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Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients

PURPOSE: This study aimed to identify time-dependent prognostic factors and demonstrate the time-dependent effects of important prognostic factors in patients with advanced gastric cancer (AGC). MATERIALS AND METHODS: We retrospectively evaluated 3,653 patients with AGC who underwent curative standa...

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Autores principales: Kwon, Jin-Ok, Jin, Sung-Ho, Min, Jae-Seok, Kim, Min-Suk, Lee, Hae-Won, Park, Sunhoo, Yu, Hang-Jong, Bang, Ho-Yoon, Lee, Jong-Inn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Gastric Cancer Association 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722991/
https://www.ncbi.nlm.nih.gov/pubmed/26819803
http://dx.doi.org/10.5230/jgc.2015.15.4.238
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author Kwon, Jin-Ok
Jin, Sung-Ho
Min, Jae-Seok
Kim, Min-Suk
Lee, Hae-Won
Park, Sunhoo
Yu, Hang-Jong
Bang, Ho-Yoon
Lee, Jong-Inn
author_facet Kwon, Jin-Ok
Jin, Sung-Ho
Min, Jae-Seok
Kim, Min-Suk
Lee, Hae-Won
Park, Sunhoo
Yu, Hang-Jong
Bang, Ho-Yoon
Lee, Jong-Inn
author_sort Kwon, Jin-Ok
collection PubMed
description PURPOSE: This study aimed to identify time-dependent prognostic factors and demonstrate the time-dependent effects of important prognostic factors in patients with advanced gastric cancer (AGC). MATERIALS AND METHODS: We retrospectively evaluated 3,653 patients with AGC who underwent curative standard gastrectomy between 1991 and 2005 at the Korea Cancer Center Hospital. Multivariate survival analysis with Cox proportional hazards regression was used in the analysis. A non-proportionality test based on the Schoenfeld residuals (also known as partial residuals) was performed, and scaled Schoenfeld residuals were plotted over time for each covariate. RESULTS: The multivariate analysis revealed that sex, depth of invasion, metastatic lymph node (LN) ratio, tumor size, and chemotherapy were time-dependent covariates violating the proportional hazards assumption. The prognostic effects (i.e., log of hazard ratio [LHR]) of the time-dependent covariates changed over time during follow-up, and the effects generally diminished with low slope (e.g., depth of invasion and tumor size), with gentle slope (e.g., metastatic LN ratio), or with steep slope (e.g., chemotherapy). Meanwhile, the LHR functions of some covariates (e.g., sex) crossed the zero reference line from positive (i.e., bad prognosis) to negative (i.e., good prognosis). CONCLUSIONS: The time-dependent effects of the prognostic factors of AGC are clearly demonstrated in this study. We can suggest that time-dependent effects are not an uncommon phenomenon among prognostic factors of AGC.
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spelling pubmed-47229912016-01-27 Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients Kwon, Jin-Ok Jin, Sung-Ho Min, Jae-Seok Kim, Min-Suk Lee, Hae-Won Park, Sunhoo Yu, Hang-Jong Bang, Ho-Yoon Lee, Jong-Inn J Gastric Cancer Original Article PURPOSE: This study aimed to identify time-dependent prognostic factors and demonstrate the time-dependent effects of important prognostic factors in patients with advanced gastric cancer (AGC). MATERIALS AND METHODS: We retrospectively evaluated 3,653 patients with AGC who underwent curative standard gastrectomy between 1991 and 2005 at the Korea Cancer Center Hospital. Multivariate survival analysis with Cox proportional hazards regression was used in the analysis. A non-proportionality test based on the Schoenfeld residuals (also known as partial residuals) was performed, and scaled Schoenfeld residuals were plotted over time for each covariate. RESULTS: The multivariate analysis revealed that sex, depth of invasion, metastatic lymph node (LN) ratio, tumor size, and chemotherapy were time-dependent covariates violating the proportional hazards assumption. The prognostic effects (i.e., log of hazard ratio [LHR]) of the time-dependent covariates changed over time during follow-up, and the effects generally diminished with low slope (e.g., depth of invasion and tumor size), with gentle slope (e.g., metastatic LN ratio), or with steep slope (e.g., chemotherapy). Meanwhile, the LHR functions of some covariates (e.g., sex) crossed the zero reference line from positive (i.e., bad prognosis) to negative (i.e., good prognosis). CONCLUSIONS: The time-dependent effects of the prognostic factors of AGC are clearly demonstrated in this study. We can suggest that time-dependent effects are not an uncommon phenomenon among prognostic factors of AGC. The Korean Gastric Cancer Association 2015-12 2015-12-31 /pmc/articles/PMC4722991/ /pubmed/26819803 http://dx.doi.org/10.5230/jgc.2015.15.4.238 Text en Copyright © 2015 by The Korean Gastric Cancer Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kwon, Jin-Ok
Jin, Sung-Ho
Min, Jae-Seok
Kim, Min-Suk
Lee, Hae-Won
Park, Sunhoo
Yu, Hang-Jong
Bang, Ho-Yoon
Lee, Jong-Inn
Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title_full Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title_fullStr Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title_full_unstemmed Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title_short Time-Dependent Effects of Prognostic Factors in Advanced Gastric Cancer Patients
title_sort time-dependent effects of prognostic factors in advanced gastric cancer patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722991/
https://www.ncbi.nlm.nih.gov/pubmed/26819803
http://dx.doi.org/10.5230/jgc.2015.15.4.238
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