Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response
In prognostic studies for breast cancer patients treated with neoadjuvant chemotherapy (NAC), the ordinary Cox proportional-hazards (PH) model has been often used to identify prognostic factors for disease-free survival (DFS). This model assumes that all patients eventually experience relapse or dea...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | International Journal of Breast Cancer |
| Online Access: | http://dx.doi.org/10.1155/2013/354579 |
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| author | Junichi Asano Akihiro Hirakawa Chikuma Hamada Kan Yonemori Taizo Hirata Chikako Shimizu Kenji Tamura Yasuhiro Fujiwara |
| author_facet | Junichi Asano Akihiro Hirakawa Chikuma Hamada Kan Yonemori Taizo Hirata Chikako Shimizu Kenji Tamura Yasuhiro Fujiwara |
| author_sort | Junichi Asano |
| collection | DOAJ |
| description | In prognostic studies for breast cancer patients treated with neoadjuvant chemotherapy (NAC), the ordinary Cox proportional-hazards (PH) model has been often used to identify prognostic factors for disease-free survival (DFS). This model assumes that all patients eventually experience relapse or death. However, a subset of NAC-treated breast cancer patients never experience these events during long-term follow-up (>10 years) and may be considered clinically “cured.” Clinical factors associated with cure have not been studied adequately. Because the ordinary Cox PH model cannot be used to identify such clinical factors, we used the Cox PH cure model, a recently developed statistical method. This model includes both a logistic regression component for the cure rate and a Cox regression component for the hazard for uncured patients. The purpose of this study was to identify the clinical factors associated with cure and the variables associated with the time to recurrence or death in NAC-treated breast cancer patients without a pathologic complete response, by using the Cox PH cure model. We found that hormone receptor status, clinical response, human epidermal growth factor receptor 2 status, histological grade, and the number of lymph node metastases were associated with cure. |
| format | Article |
| id | doaj-art-c597ae473fa546f38cd2d11fca560e7a |
| institution | OA Journals |
| issn | 2090-3170 2090-3189 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Breast Cancer |
| spelling | doaj-art-c597ae473fa546f38cd2d11fca560e7a2025-08-20T02:18:39ZengWileyInternational Journal of Breast Cancer2090-31702090-31892013-01-01201310.1155/2013/354579354579Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete ResponseJunichi Asano0Akihiro Hirakawa1Chikuma Hamada2Kan Yonemori3Taizo Hirata4Chikako Shimizu5Kenji Tamura6Yasuhiro Fujiwara7Department of Management Science, Tokyo University of Science, Shinjuku-ku, Tokyo 162-8601, JapanCenter for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, JapanDepartment of Management Science, Tokyo University of Science, Shinjuku-ku, Tokyo 162-8601, JapanDepartment of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, JapanDepartment of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanIn prognostic studies for breast cancer patients treated with neoadjuvant chemotherapy (NAC), the ordinary Cox proportional-hazards (PH) model has been often used to identify prognostic factors for disease-free survival (DFS). This model assumes that all patients eventually experience relapse or death. However, a subset of NAC-treated breast cancer patients never experience these events during long-term follow-up (>10 years) and may be considered clinically “cured.” Clinical factors associated with cure have not been studied adequately. Because the ordinary Cox PH model cannot be used to identify such clinical factors, we used the Cox PH cure model, a recently developed statistical method. This model includes both a logistic regression component for the cure rate and a Cox regression component for the hazard for uncured patients. The purpose of this study was to identify the clinical factors associated with cure and the variables associated with the time to recurrence or death in NAC-treated breast cancer patients without a pathologic complete response, by using the Cox PH cure model. We found that hormone receptor status, clinical response, human epidermal growth factor receptor 2 status, histological grade, and the number of lymph node metastases were associated with cure.http://dx.doi.org/10.1155/2013/354579 |
| spellingShingle | Junichi Asano Akihiro Hirakawa Chikuma Hamada Kan Yonemori Taizo Hirata Chikako Shimizu Kenji Tamura Yasuhiro Fujiwara Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response International Journal of Breast Cancer |
| title | Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response |
| title_full | Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response |
| title_fullStr | Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response |
| title_full_unstemmed | Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response |
| title_short | Use of Cox’s Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response |
| title_sort | use of cox s cure model to establish clinical determinants of long term disease free survival in neoadjuvant chemotherapy treated breast cancer patients without pathologic complete response |
| url | http://dx.doi.org/10.1155/2013/354579 |
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