<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_abm-2018-0023_s_005_w2aab3b7b4b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Following treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.</p></sec><sec id="j_abm-2018-0023_s_006_w2aab3b7b4b1b6b1aab1c16b2Aa"><h3>Objective</h3><p>To estimate postoperative cure while considering the competing risks in Iranian patients with gastric cancer.</p></sec><sec id="j_abm-2018-0023_s_007_w2aab3b7b4b1b6b1aab1c16b3Aa"><h3>Method</h3><p>Data were obtained from the Cancer Institute of Imam Hospital in Tehran. The analysis was conducted within the framework of relative survival by fitting the data to a flexible parametric cure model, taking into account the competing risks using general population data by adjusting for age, sex, and year of diagnosis.</p></sec><sec id="j_abm-2018-0023_s_008_w2aab3b7b4b1b6b1aab1c16b4Aa"><h3>Results</h3><p>Of the 326 patients (224 male and 102 female) whose data were included, 235 deaths (72.1%) occurred during the follow-up period. The probability of conditional cure in terms of crude ratios of dying from causes other than gastric cancer in the surviving patients increased with the passage of time, and the slope of excess mortality approached almost 0 after 7 years. The estimated cure ratios showed a variation from 69% for 50-year-old men with diagnosis at early stages (I and II) to 3% for 80-year-old women with diagnosis at stage IV.</p></sec><sec id="j_abm-2018-0023_s_009_w2aab3b7b4b1b6b1aab1c16b5Aa"><h3>Conclusion</h3><p>The ratio of patients in Iran who were estimated to die from cancer reduced significantly with the passage of time following the diagnosis, and the statistical cure point was estimated to be 7 years after diagnosis. However, aging was shown to be inversely associated. Although the same trend was observed in both sexes, we showed that men were statistically more likely to reach the cure point.</p></sec></abstract>

BackgroundFollowing treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.ObjectiveTo estimate postoperative cure while considering the competing risks in Iranian patients with gastric cancer.MethodData were obtained from the Cancer Institute of Imam Hospital in Tehran. The analysis was conducted within the framework of relative survival by fitting the data to a flexible parametric cure model, taking into account the competing risks using general population data by adjusting for age, sex, and year of diagnosis.ResultsOf the 326 patients (224 male and 102 female) whose data were included, 235 deaths (72.1%) occurred during the follow-up period. The probability of conditional cure in terms of crude ratios of dying from causes other than gastric cancer in the surviving patients increased with the passage of time, and the slope of excess mortality approached almost 0 after 7 years. The estimated cure ratios showed a variation from 69% for 50-year-old men with diagnosis at early stages (I and II) to 3% for 80-year-old women with diagnosis at stage IV.ConclusionThe ratio of patients in Iran who were estimated to die from cancer reduced significantly with the passage of time following the diagnosis, and the statistical cure point was estimated to be 7 years after diagnosis. However, aging was shown to be inversely associated. Although the same trend was observed in both sexes, we showed that men were statistically more likely to reach the cure point.

Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks

Department of Epidemiology and Biostatistics, School of Public Health

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

BackgroundFollowing treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.ObjectiveTo...

Stage at	Age at diagnosis	Ratio (95% CI)
diagnosis	(years)	Men	Women
I and II	50	0.69 (0.46, 0.84)	0.63 (0.28, 0.80)
	60	0.48 (0.31, 0.63)	0.45 (0.24, 0.64)
	70	0.40 (0.18, 0.61)	0.25 (0.08, 0.45)
	80	0.08 (0.02, 0.26)	0.05 (0.01, 0.27)
III	50	0.49 (0.25, 0.69)	0.20 (0.01, 0.54)
	60	0.45 (0.24, 0.64)	0.17 (0.08, 0.29)
	70	0.28 (0.14, 0.43)	0.11 (0.04, 0.25)
	80	0.07 (0.01, 0.17)	0.06 (0.01, 0.25)
IV	50	0.32 (0.19, 0.45)	0.27 (0.13, 0.42)
	60	0.22 (0.14, 0.31)	0.12 (0.03, 0.28)
	70	0.14 (0.08, 0.22)	0.10 (0.02, 0.19)
	80	0.04 (0.01, 0.14)	0.03 (0.01, 0.16)

Characteristics	No. (%)	No. of deaths (%)^†	Percentage of deaths
Total	326	235	72.1
Stage at diagnosis
I	22 (6.7)	13 (5.5)	59.1
II	60 (18.4)	35 (14.9)	58.3
III	53 (16.3)	37 (15.8)	69.8
IV	191 (58.6)	150 (63.8)	78.5
Age at diagnosis (years)
<61	87 (26.7)	52 (22.1)	59.7
61–70	122 (37.4)	83 (35.3)	68.0
>70	117 (35.9)	100 (42.6)	85.5
Year of diagnosis
Before 1996	76 (23.3)	55 (23.4)	72.4
1996–1997	109 (33.4)	81 (34.5)	74.3
After 1997	141 (43.3)	99 (42.1)	70.2
Sex
Male	224 (68.7)	155 (65.9)	69.2
Female	102 (31.3)	80 (34.1)	78.4

Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks

Article Category: Brief communication

Pubblicato online: 30 dic 2017

Pagine: 461 - 467

DOI: https://doi.org/10.1515/abm-2018-0023

Parole chiave
competing risk, cure, gastric cancer, Iran, relative survival

© 2017 Fatemeh Paknazar et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2. A

Statistical crude ratios of patients who died from causes other than gastric cancer estimated using the flexible parametric cure model in the presence of competing risks by stage and age at diagnosis and sex

Characteristics of the patients with gastric cancer (1993–2000)

Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks

Article Category: Brief communication

Pubblicato online: 30 dic 2017

Pagine: 461 - 467

DOI: https://doi.org/10.1515/abm-2018-0023

Parole chiavecompeting risk, cure, gastric cancer, Iran, relative survival

© 2017 Fatemeh Paknazar et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2. A

Statistical crude ratios of patients who died from causes other than gastric cancer estimated using the flexible parametric cure model in the presence of competing risks by stage and age at diagnosis and sex

Characteristics of the patients with gastric cancer (1993–2000)

Parole chiave
competing risk, cure, gastric cancer, Iran, relative survival