper presents proportional odds cure models to allow spatial correlations by including spatial frailty in the interval censored data setting. Parametric cure rate models with independent and dependent spatial frailties are proposed and compared. Our approach enables different underlying activation mechanisms that lead to the event of interest; in addition, the number of competing causes which may be responsible for the occurrence of the event of interest follows a Geometric distribution. Markov chain Monte Carlo method is used in a Bayesian framework for inferential purposes. For model comparison some Bayesian criteria were used. An influence diagnostic analysis was conducted to detect possible influential or extreme observations that may cause distortions on the results of the analysis. Finally, the proposed models are applied for the analysis of a real data set on smoking cessation. The results of the application show that the parametric cure model with frailties under the first activation scheme has better findings.