Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram

Tommy Sheu; David M. Vock; Abdallah S.R. Mohamed; Neil Gross; Collin Mulcahy; Mark Zafereo; G. Brandon Gunn; Adam S. Garden; Parag Sevak; Jack Phan; Jan S. Lewin; Steven J. Frank; Beth M. Beadle; William H. Morrison; Stephen Y. Lai; Katherine Hutcheson; G. Elisabeta Marai; Guadalupe M. Canahuate; Merrill Kies; Adel El-Naggar; Randal S. Weber; David I. Rosenthal; Clifton D. Fuller

doi:10.1038/srep43928

Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram

Tommy Sheu, David M. Vock, Abdallah S.R. Mohamed, Neil Gross, Collin Mulcahy, Mark Zafereo, G. Brandon Gunn, Adam S. Garden, Parag Sevak, Jack Phan, Jan S. Lewin, Steven J. Frank, Beth M. Beadle, William H. Morrison, Stephen Y. Lai, Katherine Hutcheson, G. Elisabeta Marai, Guadalupe M. Canahuate, Merrill Kies, Adel El-NaggarRandal S. Weber, David I. Rosenthal, Clifton D. Fuller

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Abstract

Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3- and 6- year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65-72%) and 49% (CI 45-53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65-74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention.

Original language	English (US)
Article number	43928
Journal	Scientific reports
Volume	7
DOIs	https://doi.org/10.1038/srep43928
State	Published - Mar 9 2017

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Sheu, T., Vock, D. M., Mohamed, A. S. R., Gross, N., Mulcahy, C., Zafereo, M., Gunn, G. B., Garden, A. S., Sevak, P., Phan, J., Lewin, J. S., Frank, S. J., Beadle, B. M., Morrison, W. H., Lai, S. Y., Hutcheson, K., Marai, G. E., Canahuate, G. M., Kies, M., ... Fuller, C. D. (2017). Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram. Scientific reports, 7, Article 43928. https://doi.org/10.1038/srep43928

Sheu, T, Vock, DM, Mohamed, ASR , Gross, N, Mulcahy, C, Zafereo, M , Gunn, GB , Garden, AS, Sevak, P, Phan, J, Lewin, JS, Frank, SJ, Beadle, BM, Morrison, WH , Lai, SY , Hutcheson, K, Marai, GE, Canahuate, GM, Kies, M, El-Naggar, A, Weber, RS, Rosenthal, DI & Fuller, CD 2017, 'Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram', Scientific reports, vol. 7, 43928. https://doi.org/10.1038/srep43928

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title = "Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram",

abstract = "Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3- and 6- year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65-72%) and 49% (CI 45-53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65-74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention.",

author = "Tommy Sheu and Vock, {David M.} and Mohamed, {Abdallah S.R.} and Neil Gross and Collin Mulcahy and Mark Zafereo and Gunn, {G. Brandon} and Garden, {Adam S.} and Parag Sevak and Jack Phan and Lewin, {Jan S.} and Frank, {Steven J.} and Beadle, {Beth M.} and Morrison, {William H.} and Lai, {Stephen Y.} and Katherine Hutcheson and Marai, {G. Elisabeta} and Canahuate, {Guadalupe M.} and Merrill Kies and Adel El-Naggar and Weber, {Randal S.} and Rosenthal, {David I.} and Fuller, {Clifton D.}",

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doi = "10.1038/srep43928",

language = "English (US)",

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T1 - Conditional survival analysis of patients with locally advanced laryngeal cancer

T2 - Construction of a dynamic risk model and clinical nomogram

AU - Sheu, Tommy

AU - Vock, David M.

AU - Mohamed, Abdallah S.R.

AU - Gross, Neil

AU - Mulcahy, Collin

AU - Zafereo, Mark

AU - Gunn, G. Brandon

AU - Garden, Adam S.

AU - Sevak, Parag

AU - Phan, Jack

AU - Lewin, Jan S.

AU - Frank, Steven J.

AU - Beadle, Beth M.

AU - Morrison, William H.

AU - Lai, Stephen Y.

AU - Hutcheson, Katherine

AU - Marai, G. Elisabeta

AU - Canahuate, Guadalupe M.

AU - Kies, Merrill

AU - El-Naggar, Adel

AU - Weber, Randal S.

AU - Rosenthal, David I.

AU - Fuller, Clifton D.

PY - 2017/3/9

Y1 - 2017/3/9

N2 - Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3- and 6- year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65-72%) and 49% (CI 45-53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65-74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention.

AB - Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3- and 6- year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65-72%) and 49% (CI 45-53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65-74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention.

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Conditional survival analysis of patients with locally advanced laryngeal cancer: Construction of a dynamic risk model and clinical nomogram

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