Markov model-based estimation of individual survival probability for medullary thyroid cancer patients
- 1 June 2002
- journal article
- research article
- Published by Springer Science and Business Media LLC in Pathology and Oncology Research
- Vol. 8 (2), 93-104
- https://doi.org/10.1007/bf03033717
Abstract
The relatively benign, but occasionally rapidly fatal clinical course of medullary thyroid cancer (MTC) has raised the need for individual survival probability estimation. A retrospective study on 91 MTC clinical case histories with a mean follow-up of 6 years indicated prevalences of local, regional and distant residual tumor on primary care completion of 23%, 54% and 54%, respectively. Local, regional and distant relapses during follow-up occurred in 8%, 23% and 26% of the patients, with a cause-specific death in 26% of the cases. Prognostic factors statistically significantly influencing the cause-specific survival were selected by uni- and multivariate analysis. A Markov method-based model was developed for the estimation of individual time-dependent local, regional and distant relapse-free and cause-specific survival probability functions, with parameters numerically determined via a maximum likelihood procedure. These parameters include relative risk factors related to prognosticators, a residual or recurrent local/regional/distant tumor, and combinations of these entities. In multivariate studies, the patient s age and gender, the genetic basis of the dis-ease, lymph node involvement, the existence of a general symptom (diarrhoea) at presentation, and the dosage of external irradiation proved to be prognosticators. The cause-specific survival function of the study population indicated mean 5, 10 and 15-year survival probabilities of 69%, 62% and 58%.Keywords
This publication has 40 references indexed in Scilit:
- Angiography effectively supports the diagnosis of hepatic metastases in medullary thyroid carcinomaCancer, 2001
- Sporadic Medullary Microcarcinoma of the Thyroid: A Retrospective Analysis of Eighty CasesThyroid®, 1998
- Prognostic factors for thyroid carcinomaCancer, 1997
- Medullary Thyroid Cancer: Analyses of Survival and Prognostic Factors and the Role of Radiation Therapy in Local ControlThyroid®, 1996
- Medullary Thyroid Carcinoma: Recent Advances and Management UpdateThyroid®, 1995
- Cox Regression in a Markov Renewal Model: An Application to the Analysis of Bone Marrow Transplant DataJournal of the American Statistical Association, 1994
- Medullary Thyroid Carcinoma: Clinicopathologic Features and Long-Term Follow-Up of 65 Patients Treated During 1946 Through 1970Mayo Clinic Proceedings, 1992
- Multifactorial analysis of survival in thyroid cancer: Pitfalls of applying the results of published studies to another populationCancer, 1986
- Medullary Carcinoma of the ThyroidMedicine, 1984
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958