Modeling recurrence in colorectal cancer

To assess the role of recurrence in prognosis of colon cancer, we investigated several methodologic issues, including application of classic survival analysis and Markov model. The data were recorded by the Registry of Digestive Tumors of Côte d'Or, France, for 874 patients who had been treated...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical epidemiology 2004-03, Vol.57 (3), p.243-251
Main Authors: Dancourt, V, Quantin, C, Abrahamowicz, M, Binquet, C, Alioum, A, Faivre, J
Format: Article
Language:English
Subjects:
Age Factors
Aged
Bias
Biological and medical sciences
Colo-rectal cancer
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Competing risk
Disease Progression
Epidemiologic Methods
Epidemiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Male
Markov chains
Markov model
Medical research
Medical sciences
Methodology
Mortality
Neoplasm Recurrence, Local
Neoplasm Staging
Prognosis
Public health. Hygiene
Public health. Hygiene-occupational medicine
Recurrence
Sex Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Studies
Survival analysis
Time-dependent covariate
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To assess the role of recurrence in prognosis of colon cancer, we investigated several methodologic issues, including application of classic survival analysis and Markov model. The data were recorded by the Registry of Digestive Tumors of Côte d'Or, France, for 874 patients who had been treated by surgery between 1976 and 1984 and followed for up to 11 years. Survival analyses included the Cox proportional hazards model and its two generalizations that allow recurrence to be taken into account as a time-dependent covariate or as a competing outcome. The Markov model was used to analyze simultaneously recurrence and death. The competing risks approach is not appropriate because censoring is indisputably informative. The Markov model and the Cox model, with recurrence as a time-dependent covariate, provided similar results, demonstrating the impact of age and gender on recurrence and revealing a reduction in the effect of site and stage on mortality. A Markov multistate model seems to give new insights about the course of digestive cancer progression and into the role of recurrence in this process.
ISSN:0895-4356
1878-5921
DOI:10.1016/j.jclinepi.2003.07.012