ObjectiveTo investigate the application status of survival analysis in studies published in Chinese oncology journals, and assess their reporting quality and summarize the existing problems, so as to promote the application of survival analysis and reporting quality. MethodsStudies that used survival analysis were collected from 1 492 studies published in Chinese Journal of Oncology, Chinese Journal of Clinical Oncology, Chinese Journal of Radiation Oncology and Chinese Journal of Cancer Prevention and Treatment in 2013. The application status of survival analysis of included studies was analysed and their reporting quality was evaluated. ResultsA total of 242 survival analysis studies were included. Among them, the utilization rates of Kaplan-Meier method, life table method, log-rank test, Breslow test and Cox proportional hazards model were 91.74%, 3.72%, 78.51%, 0.41% and 46.28%, respectively. 112 studies did multivariate analysis through Cox proportional hazards model. A total of 396 end points and 10 different types of survival time were reported. Overall survival (OS) was reported in 233 studies (92.15%). Survival terms were defined to 158 end points (39.90%) of 103 studies (42.56%). The follow-up rates were mentioned in 155 studies (64.05%), of which 4 studies were under 80% and the lowest was 75.25%, 55 studies were 100%. The main problems of survival analysis studies published in Chinese journals were as follows:None of the studies which used Cox proportional hazards model reported the proportional hazards assumption. None of the studies used the method of parametric survival analysis. 130 studies (53.72%) did not use the method of multiple factor analysis. 139 studies (57.44%) did not define the survival terms. Only 11 of 100 studies which reported loss to follow-up had stated how to treat it in the analysis. None of the studies reported the methods of calculating sample size. None of the studies reported the censoring proportion. ConclusionThe methods of survival analysis are used in a low rate in studies published in Chinese oncology journals, and the overall reporting quality of survival analyses is poor. So the reporting guideline of survival analysis should be developed and the authors should be encouraged to cooperate with professional statisticians, in order to improve the design, analysis and reporting quality of survival analysis studies.
Network meta-analyses (NMA) of survival data often rely on the proportional hazards (PH) assumption, however, this assumption fails when survival curves intersect. With the emergence of innovative therapies such as immunotherapy, the importance of NMA based on non-proportional hazards (non-PH) in the current evidence-based medicine evaluation of oncology drugs has become increasingly prominent. Fractional polynomial (FP) models do not rely on the assumption of PH, which can flexibly capture the characteristics of survival curves, and the corresponding fitting effects are better than those of the PH models. This study introduced a complete workflow in R for NMA using FP models with non-PH.
Objective To investigate the clinical characteristics, short-term therapy outcome and survival in patients of lung cancer with different smoking status. Methods 3751 cases were enrolled and the differences in age, sex, pathological type, stage, treatment modality, efficiency and survival were compared according patients′smoking status. Results 1206 ( 32. 2% ) patients were never smokers and 2545 ( 67. 8% ) were smokers. 80. 3% male patients and 10. 5% female patients were smokers. Among never smoking lung cancer patients, proportion of female gender, adenocarcinoma, second primary neoplasm,advanced stages and non-operative treatment were high. In the smokers, much more COPD and pulmonary tuberculosis, squamous cancer and operative treatmentwere found. No statistical differences were detected in overall outcome and survival. Conclusions The clinical characters and treatmentmodalities of patients with lung cancer of different smoking status were significant different, but had the same survival. Patients’smoking status should be accountted into the diagnosis and treatment of lung cancer.
ObjectiveTo investigate the predictive value of thyroid transcription factor-1 (TTF-1) in the treatment of advanced lung adenocarcinoma with different chemotherapy regimens.MethodsA total of 126 patients with advanced lung cancer were divided into three groups according to the chemotherapy regimen, namely a pemetrexed+nedaplatin group (PEM+NDP group), a pemetrexed+cisplatin/carboplatin group (PEM+DDP/CBP group) and a third-generation (3G) chemotherapy+cisplatin/carboplatin group (3G agent+DDP/CBP group). The predictive value of TTF-1 in the above three treatment regimens was analyzed. The patients were followed up by telephone or outpatient visit until April 2017.ResultsThere were no significant differences in disease control rate or objective response rate between the three different chemotherapy regimens (all P>0.05). The survival rate of PEM+NDP group was significantly higher than that of PEM+DDP/CBP group and 3G agent+DDP/CBP group (9.68%vs. 5.56% and 6.80%, both P<0.05). ECOG score and brain metastasis were independent risk factors for the prognosis of chemotherapy regimens. TTF-1 was an independent risk factor for PEM+NDP therapy.ConclusionTTF-1 is an independent risk factor for PEM+NDP chemotherapy, but not for 3G agent + DDP/CBP or PEM+DDP/CBP regimens.
目的 探讨影响岩斜区脑膜瘤（PCM）预后的相关因素。 方法 回顾分析解放军452医院2005年9月－2009年6月及四川大学华西医院1999年9月－2009年2月110例患者的临床资料及随访结果，通过单因素生存分析及Cox比例风险模型分析探讨影响PCM预后的相关因素。 结果 单因素生存分析发现8种相关因素影响PCM患者的预后，但Cox多因素分析仅发现脑干T2像高信号（OR=5.54，P=0.012）、肿瘤侵入脑干（OR=5.10，P=0.034）、病理高级别（OR=4.03，P=0.011）这3种因素有统计学意义。 结论 脑干T2像高信号、肿瘤侵入脑干、病理高级别可影响岩斜区脑膜瘤患者的预后。
ObjectiveTo study the clinical value of changes of serumα-fetoprotein(AFP) and soluble cell adhesion molecule-1(sICAM-1) levels before and after surgical treatment of primary hepatocellular carcinoma(PHC) as predictors of patient survival. MethodsThe clinical data and followed-up results of 86 patients with hepatocellular carcinoma received hepatectomy or radiofrequency ablation(RFA) in Xijing Hospital and the 451st Hospital of PLA were retrospectivly analyzed. The changes of peripheral blood AFP and sICAM-1 levels in patients before and in 1 month after treatment were observed and all patients were divided into different groups according to the changes in both two markers. Then survival rates of each group were analyzed. ResultsThe patients with AFP < 20μg/L or sICAM-1 < 1 000 U/L before treatment had lower tumor recurrence rate and higher survival rate than patients with elevated serum levels of the both markers(AFP:P=0.018, P < 0.001;sICAM-1:P=0.027, P < 0.001). The larger tumor, late TNM stage, and higher rate of recurrence were associated with elevated serum levels of the both markers(AFP:P=0.016, P=0.026 and P=0.025;sICAM-1:P < 0.001, P=0.024 and P=0.032). The better survival situation was closely related with these cases treated with hepatectomy and their levels of both markers were lower than the above cutoff values both before and after treatment, or leves of both markers above the cut-off values returned to within the normal range after treatment (AFP:P=0.006, P=0.001;sICAM-1:P=0.001, P=0.002). The patients who had simultaneous increase of AFP and sICAM-1 after operation showed the worst tumor-free and overall survivals(P=0.007, P < 0.001). ConclusionTo test the changes of serum AFP and sICAM-1 levels in early stage after treatment for patients who received radical resection of hepatocellular carcinoma has good clinical value for monitoring of tumor recurrence and predict prognosis.
ObjectiveTo investigate the expression and clinical significance of HOXB7 mRNA and protein in colorectal cancer (CRC) tissues.MethodsThe expressions of HOXB7 mRNA were evaluated in 6 cases of adjacent colorectal mucosal (ACRM) tissues and 6 cases of CRC tissues by using RT-PCR. The HOXB7 protein expressions were evaluated in 30 cases of ACRM tissues and 98 cases of CRC tissues by using immunohistochemistry. The correlations between the expression of HOXB7 protein, and the clinicopathologic factors or the patient’ survival were analyzed.ResultsRT-PCR results showed that expression level of HOXB7 mRNA in CRC tissues was significantly higher than that of ACRM tissues (P=0.003). Immunohistochemistry results showed that significantly higher positive-expression rate of HOXB7 protein in CRC tissues compared with ACRM tissues (P<0.05). Positive expression of HOXB7 protein was associated with depth of tumor invasion, lymph node metastasis, and the TNM stage (P<0.05). Kaplan-Meier survival curves showed that positive expression of HOXB7 protein was not inversely correlated with survival of CRC patients (P=0.865).ConclusionPositive expression of HOXB7 protein is a novel biomarker for estimating the progression of CRC, but remains of textual research may be to confirm the significance of HOXB7 protein for prognosis evaluation.
Objective To investigate surgical outcomes and prognostic factors for patients with coronary heart disease and low left ventricular ejection fraction （LVEF≤40%） undergoing off-pump coronary artery bypass grafting （OPCAB）. Methods We retrospectively analyzed clinical records of 63 discharged patients with coronary heart disease and low LVEF who underwent OPCAB in Peking University People’s Hospital from 2001 to 2004 year. There were 48 males and 15 females with mean age of 65.1±9.2 years and mean LVEF of 33.8%±5.0%. Regular follow-up evaluation was completed. We investigated risk factors for long-term survival of the patients by Kapalan-Meier survival curve, log-rank test and Cox regression model.?Results?Follow-up time was 3-107 （71.3±24.4） months, and six patients were lost during the follow-up. Nineteen patients （30.2%） died during follow-up including 10 patients （15.9%） who had cardiac-related death. The survival rate at 1, 3, 5 and 8 year was 96.7% （61）, 94.9% （60）, 85.9% （55）, 77.2% （53） respectively. Univariate analysis shows LVEF≤30% and acute myocardial infarction within 30 days are risk factors for long-term survival（P＜0.05）. Cox regression analysis showed that LVEF≤30%（RR=4.662, P＜0.05）and acute myocardial infarction within 30 days（RR=5.544, P＜0.05）were two independent risk factors for cardiac-related death after discharge. Conclusion Patients with coronary heart disease and low LVEF can have satisfactory surgical outcomes after OPCAB. LVEF≤30% and acute myocardial infarction within 30 days are the two independent risk factors for cardiac-related death after discharge.
ObjectiveTo detect expressions of Lgr5 and E-cadherin (E-cad) proteins in gastric cancer tissues and analyze their relationships with the clinicopathologic characteristics and prognosis of patients with gastric cancer.MethodsThe expressions of Lgr5 and E-cad proteins in the 69 patients with gastric cancer and adjacent normal gastric mucosa tissues were measured by the immunohistochemical SABC method, and the relationships between the Lgr5 or E-cad protein expression in the gastric cancer tissues and the clinicopathologic characteristics and the survival of patients with gastric cancer were analyzed.ResultsThe expressions of Lgr5 and E-cad proteins were positive in 60 cases (87.0%) and 30 cases (43.5%) of gastric cancer tissues, respectively, and in 5 cases (16.7%) and 30 cases (100%) of adjacent normal gastric mucosa tissues. There was a significant difference in the positive rate of Lgr5 or E-cad protein expression in the different tissues, respectively (Lgr5 protein: χ2=45.814, P<0.001; E-cad protein: χ2=11.249, P=0.001). The positive rates of Lgr5 and E-cad protein expressions in the gastric cancer were related to the degree of differentiation and the depth of invasion. Meanwhile the positive rate of Lgr5 protein expression in the gastric cancer tissue was also related to the lymph node metastasis and Helicobacter pylori infection, while the positive rate of E-cad protein expression was not related to these (P>0.05). The 5-year total survival time had no significant difference in the patients between with positive and with negative expressions of Lgr5 protein (χ2=1.819, P=0.117), which had a significant difference in the patients between with positive and with negative expressions of E-cad protein (χ2=5.814, P=0.016). The positive expression of Lgr5 was negatively correlated with that of E-cad (rs=−0.355, P=0.003).ConclusionsLgr5 protein may get involved in the mechanism of tumor invasion, lymph nodal metastasis, and low differentiation, while no relationship between the Lgr5 protein and prognosis has been confirmed. E-cad protein may get involved in the mechanism of tumor invasion and affect the prognosis of patients.