BACKGROUND The prognosis of many patients with distant metastatic hepatocellular carcinoma(HCC)improved after they survived for several months.Compared with tradi-tional survival analysis,conditional survival(CS)which...BACKGROUND The prognosis of many patients with distant metastatic hepatocellular carcinoma(HCC)improved after they survived for several months.Compared with tradi-tional survival analysis,conditional survival(CS)which takes into account changes in survival risk could be used to describe dynamic survival probabilities.AIM To evaluate CS of distant metastatic HCC patients.METHODS Patients diagnosed with distant metastatic HCC between 2010 and 2015 were extracted from the Surveillance,Epidemiology and End Results database.Univariate and multivariate Cox regression analysis were used to identify factors for overall survival(OS),while competing risk model was used to identify risk factors for cancer-specific survival(CSS).Six-month CS was used to calculate the probability of survival for an additional 6 mo at a specific time after initial diagnosis,and standardized difference(d)was used to evaluate the survival differences between subgroups.Nomograms were constructed to predict CS.Positiveα-fetoprotein expression,higher T stage(T3 and T4),N1 stage,non-primary site surgery,non-chemotherapy,non-radiotherapy,and lung metastasis were independent risk factors for actual OS and CSS through univariate and multivariate analysis.Actual survival rates decreased over time,while CS rates gradually increased.As for the 6-month CS,the survival difference caused by chemotherapy and radiotherapy gradually disappeared over time,and the survival difference caused by lung metastasis reversed.Moreover,the influence of age and gender on survival gradually appeared.Nomograms were fitted for patients who have lived for 2,4 and 6 mo to predict 6-month conditional OS and CSS,respectively.The area under the curve(AUC)of nomograms for conditional OS decreased as time passed,and the AUC for conditional CSS gradually increased.CONCLUSION CS for distant metastatic HCC patients substantially increased over time.With dynamic risk factors,nomograms constructed at a specific time could predict more accurate survival rates.展开更多
Using data from the Surveillance, Epidemiology, and End Results (SEER) Program based at the National Cancer Institute in the US, conditional survival rates are reported for 1,988 Ewing Sarcoma patients diagnosed durin...Using data from the Surveillance, Epidemiology, and End Results (SEER) Program based at the National Cancer Institute in the US, conditional survival rates are reported for 1,988 Ewing Sarcoma patients diagnosed during the period 2000-2015. These patients represent the experience of 26.5% of the US population. Specifically, 5-year conditional relative survival rates are calculated for these patients for the first eight years subsequent to diagnosis of their cancer by Extent of Disease (EOD) (Localized, Regional, and Distant as coded by the SEER Program), gender, and age (<18, 18 - 34, and 35+). Findings include showing how the conditional survival rate patterns improve over time and that there are differences by gender, age, and EOD.展开更多
Purpose:This study aimed to examine the effect of radiation esophagitis(RE)and the dynamics of RE on subse-quent survival in non-small cell lung cancer(NSCLC)patients who underwent radiotherapy.Experimental Design:Pat...Purpose:This study aimed to examine the effect of radiation esophagitis(RE)and the dynamics of RE on subse-quent survival in non-small cell lung cancer(NSCLC)patients who underwent radiotherapy.Experimental Design:Patients with NSCLC treated with fractionated thoracic radiotherapy enrolled in prospective trials were eligible.RE was graded prospectively according to Common Terminology Criteria for Adverse Events(CTCAE)v3.0 per protocol requirement weekly during-RT and 1 month after RT.This study applied conditional survival assessment which has advantage over traditional survival analysis as it assesses the survival from the event instead of from the baseline.P-value less than 0.05 was considered to be significant.The primary endpoint is overall survival.Results:A total of 177 patients were eligible,with a median follow-up of 5 years.The presence of RE,the maximum RE grade,the evolution of RE and the onset timing of RE events were all correlated with subsequent survival.At all conditional time points,patients first presented with RE grade1(initial RE1)had significant inferior subsequent survival(multivariable HRs median:1.63,all P-values<0.05);meanwhile those with RE progressed had significant inferior subsequent survival than those never develop RE(multivariable HRs median:2.08,all P-values<0.05).Multivariable Cox proportional-hazards analysis showed significantly higher C-indexes for models with inclusion of RE events than those without(all P-values<0.05).Conclusion:This study comprehensively evaluated the impact of RE with conditional survival assessment and demonstrated that RE is associated with inferior survival in NSCLC patients treated with RT.展开更多
An engineering numerical model for three dimensional motion of multichain-buoy mooring system in shallow water and survival condition is given in this paper. Shooting-aim method is employed for solving the dynamic equ...An engineering numerical model for three dimensional motion of multichain-buoy mooring system in shallow water and survival condition is given in this paper. Shooting-aim method is employed for solving the dynamic equations of chain system in order to match the computation of buoy motion. The responses of buoy and chain have been computed for different wind-wave-current directions and different rigidity of chain. The results show that the present numerical model is reasonable.展开更多
Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than...Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.展开更多
To the editor,The article by Vrancken Peeters and colleagues,1 showing updated five-year conditional relative survival(5-year CRS)for young breast cancer patients by relevant prognostic factors and longer follow-up th...To the editor,The article by Vrancken Peeters and colleagues,1 showing updated five-year conditional relative survival(5-year CRS)for young breast cancer patients by relevant prognostic factors and longer follow-up than previous European studies,2,3 has filled an important gap in knowledge for the most common cancer among young women.展开更多
Background:Conditional survival(CS)provides dynamic prognostic estimates by considering the patients existing survival time.Since CS for endemic nasopharyngeal carcinoma(NPC)is lacking,we aimed to assess the CS of end...Background:Conditional survival(CS)provides dynamic prognostic estimates by considering the patients existing survival time.Since CS for endemic nasopharyngeal carcinoma(NPC)is lacking,we aimed to assess the CS of endemic NPC and establish a web-based calculator to predict individualized,conditional sitespecific recurrence risk.Methods:Using an NPC-specific database with a big-data intelligence platform,10,058 endemic patients with non-metastatic stage I–IVA NPC receiving intensity-modulated radiotherapy with or without chemotherapy between April 2009 and December 2015 were investigated.Crude CS estimates of conditional overall survival(COS),conditional disease-free survival(CDFS),conditional locoregional relapse-free survival(CLRRFS),conditional distant metastasis-free survival(CDMFS),and conditional NPC-specific survival(CNPC-SS)were calculated.Covariate-adjusted CS estimates were generated using inverse probability weighting.A prediction model was established using competing risk models and was externally validated with an independent,non-metastatic stage I–IVA NPC cohort undergoing intensity-modulated radiotherapy with or without chemotherapy(n=601)at another institution.Results:The median follow-up of the primary cohort was 67.2 months.The 5-year COS,CDFS,CLRRFS,CDMFS,and CNPC-SS increased from 86.2%,78.1%,89.8%,87.3%,and 87.6%at diagnosis to 87.3%,87.7%,94.4%,96.0%,and 90.1%,respectively,for an existing survival time of 3 years since diagnosis.Differences in CS estimates between prognostic factor subgroups of each endpoint were noticeable at diagnosis but diminished with time,whereas an ever-increasing disparity in CS between different age subgroups was observed over time.Notably,the prognoses of patients that were poor at diagnosis improved greatly as patients survived longer.For individualized CS predictions,we developed a web-based model to estimate the conditional risk of local(C-index,0.656),regional(0.667),bone(0.742),lung(0.681),and liver(0.711)recurrence,which significantly outperformed the current staging system(P<0.001).The performance of this webbased model was further validated using an external validation cohort(median follow-up,61.3 months),with C-indices of 0.672,0.736,0.754,0.663,and 0.721,respectively.Conclusions:We characterized the CS of endemic NPC in the largest cohort to date.Moreover,we established a web-based calculator to predict the CS of sitespecific recurrence,which may help to tailor individualized,risk-based,timeadapted follow-up strategies.展开更多
文摘BACKGROUND The prognosis of many patients with distant metastatic hepatocellular carcinoma(HCC)improved after they survived for several months.Compared with tradi-tional survival analysis,conditional survival(CS)which takes into account changes in survival risk could be used to describe dynamic survival probabilities.AIM To evaluate CS of distant metastatic HCC patients.METHODS Patients diagnosed with distant metastatic HCC between 2010 and 2015 were extracted from the Surveillance,Epidemiology and End Results database.Univariate and multivariate Cox regression analysis were used to identify factors for overall survival(OS),while competing risk model was used to identify risk factors for cancer-specific survival(CSS).Six-month CS was used to calculate the probability of survival for an additional 6 mo at a specific time after initial diagnosis,and standardized difference(d)was used to evaluate the survival differences between subgroups.Nomograms were constructed to predict CS.Positiveα-fetoprotein expression,higher T stage(T3 and T4),N1 stage,non-primary site surgery,non-chemotherapy,non-radiotherapy,and lung metastasis were independent risk factors for actual OS and CSS through univariate and multivariate analysis.Actual survival rates decreased over time,while CS rates gradually increased.As for the 6-month CS,the survival difference caused by chemotherapy and radiotherapy gradually disappeared over time,and the survival difference caused by lung metastasis reversed.Moreover,the influence of age and gender on survival gradually appeared.Nomograms were fitted for patients who have lived for 2,4 and 6 mo to predict 6-month conditional OS and CSS,respectively.The area under the curve(AUC)of nomograms for conditional OS decreased as time passed,and the AUC for conditional CSS gradually increased.CONCLUSION CS for distant metastatic HCC patients substantially increased over time.With dynamic risk factors,nomograms constructed at a specific time could predict more accurate survival rates.
文摘Using data from the Surveillance, Epidemiology, and End Results (SEER) Program based at the National Cancer Institute in the US, conditional survival rates are reported for 1,988 Ewing Sarcoma patients diagnosed during the period 2000-2015. These patients represent the experience of 26.5% of the US population. Specifically, 5-year conditional relative survival rates are calculated for these patients for the first eight years subsequent to diagnosis of their cancer by Extent of Disease (EOD) (Localized, Regional, and Distant as coded by the SEER Program), gender, and age (<18, 18 - 34, and 35+). Findings include showing how the conditional survival rate patterns improve over time and that there are differences by gender, age, and EOD.
基金supported by Shenzhen Fundamental Research Program(JCYJ2020109150427184)Shenzhen Science and Technology Program(KQTD20180411185028798)Shenzhen Fun-damental Research Program(JCYJ20180508153249223).
文摘Purpose:This study aimed to examine the effect of radiation esophagitis(RE)and the dynamics of RE on subse-quent survival in non-small cell lung cancer(NSCLC)patients who underwent radiotherapy.Experimental Design:Patients with NSCLC treated with fractionated thoracic radiotherapy enrolled in prospective trials were eligible.RE was graded prospectively according to Common Terminology Criteria for Adverse Events(CTCAE)v3.0 per protocol requirement weekly during-RT and 1 month after RT.This study applied conditional survival assessment which has advantage over traditional survival analysis as it assesses the survival from the event instead of from the baseline.P-value less than 0.05 was considered to be significant.The primary endpoint is overall survival.Results:A total of 177 patients were eligible,with a median follow-up of 5 years.The presence of RE,the maximum RE grade,the evolution of RE and the onset timing of RE events were all correlated with subsequent survival.At all conditional time points,patients first presented with RE grade1(initial RE1)had significant inferior subsequent survival(multivariable HRs median:1.63,all P-values<0.05);meanwhile those with RE progressed had significant inferior subsequent survival than those never develop RE(multivariable HRs median:2.08,all P-values<0.05).Multivariable Cox proportional-hazards analysis showed significantly higher C-indexes for models with inclusion of RE events than those without(all P-values<0.05).Conclusion:This study comprehensively evaluated the impact of RE with conditional survival assessment and demonstrated that RE is associated with inferior survival in NSCLC patients treated with RT.
基金This work was financially supported by the National Natural Science Foundation of China
文摘An engineering numerical model for three dimensional motion of multichain-buoy mooring system in shallow water and survival condition is given in this paper. Shooting-aim method is employed for solving the dynamic equations of chain system in order to match the computation of buoy motion. The responses of buoy and chain have been computed for different wind-wave-current directions and different rigidity of chain. The results show that the present numerical model is reasonable.
基金supported by The Netherlands Organization for Scientific Research VIDI(grant number:198.007).
文摘Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.
基金supported by the Italian Association for Cancer Re-search(AIRC)(grant number:28893)the Italian Ministry of Health(Ricerca Corrente)(no grant number).
文摘To the editor,The article by Vrancken Peeters and colleagues,1 showing updated five-year conditional relative survival(5-year CRS)for young breast cancer patients by relevant prognostic factors and longer follow-up than previous European studies,2,3 has filled an important gap in knowledge for the most common cancer among young women.
基金This work was supported by the National Natural Science Foundation of China(81872463 and 81930072)Special Support Program of Sun Yat-sen University(16zxtzlc06)+4 种基金Key-Area Research and Development Program of Guangdong Province(2019A1515012045 and 2019B020230002)Natural Science Foundation of Guangdong Province(2017A030312003)Health&Medical Collaborative Innovation Project of Guangzhou City,China(201803040003)Innovation Team Development Plan of the Ministry of Education(No.IRT_17R110)Overseas Expertise Introduction Project for Discipline Innovation(111 Project,B14035).
文摘Background:Conditional survival(CS)provides dynamic prognostic estimates by considering the patients existing survival time.Since CS for endemic nasopharyngeal carcinoma(NPC)is lacking,we aimed to assess the CS of endemic NPC and establish a web-based calculator to predict individualized,conditional sitespecific recurrence risk.Methods:Using an NPC-specific database with a big-data intelligence platform,10,058 endemic patients with non-metastatic stage I–IVA NPC receiving intensity-modulated radiotherapy with or without chemotherapy between April 2009 and December 2015 were investigated.Crude CS estimates of conditional overall survival(COS),conditional disease-free survival(CDFS),conditional locoregional relapse-free survival(CLRRFS),conditional distant metastasis-free survival(CDMFS),and conditional NPC-specific survival(CNPC-SS)were calculated.Covariate-adjusted CS estimates were generated using inverse probability weighting.A prediction model was established using competing risk models and was externally validated with an independent,non-metastatic stage I–IVA NPC cohort undergoing intensity-modulated radiotherapy with or without chemotherapy(n=601)at another institution.Results:The median follow-up of the primary cohort was 67.2 months.The 5-year COS,CDFS,CLRRFS,CDMFS,and CNPC-SS increased from 86.2%,78.1%,89.8%,87.3%,and 87.6%at diagnosis to 87.3%,87.7%,94.4%,96.0%,and 90.1%,respectively,for an existing survival time of 3 years since diagnosis.Differences in CS estimates between prognostic factor subgroups of each endpoint were noticeable at diagnosis but diminished with time,whereas an ever-increasing disparity in CS between different age subgroups was observed over time.Notably,the prognoses of patients that were poor at diagnosis improved greatly as patients survived longer.For individualized CS predictions,we developed a web-based model to estimate the conditional risk of local(C-index,0.656),regional(0.667),bone(0.742),lung(0.681),and liver(0.711)recurrence,which significantly outperformed the current staging system(P<0.001).The performance of this webbased model was further validated using an external validation cohort(median follow-up,61.3 months),with C-indices of 0.672,0.736,0.754,0.663,and 0.721,respectively.Conclusions:We characterized the CS of endemic NPC in the largest cohort to date.Moreover,we established a web-based calculator to predict the CS of sitespecific recurrence,which may help to tailor individualized,risk-based,timeadapted follow-up strategies.
