scholarly journals The Effect of MSM and CD4+ Count on the Development of Cancer AIDS (AIDS-defining Cancer) and Non-cancer AIDS in the HAART Era

2019 ◽  
Vol 16 (4) ◽  
pp. 288-296
Author(s):  
Prosanta Mondal ◽  
Hyun J. Lim ◽  
OHTN Cohort Study Team
Keyword(s):  
Competing Risks ◽  
Joint Modeling ◽  
Study Data ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Survival Outcomes ◽  
Risk Category ◽  
Joint Models ◽  
Kaplan Meier ◽  
Sex With Men

Background: The HIV epidemic is increasing among Men who have Sex with Men (MSM) and the risk for AIDS defining cancer (ADC) is higher among them. Objective: To examine the effect of MSM and CD4+ count on time to cancer AIDS (ADC) and noncancer AIDS in competing risks setting in the HAART era. Method: Using Ontario HIV Treatment Network Cohort Study data, HIV-positive adults diagnosed between January 1997 and October 2012 having baseline CD4+ counts ≤ 500 cells/mm3 were evaluated. Two survival outcomes, cancer AIDS and non-cancer AIDS, were treated as competing risks. Kaplan-Meier analysis, Cox cause-specific hazards (CSH) model and joint modeling of longitudinal and survival outcomes were used. Results: Among the 822 participants, 657 (79.9%) were males; 686 (83.5%) received anti-retroviral (ARV) ever. Regarding risk category, the majority (58.5%) were men who have Sex with men (MSM). Mean age was 37.4 years (SD = 10.3). In the multivariate Cox CSH models, MSM were not associated with cancer AIDS but with non-cancer AIDS [HR = 2.92; P = 0.055, HR = 0.54; P = 0.0009, respectively]. However, in joint models of longitudinal and survival outcomes, MSM were associated with cancer AIDS but not with non-cancer AIDS [HR = 3.86; P = 0.013, HR = 0.73; P = 0.10]. CD4+ count, age, ARV ever were associated with both events in the joint models. Conclusion: This study demonstrates the importance of considering competing risks, and timedependent biomarker in the survival model. MSM have higher hazard for cancer AIDS. CD4+ count is associated with both survival outcomes.

scholarly journals Predictors of outcome in pleomorphic xanthoastrocytoma

2020 ◽  
Author(s):  
Antonio Dono ◽  
Victor Lopez-Rivera ◽  
Ankush Chandra ◽  
Cole T Lewis ◽  
Rania Abdelkhaleq ◽  
...  
Keyword(s):  
Tumor Size ◽  
Postoperative Radiotherapy ◽  
Treatment Strategies ◽  
Pleomorphic Xanthoastrocytoma ◽  
Survival Outcomes ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Male Patients

Abstract Background Pleomorphic xanthoastrocytomas (PXA) are circumscribed gliomas that typically have a favorable prognosis. Limited studies have revealed factors affecting survival outcomes in PXA. Here, we analyzed the largest PXA dataset in the literature and identify factors associated with outcomes. Methods Using the Surveillance, Epidemiology, and End Results (SEER) 18 Registries database, we identified histologically confirmed PXA patients between 1994 and 2016. Overall survival (OS) was analyzed using Kaplan-Meier survival and multivariable Cox proportional hazard models. Results In total, 470 patients were diagnosed with PXA (males = 53%; median age = 23 years [14-39 years]), the majority were Caucasian (n = 367; 78%). The estimated mean OS was 193 months [95% CI: 179-206]. Multivariate analysis revealed that greater age at diagnosis (≥39 years) (3.78 [2.16-6.59], P < .0001), larger tumor size (≥30 mm) (1.97 [1.05-3.71], P = .034), and postoperative radiotherapy (RT) (2.20 [1.31-3.69], P = .003) were independent predictors of poor OS. Pediatric PXA patients had improved survival outcomes compared to their adult counterparts, in which chemotherapy (CT) was associated with worse OS. Meanwhile, in adults, females and patients with temporal lobe tumors had an improved survival; conversely, tumor size ≥30 mm and postoperative RT were associated with poor OS. Conclusions In PXA, older age and larger tumor size at diagnosis are risk factors for poor OS, while pediatric patients have remarkably improved survival. Postoperative RT and CT appear to be ineffective treatment strategies while achieving GTR confer an improved survival in male patients and remains the cornerstone of treatment. These findings can help optimize PXA treatment while minimizing side effects. However, further studies of PXAs with molecular characterization are needed.

scholarly journals Competing risks joint models using R-INLA

2021 ◽  
Vol 21 (1-2) ◽  
pp. 56-71
Author(s):  
Janet van Niekerk ◽  
Haakon Bakka ◽  
Håvard Rue
Keyword(s):  
Competing Risks ◽  
Count Data ◽  
Joint Model ◽  
Point Of View ◽  
Spatial Structures ◽  
Joint Models ◽  
Hazard Functions ◽  
Longitudinal Count Data ◽  
Non Gaussian ◽  
Made In

The methodological advancements made in the field of joint models are numerous. None the less, the case of competing risks joint models has largely been neglected, especially from a practitioner's point of view. In the relevant works on competing risks joint models, the assumptions of a Gaussian linear longitudinal series and proportional cause-specific hazard functions, amongst others, have remained unchallenged. In this article, we provide a framework based on R-INLA to apply competing risks joint models in a unifying way such that non-Gaussian longitudinal data, spatial structures, times-dependent splines and various latent association structures, to mention a few, are all embraced in our approach. Our motivation stems from the SANAD trial which exhibits non-linear longitudinal trajectories and competing risks for failure of treatment. We also present a discrete competing risks joint model for longitudinal count data as well as a spatial competing risks joint model as specific examples.

Clinicopathological Prognostic Factors Influencing Survival Outcomes of Vulvar Cancer

2021 ◽  
Author(s):  
Monwanee Muangchang ◽  
Prapaporn Suprasert ◽  
Surapan Khunamornpong
Keyword(s):  
Prognostic Factors ◽  
Progression Free Survival ◽  
Survival Outcomes ◽  
Tumor Diameter ◽  
Large Tumor ◽  
Node Positive ◽  
Kaplan Meier ◽  
Postmenopausal Status ◽  
Vulva Cancer ◽  
Tumor Area

Abstract Backgroud: Squamous cell carcinoma (SCCA) is the most common vulva cancer. This study purpose to evaluate the clinicopathological prognostic factors for survival outcomes of this disease after treated with surgery. Methods: All SCCA vulva cancer patients who underwent surgery between January 2006 and December 2017 were reviewed. The clinicopathological factors were analyzed to identify the prognostic factors for the progression-free survival (PFS) and overall survival (OS) using the Kaplan- Meier method and Cox-Proportional Hazard model.Results: One hundred twenty-five patients were recruited with a median age of 57 years. The recurrence rate was 35.2%. Patients with recurrence revealed a significant poorer five-year OS rate than those who did not recur (23.7% vs. 79.4%, P < 0.001). About 58.1% of palpable groin nodes revealed metastasis. The independent poor prognostic factors for PFS were groin node-positive and a tumor diameter more than 25 mm. whereas postmenopausal status, preoperative tumor area more than 11 cm2, and groin node enlargement were independent poor prognostic factors for OS. Conclusion: Groin node-positive and tumor diameter longer than 25 mm. were independent poor prognostic factors for PFS whereas postmenopausal status, large tumor area than 11 cm2, and enlargement of groin nodes were independent poor prognostic factors for OS. Patients with these factors should be closely followed.

Neo-Family History Score Is A Novel Biomarker of Pathological Complete Response, Safety, and Survival Outcomes In Patients With Breast Cancer Receiving Neoadjuvant Platinum-Based Chemotherapy: A Retrospective Analysis of Two Prospective Trials

2021 ◽  
Author(s):  
Yaqian Xu ◽  
Yanping Lin ◽  
Yifan Wu ◽  
Yaohui Wang ◽  
Liheng Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Family History ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Survival Outcomes ◽  
Receptor Status ◽  
Node Positive ◽  
Kaplan Meier ◽  
Platinum Based Chemotherapy

Abstract Background: Homologous recombination repair gene mutations are associated with increased platinum-based chemosensitivity, whereas few studies have reported the predictive value of family history of cancer for breast cancer in the neoadjuvant setting. This study aimed to construct a brief and effective novel family history scoring system and explore its association with pathological complete response (pCR), survival outcomes, and safety for locally advanced breast cancer receiving platinum-based neoadjuvant chemotherapy.Methods: A total of 262 patients treated with neoadjuvant cisplatin and paclitaxel were included. Neo-Family History Score (NeoFHS) was calculated according to cancer type, age at diagnosis, kinship, and number of affected relatives. Logistic regression was performed to analyze the association between pCR and NeoFHS. Survival rates were compared by Kaplan-Meier curves, examined by log-rank test and Cox proportional hazard regressions.Results: For all patients enrolled in this study, clinical tumor stage (p=0.048), estrogen receptor status (p=0.001), progesterone receptor status (p=0.036), human epidermal growth factor receptor 2 (HER2) status (p=0.013), and molecular subtype (p=0.016) were significantly related to NeoFHS. The multivariate logistic regression revealed that NeoFHS is an independent predictive factor of pCR (OR=2.262, 95% CI 1.159-4.414, p=0.017), especially in node-positive (OR=3.088, 95% CI 1.498-6.367, p=0.002), hormone receptor-positive (OR=2.645, 95% CI 1.164-6.010, p=0.020), and HER2-negative subgroups (OR=4.786, 95% CI 1.550-14.775, p=0.006). Kaplan-Meier estimates suggested that NeoFHS could serve as an independent prognostic factor for relapse-free survival in the whole group (adjusted HR=0.305, 95% CI 0.102-0.910, p=0.033) and node-positive subgroup (adjusted HR=0.317, 95% CI 0.103-0.973, p=0.045). Furthermore, alopecia (p=0.001), nausea (p=0.001), peripheral neuropathy (p=0.018), diarrhea (p=0.026), constipation (p=0.037) of any grade and leukopenia of grade 3 or greater (p=0.005) were more common in patients with higher NeoFHS.Conclusions: Our study revealed that NeoFHS is a practical and effective biomarker for predicting not only pCR and survival outcomes but also chemotherapy-induced AEs for neoadjuvant platinum-based chemotherapy for breast cancer. It may help screen candidate responders and guide safety managements in the future.

scholarly journals Joint Modeling of Longitudinal Changes of Respiratory Rate, Pulse Rate and Oxygen Saturation With Time to Convalescence Among Pneumonia Patients: A comparison of Separate and Joint Models

2021 ◽  
Author(s):  
Yenefenta Wube Bayleyegne ◽  
Sindu Azmeraw Kassahun
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Pulse Rate ◽  
Recovery Time ◽  
Child Survival ◽  
Joint Modeling ◽  
Joint Models ◽  
Longitudinal Outcomes ◽  
Under Five ◽  
Cohort Study Design

Abstract Background: Globally, pneumonia is the first infectious disease which is the leading cause of children under age five morbidity and mortality with 98% of deaths in developing countries. Objective: The study aimed to identify the determinant factors that jointly affect the longitudinal measures of pneumonia (respiratory rate, pulse rate and oxygen saturation) and time to convalescence or recovery of under five admitted pneumonia patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia.Methods: A prospective cohort study design was used on 101 sampled under five admitted pneumonia patients from December 2019 to February 2020. The study was conducted using joint model of longitudinal outcomes and survival outcomes.Results: The significant values of shared parameters in the survival sub model shows that the use of joint modeling of multivariate longitudinal outcomes with the time to event outcome is the best model compared to separate models. The estimated values of the association parameters for γ_1, γ_2 and γ_3 were -0.297, -0.121 and 0.5452 respectively and indicates that; respiratory rate and pulse rate were negatively related with recovery time, whereas oxygen saturation was positively associated with recovery time. As age of patients increased by one month, the average respiratory rate and pulse rate were significantly decreased by 0.3759 bpm and 1.1012 bpm respectively keeping other variables constant, but age has no information about oxygen saturation. Conclusion: Residence, birth order, severity and visit were found as determinants of the longitudinal measures of pneumonia and time to recovery of under-five admitted pneumonia patients jointly. To improve child survival, the community should be responsible for post ponding child birth and marriage.

Survival analysis

2020 ◽  
pp. 181-218
Author(s):  
Bendix Carstensen
Keyword(s):  
Survival Analysis ◽  
Competing Risks ◽  
Cox Model ◽  
Survival Function ◽  
Event Analysis ◽  
Time To Event ◽  
Poisson Models ◽  
Kaplan Meier ◽  
Analysis Survival ◽  
Event Rates

This chapter describes survival analysis. Survival analysis concerns data where the outcome is a length of time, namely the time from inclusion in the study (such as diagnosis of some disease) till death or some other event — hence the term 'time to event analysis', which is also used. There are two primary targets normally addressed in survival analysis: survival probabilities and event rates. The chapter then looks at the life table estimator of survival function and the Kaplan–Meier estimator of survival. It also considers the Cox model and its relationship with Poisson models, as well as the Fine–Gray approach to competing risks.

scholarly journals Survival outcomes of patients with pathological stage I gastric cancer using the competing risks survival method

2019 ◽  
Vol 10 (6) ◽  
pp. 1110-1119
Author(s):  
Victor Hugo Fonseca de Jesus ◽  
Wilson Luiz da Costa Junior ◽  
Tiago Cordeiro Felismino ◽  
Vinicius Fernando Calsavara ◽  
Alessandro Landskron Diniz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Competing Risks ◽  
Stage I ◽  
Survival Outcomes ◽  
Pathological Stage

scholarly journals Simultaneous variable selection for joint models of longitudinal and survival outcomes

Biometrics ◽  
2014 ◽  
Vol 71 (1) ◽  
pp. 178-187 ◽  
Author(s):  
Zangdong He ◽  
Wanzhu Tu ◽  
Sijian Wang ◽  
Haoda Fu ◽  
Zhangsheng Yu
Keyword(s):  
Variable Selection ◽  
Survival Outcomes ◽  
Joint Models ◽  
Selection For

scholarly journals Predictors of Delayed Antiretroviral Therapy Initiation, Mortality, and Loss to Followup in HIV Infected Patients Eligible for HIV Treatment: Data from an HIV Cohort Study in India

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Gerardo Alvarez-Uria ◽  
Raghavakalyan Pakam ◽  
Manoranjan Midde ◽  
Praveen Kumar Naik
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Rural Areas ◽  
Hiv Treatment ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
Hiv Patients ◽  
Disadvantaged Community ◽  
Timely Initiation ◽  
Art Initiation

Studies from Sub-Saharan Africa have shown that a substantial number of HIV patients eligible for antiretroviral therapy (ART) do not start treatment. However, data from other low- or middle-income countries are scarce. In this study, we describe the outcomes of 4105 HIV patients who became ART eligible from January 2007 to November 2011 in an HIV cohort study in India. After three years of ART eligibility, 78.4% started ART, 9.3% died before ART initiation, and 10.3% were lost to followup. Diagnosis of tuberculosis, being homeless, lower CD4 count, longer duration of pre-ART care, belonging to a disadvantaged community, being widowed, and not living near a town were associated with delayed ART initiation. Diagnosis of tuberculosis, being homeless, lower CD4 count, shorter duration of pre-ART care, belonging to a disadvantaged community, illiteracy, and age >45 years were associated with mortality. Being homeless, being single, not living near a town, having a CD4 count <150 cells/μL, and shorter duration of pre-ART care were associated with loss to followup. These results highlight the need to improve the timely initiation of ART in HIV programmes in India, especially in ART eligible patients with tuberculosis, low CD4 counts, living in rural areas, or having a low socioeconomic status.

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