• 제목/요약/키워드: Proportional hazard models

검색결과 82건 처리시간 0.024초

Prediction of Tumor Progression During Neoadjuvant Chemotherapy and Survival Outcome in Patients With Triple-Negative Breast Cancer

  • Heera Yoen;Soo-Yeon Kim;Dae-Won Lee;Han-Byoel Lee;Nariya Cho
    • Korean Journal of Radiology
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    • 제24권7호
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    • pp.626-639
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    • 2023
  • Objective: To investigate the association of clinical, pathologic, and magnetic resonance imaging (MRI) variables with progressive disease (PD) during neoadjuvant chemotherapy (NAC) and distant metastasis-free survival (DMFS) in patients with triple-negative breast cancer (TNBC). Materials and Methods: This single-center retrospective study included 252 women with TNBC who underwent NAC between 2010 and 2019. Clinical, pathologic, and treatment data were collected. Two radiologists analyzed the pre-NAC MRI. After random allocation to the development and validation sets in a 2:1 ratio, we developed models to predict PD and DMFS using logistic regression and Cox proportional hazard regression, respectively, and validated them. Results: Among the 252 patients (age, 48.3 ± 10.7 years; 168 in the development set; 84 in the validation set), PD was occurred in 17 patients and 9 patients in the development and validation sets, respectively. In the clinical-pathologic-MRI model, the metaplastic histology (odds ratio [OR], 8.0; P = 0.032), Ki-67 index (OR, 1.02; P = 0.044), and subcutaneous edema (OR, 30.6; P = 0.004) were independently associated with PD in the development set. The clinical-pathologic-MRI model showed a higher area under the receiver-operating characteristic curve (AUC) than the clinical-pathologic model (AUC: 0.69 vs. 0.54; P = 0.017) for predicting PD in the validation set. Distant metastases occurred in 49 patients and 18 patients in the development and validation sets, respectively. Residual disease in both the breast and lymph nodes (hazard ratio [HR], 6.0; P = 0.005) and the presence of lymphovascular invasion (HR, 3.3; P < 0.001) were independently associated with DMFS. The model consisting of these pathologic variables showed a Harrell's C-index of 0.86 in the validation set. Conclusion: The clinical-pathologic-MRI model, which considered subcutaneous edema observed using MRI, performed better than the clinical-pathologic model for predicting PD. However, MRI did not independently contribute to the prediction of DMFS.

Association between Osteoporosis and Meniere's Disease: Two Longitudinal Follow-Up Cohort Studies

  • Hyo Geun Choi;Juyong Chung;Dae Myoung Yoo;Chang Ho Lee;So Young Kim
    • Journal of Web Engineering
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    • 제14권22호
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    • pp.4885-4900
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    • 2022
  • A high rate of Meniere's disease (MD) in patients with osteoporosis has been suggested. This research intended to estimate the bidirectional association of MD with osteoporosis. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort 2002-2019 was examined. In study I, 9529 patients with MD and 38,116 control I participants were analyzed for a previous history of osteoporosis. In study II, 65,858 patients with osteoporosis and 65,858 control II participants were analyzed for a previous history of MD. Stratified Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MD for osteoporosis in study I and of osteoporosis for MD in study II. The rate of a prior history of osteoporosis was 13.3% for the MD group and 11.3% for the control I group. The patients with MD had a 1.12 times higher HR for previous osteoporosis (95% CI = 1.04-1.20). In study II, the rate or a prior history of MD was 3.7% for patients with osteoporosis and 2.0% for the control II group. The patients with osteoporosis had a 1.50 times higher HR for previous MD (95% CI = 1.40-1.61). Most subgroups according to age, sex, and comorbid conditions demonstrated consistent bidirectional associations between MD and osteoporosis. Adult patients with MD had a greater risk of osteoporosis. In addition, adult patients with osteoporosis also showed a higher risk of MD.

Prognostic Significance of 18F-fluorodeoxyglucose Positron Emission Tomography (PET)-based Parameters in Neoadjuvant Chemoradiation Treatment of Esophageal Carcinoma

  • Ma, Jin-Bo;Chen, Er-Cheng;Song, Yi-Peng;Liu, Peng;Jiang, Wei;Li, Ming-Huan;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2477-2481
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    • 2013
  • Aims and Background: The purpose of the research was to study the prognostic value of tumor 18F-FDG PET-based parameters in neoadjuvant chemoradiation for patients with squamous esophageal carcinoma. Methods: Sixty patients received chemoradiation therapy followed by esophagectomy and two 18FDG-PET examinations at pre- and post-radiation therapy. PET-based metabolic-response parameters were calculated based on histopathologic response. Linear regression correlation and Cox proportional hazards models were used to determine prognostic value of all PET-based parameters with reference to overall survival. Results: Sensitivity (88.2%) and specificity (86.5%) of a percentage decrease of SUVmax were better than other PET-based parameters for prediction of histopathologic response. Only percentage decrease of SUVmax and tumor length correlated with overall survival time (linear regression coefficient ${\beta}$: 0.704 and 0.684, P<0.05). The Cox proportional hazards model indicated higher hazard ratio (HR=0.897, P=0.002) with decrease of SUVmax compared with decrease of tumor size (HR=0.813, P=0.009). Conclusion: Decrease of SUVmax and tumor size are significant prognostic factors in chemoradiation of esophageal carcinoma.

사회경제적 위치와 유방암 수술 후 총 사망위험과의 관련성 (Association Between Socioeconomic Status and All-Cause Mortality After Breast Cancer Surgery: Nationwide Retrospective Cohort Study)

  • 박미진;정우진;이선미;박종혁;장후선
    • Journal of Preventive Medicine and Public Health
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    • 제43권4호
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    • pp.330-340
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    • 2010
  • Objectives: This study aims to evaluate and explain the socioeconomic inequalities of all-cause mortality after breast cancer surgery in South Korea. Methods: This population based study included all 8868 females who underwent radical mastectomy for breast cancer between January 2002 and June 2003. Follow-up for mortality continued from January 2002 to June 2006. The patients were divided into 4 socioeconomic classes according to their socioeconomic status as defined by the National Health Insurance contribution rate. The relationship between socioeconomic status and all-cause mortality after breast cancer surgery was assessed using the Cox proportional hazards model with adjusting for age, the Charlson’s index score, emergency hospitalization, the type of hospital and the hospital ownership. Results: Those in the lowest socioeconomic status group had a significantly higher hazard ratio of 2.09 (95% CI =1.50 - 2.91) compared with those in the highest socioeconomic group after controlling for all the identifiable confounding variables. For allcause mortality after radical mastectomy, all the other income groups showed significantly higher 3-year mortality rates than did the highest income group. Conclusions: The socioeconomic status of breast cancer patients should be considered as an independent prognostic factor that affects all-cause mortality after radical mastectomy, and this is possibly due to a delayed diagnosis, limited access or minimal treatment leading to higher mortality. This study may provide tangible support to intensify surveillance and treatment for breast cancer among low socioeconomic class women.

Postoperative Radiotherapy Improves Survival in Gastric Signet-Ring Cell Carcinoma: a SEER Database Analysis

  • Wei, Feng;Lyu, Hongwei;Wang, Shuoer;Chu, Yan;Chen, Fengyuan
    • Journal of Gastric Cancer
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    • 제19권4호
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    • pp.393-407
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    • 2019
  • Purpose: To identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC). Materials and methods: Patients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts. Results: We found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590-0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570-0.890; P=0.003). Conclusions: Postoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

Slip Movement Simulations of Major Faults Under Very Low Strength

  • Park, Moo-Choon;Han, Uk
    • 자원환경지질
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    • 제33권1호
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    • pp.61-75
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    • 2000
  • Through modeling fault network using thin plate finite element technique in the San Andreas Fault system with slip rate over 1mm/year, as well as elevation, heat flow, earthquakes, geodetic data and crustal thickness, we compare the results with velocity boundary conditions of plate based on the NUVEL-1 plate model and the approximation of deformation in the Great Basin region. The frictional and dislocation creep constants of the crust are calculated to reproduce the observed variations in the maximum depth of seismicity which corresponds to the temperature ranging from $350^{\circ}C$ to $410^{\circ}C$. The rheologic constants are defined by the coefficient of friction on faults, and the apparent activation energy for creep in the lower crust. Two parameters above represent systematic variations in three experiments. The pattern of model indicates that the friction coefficient of major faults is 0.17~0.25. we test whether the weakness of faults is uniform or proportional to net slip. The geologic data show a good agreement when fault weakness is a trend of an additional 30% slip dependent weakening of the San Andreas. The results of study suggest that all weakening is slip dependent. The best models can be explained by the available data with RMS mismatch of as little as 3mm/year, so their predictions can be closely related with seismic hazard estimation, at least along faults where no data are available.

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Incidence of and Factors for Self-reported Fragility Fractures Among Middle-aged and Elderly Women in Rural Korea: An 11-Year Follow-up Study

  • Ahn, Soon-Ki;Kam, Sin;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • 제47권6호
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    • pp.289-297
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    • 2014
  • Objectives: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. Methods: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). Results: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. Conclusions: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

생존분석을 이용한 디스플레이 FAB의 반송시간 예측모형 (Prediction Model on Delivery Time in Display FAB Using Survival Analysis)

  • 한바울;백준걸
    • 대한산업공학회지
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    • 제40권3호
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    • pp.283-290
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    • 2014
  • In the flat panel display industry, to meet production target quantities and the deadline of production, the scheduler and dispatching systems are major production management systems which control the order of facility production and the distribution of WIP (Work In Process). Especially the delivery time is a key factor of the dispatching system for the time when a lot can be supplied to the facility. In this paper, we use survival analysis methods to identify main factors of the delivery time and to build the delivery time forecasting model. To select important explanatory variables, the cox proportional hazard model is used to. To make a prediction model, the accelerated failure time (AFT) model was used. Performance comparisons were conducted with two other models, which are the technical statistics model based on transfer history and the linear regression model using same explanatory variables with AFT model. As a result, the mean square error (MSE) criteria, the AFT model decreased by 33.8% compared to the statistics prediction model, decreased by 5.3% compared to the linear regression model. This survival analysis approach is applicable to implementing the delivery time estimator in display manufacturing. And it can contribute to improve the productivity and reliability of production management system.

The Importance of a Borrower's Track Record on Repayment Performance: Evidence in P2P Lending Market

  • KIM, Dongwoo
    • The Journal of Asian Finance, Economics and Business
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    • 제7권7호
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    • pp.85-93
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    • 2020
  • In peer-to-peer (P2P) loan markets, as most lenders are unskilled and inexperienced ordinary individuals, it is important to know the characteristics of borrowers that significantly impact their repayment performance. This study investigates the effects and importance of borrowers' past repayment performance track record within the platform to identify its predictive power. To this end, I analyze the detailed loan repayment data from two leading P2P lending platforms in Korea using a Cox proportional hazard, multiple linear regression, and logit models. Furthermore, the predictive power of the factors proxied by borrowers' track records are evaluated through the receiver operating characteristic (ROC) curves. As a result, it is found that the borrowers' past track record within the platform have the most important impact on the repayment performance of their current loans. In addition, this study also reveals that the borrowers' track record is much more predictive of their repayment performance than any other factor. The findings of this study emphasize that individual lenders must take into account the quality of borrowers' past transaction history when making a funding decision, and that platform operators should actively share the borrowers' past records within the markets with lenders.

Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience

  • Heera Yoen;Hye Eun Park;Se Hyung Kim;Jeong Hee Yoon;Bo Yun Hur;Jae Seok Bae;Jung Ho Kim;Hyeon Jeong Oh;Joon Koo Han
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1065-1076
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    • 2020
  • Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.