Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks
Article Category: Brief communication
Published Online: Dec 30, 2017
Page range: 461 - 467
DOI: https://doi.org/10.1515/abm-2018-0023
Keywords
© 2017 Fatemeh Paknazar et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Background
Following treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.
Objective
To estimate postoperative cure while considering the competing risks in Iranian patients with gastric cancer.
Method
Data were obtained from the Cancer Institute of Imam Hospital in Tehran. The analysis was conducted within the framework of relative survival by fitting the data to a flexible parametric cure model, taking into account the competing risks using general population data by adjusting for age, sex, and year of diagnosis.
Results
Of the 326 patients (224 male and 102 female) whose data were included, 235 deaths (72.1%) occurred during the follow-up period. The probability of conditional cure in terms of crude ratios of dying from causes other than gastric cancer in the surviving patients increased with the passage of time, and the slope of excess mortality approached almost 0 after 7 years. The estimated cure ratios showed a variation from 69% for 50-year-old men with diagnosis at early stages (I and II) to 3% for 80-year-old women with diagnosis at stage IV.
Conclusion
The ratio of patients in Iran who were estimated to die from cancer reduced significantly with the passage of time following the diagnosis, and the statistical cure point was estimated to be 7 years after diagnosis. However, aging was shown to be inversely associated. Although the same trend was observed in both sexes, we showed that men were statistically more likely to reach the cure point.