Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala

Introduction: Breast cancer is a leading cause of morbidity among women all around the world. Monitoring the survival pattern and identifying the prognostic factors on survival are always great concerns in cancer researches. Cure rate regression model is a useful statistical tool to predict the cure...

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Main Authors: Rejani Parassery Parameswaran, Shehna Abdul Khader, Paduthol Godan Sankaran, Rajagopalan Pillai Mahadevan, Krishnan Nair Lalithamma Jayakumar
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-04-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/16194/51739_140122_51739_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SHU)_PB(SC_SHU)_PN(KM).pdf
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author Rejani Parassery Parameswaran
Shehna Abdul Khader
Paduthol Godan Sankaran
Rajagopalan Pillai Mahadevan
Krishnan Nair Lalithamma Jayakumar
author_facet Rejani Parassery Parameswaran
Shehna Abdul Khader
Paduthol Godan Sankaran
Rajagopalan Pillai Mahadevan
Krishnan Nair Lalithamma Jayakumar
author_sort Rejani Parassery Parameswaran
collection DOAJ
description Introduction: Breast cancer is a leading cause of morbidity among women all around the world. Monitoring the survival pattern and identifying the prognostic factors on survival are always great concerns in cancer researches. Cure rate regression model is a useful statistical tool to predict the cure rate of cancer diseases and to determine the factors associated with survival of patients. Aim: To estimate the cured proportion and to make out the factors associated with survival time of infiltrating ductal breast carcinoma patients in a tertiary care hospital of central Kerala. Materials and Methods: The retrospective cohort study was conducted in the Department of Radiotherapy of a major tertiary care hospital of central part of Kerala, India. A total of 313 female patients diagnosed with infiltrating ductal breast cancer during January 2012 to December 2015 were considered for the study. The impact of the covariates, age at diagnosis of disease, grade of cancer, stage of disease, tumour stage, status of regional lymph node, distant metastasis, and triple-negative status on survival of patients were studied. The parametric mixture cure rate regression model was used for estimation and inferential procedures. The cure rate with respect to each study variable and their role on long term survival of patients were investigated. Results: Mean age of patients was 51.95±10.91 years. The minimum cure rate found out (29.8%) among the patients presented with distant metastasis. The bivariate analysis showed the factors, stage of cancer (T-stage), status of regional lymph node and distant metastasis status influence significantly on incidence of death due to breast cancer in long run period and grade of cancer determines the survival of patients at shorter duration of time. The presence of regional lymph node and distant metastasis status were found out to be two important indicators that determine cure rate of infiltrating ductal breast cancer patients in multivariate analysis. The hazard of patients living with higher grade cancer was seen 1.48 times more than that of others (Hazard Ratio=1.48, p-value <0.001). Conclusion: The cure rate of patients estimated between 29.8% and 69.6% with respect to various factors under study. The status of regional lymph node and distant metastasis status were found to be associated with cure rate of patients. The study results showed that the grade of cancer is one significant factor that determines survival of patients. The study recommends cure rate regression model as a useful tool to analyse breast cancer survival data in the presence of cured proportion.
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spelling doaj.art-4a39e1d570e74fa4b4b070252e07a4b22023-02-10T05:09:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-04-01164YC01YC0510.7860/JCDR/2022/51739.16194Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central KeralaRejani Parassery Parameswaran0Shehna Abdul Khader1Paduthol Godan Sankaran2Rajagopalan Pillai Mahadevan3Krishnan Nair Lalithamma Jayakumar4Associate Professor (Statistics), Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.Associate Professor, Department of Radiotherapy, Government Medical College, Thrissur, Kerala, India.Professor, Department of Statistics, Cochin University of Science and Technology, Cochin, Kerala, India.Professor and Head, Department of Radiotherapy, Government Medical College, Thiruvananthapuram, Kerala, India.Professor, Department of Radiation Oncology, Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu, India.Introduction: Breast cancer is a leading cause of morbidity among women all around the world. Monitoring the survival pattern and identifying the prognostic factors on survival are always great concerns in cancer researches. Cure rate regression model is a useful statistical tool to predict the cure rate of cancer diseases and to determine the factors associated with survival of patients. Aim: To estimate the cured proportion and to make out the factors associated with survival time of infiltrating ductal breast carcinoma patients in a tertiary care hospital of central Kerala. Materials and Methods: The retrospective cohort study was conducted in the Department of Radiotherapy of a major tertiary care hospital of central part of Kerala, India. A total of 313 female patients diagnosed with infiltrating ductal breast cancer during January 2012 to December 2015 were considered for the study. The impact of the covariates, age at diagnosis of disease, grade of cancer, stage of disease, tumour stage, status of regional lymph node, distant metastasis, and triple-negative status on survival of patients were studied. The parametric mixture cure rate regression model was used for estimation and inferential procedures. The cure rate with respect to each study variable and their role on long term survival of patients were investigated. Results: Mean age of patients was 51.95±10.91 years. The minimum cure rate found out (29.8%) among the patients presented with distant metastasis. The bivariate analysis showed the factors, stage of cancer (T-stage), status of regional lymph node and distant metastasis status influence significantly on incidence of death due to breast cancer in long run period and grade of cancer determines the survival of patients at shorter duration of time. The presence of regional lymph node and distant metastasis status were found out to be two important indicators that determine cure rate of infiltrating ductal breast cancer patients in multivariate analysis. The hazard of patients living with higher grade cancer was seen 1.48 times more than that of others (Hazard Ratio=1.48, p-value <0.001). Conclusion: The cure rate of patients estimated between 29.8% and 69.6% with respect to various factors under study. The status of regional lymph node and distant metastasis status were found to be associated with cure rate of patients. The study results showed that the grade of cancer is one significant factor that determines survival of patients. The study recommends cure rate regression model as a useful tool to analyse breast cancer survival data in the presence of cured proportion.https://www.jcdr.net/articles/PDF/16194/51739_140122_51739_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SHU)_PB(SC_SHU)_PN(KM).pdfdistant metastasis statushazard ratiostage of cancerstatus of lymph nodetumour stageweibull distribution
spellingShingle Rejani Parassery Parameswaran
Shehna Abdul Khader
Paduthol Godan Sankaran
Rajagopalan Pillai Mahadevan
Krishnan Nair Lalithamma Jayakumar
Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
Journal of Clinical and Diagnostic Research
distant metastasis status
hazard ratio
stage of cancer
status of lymph node
tumour stage
weibull distribution
title Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
title_full Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
title_fullStr Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
title_full_unstemmed Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
title_short Survival Analysis of Infiltrating Ductal Breast Cancer Patients with Cure Rate Regression Model- A Retrospective Cohort Study from a Tertiary Care Hospital in Central Kerala
title_sort survival analysis of infiltrating ductal breast cancer patients with cure rate regression model a retrospective cohort study from a tertiary care hospital in central kerala
topic distant metastasis status
hazard ratio
stage of cancer
status of lymph node
tumour stage
weibull distribution
url https://www.jcdr.net/articles/PDF/16194/51739_140122_51739_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SHU)_PB(SC_SHU)_PN(KM).pdf
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