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Stat Med ; 34(8): 1366-88, 2015 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-25620602

RESUMO

The postmastectomy survival rates are often based on previous outcomes of large numbers of women who had a disease, but they do not accurately predict what will happen in any particular patient's case. Pathologic explanatory variables such as disease multifocality, tumor size, tumor grade, lymphovascular invasion, and enhanced lymph node staining are prognostically significant to predict these survival rates. We propose a new cure rate survival regression model for predicting breast carcinoma survival in women who underwent mastectomy. We assume that the unknown number of competing causes that can influence the survival time is given by a power series distribution and that the time of the tumor cells left active after the mastectomy for metastasizing follows the beta Weibull distribution. The new compounding regression model includes as special cases several well-known cure rate models discussed in the literature. The model parameters are estimated by maximum likelihood. Further, for different parameter settings, sample sizes, and censoring percentages, some simulations are performed. We derive the appropriate matrices for assessing local influences on the parameter estimates under different perturbation schemes and present some ways to assess local influences. The potentiality of the new regression model to predict accurately breast carcinoma mortality is illustrated by means of real data.


Assuntos
Neoplasias da Mama/mortalidade , Mastectomia/estatística & dados numéricos , Modelos Biológicos , Distribuição por Idade , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Simulação por Computador , Feminino , Humanos , Funções Verossimilhança , Linfonodos/patologia , Metástase Linfática , Gradação de Tumores , Prognóstico , Modelos de Riscos Proporcionais , Análise de Regressão , Distribuições Estatísticas , Taxa de Sobrevida , Fatores de Tempo
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