Competing risk: An illustration with aspiration pneumonia in head and neck cancer patients undergoing radical radiotherapy: A biostatistician′s perspective

Bhattacharyya, Tapesh; Bhattacharjee, Atanu

doi:10.4103/0019-509x.175322

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…Results from this current study also indicate a significant association of ARI with HNC and this could be due to the location of the cancer since HNC mostly affect the upper airways serving as an effective barrier to infection [ 44 – 46 ]. Also, most of the HNC patients reported with advanced cancers at clinical stages III and IV, putting them at increased risk of a more compromised immune system hence susceptible to infections including ARI [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 91%

Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana

et al. 2022

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Background Influenza co-infection with bacteria is a leading cause of influenza-related deaths and severe respiratory infections, especially among high-risk groups like cancer patients undergoing treatment. However, acute respiratory infection (ARI)-like symptoms developed by upper-torso cancer (UTC) patients receiving radiotherapy are considered as side-effects of the radiation. Hence influenza and bacterial pathogens implicated in ARI are not investigated. Methods This prospective cohort study examined 85 in-patients with upper-torso cancers undergoing radiotherapy at the National Radiotherapy, Oncology and Nuclear Medicine Centre (NRONMC) of Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Eligible patients who consented were recruited into the study from September 2018 to April 2019. Influenza viruses A and B in addition to the following bacteria species Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis and Staphylococcus aureus were detected from oropharyngeal and nasopharyngeal swab specimens collected at three different time points. Presence of respiratory pathogens were investigated by influenza virus isolation in cell culture, bacterial culture, polymerase chain reaction (PCR) and next generation sequencing (NGS) assays. Results Of the 85 eligible participants enrolled into the study, 87% were females. Participants were 17 to 77 years old, with a median age of 49 years. Most of the participants (88%) enrolled had at least one pathogen present. The most prevalent pathogen was N. meningitidis (63.4%), followed by H. influenzae (48.8%), Influenza viruses A and B (32.9%), S. pneumoniae (32.9%) and S. aureus (12.2%). Approximately, 65% of these participants developed ARI-like symptoms. Participants with previous episodes of ARI, did not live alone, HNC and total radiation less than 50 Gy were significantly associated with ARI. All treatment forms were also significantly associated with ARI. Conclusion Data generated from the study suggests that ARI-like symptoms observed among UTC patients receiving radiotherapy in Ghana, could be due to influenza and bacterial single and co-infections in addition to risk factors and not solely the side-effects of radiation as perceived. These findings will be prime importance for diagnosis, prevention, treatment and control for cancer patients who present with such episodes during treatment.

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Section: Discussionmentioning

confidence: 91%

Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana

et al. 2022

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“…It assumes that the impacts of covariates are constant over time. 8 It is documented that nearly 5% of studies investigate the proportional hazard assumption. 9 In this work, we faced that the duration of OS was not followed the proportional hazard assumption between the groups.…”

Section: Discussionmentioning

confidence: 99%

Human epidermal growth factor receptor 2 borderline mortality in breast cancer patients: Evidence from surveillance, epidemiology, and end results program population-based study

Bhattacharjee

Bhattacharyya

Thomas

2018

Clinical Epidemiology and Global Health

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Background: Breast cancers with Human Epidermal Growth Factor Receptor 2 (HER2) borderline outcomes are very puzzling for patient management. To whether HER2 borderlines are having different prognostic status in comparison to HER2 positive/negative. Methods: This is a study among women diagnosed with invasive breast cancer from 1973 to 2014 who were identified in the Surveillance, Epidemiology, and End Results (SEER) of 9 registries database and having diagnosed with HER2 status (N = 102167), i.e. HER2 positive (N = 14678), HER2 negative (N = 85354) and HER2 borderline (N = 2135). Results: This Surveillance, Epidemiology, and End Results (SEER) study represents the largest report of prospective invasive breast cancer with HER2 status till five years from the date of registration. The five years survival rate among HER2 borderline was found completely separate with HER2 positive and HER2 negative patients. In several subtypes of analysis, it has been found that status of survival among HER borderline patients is significantly poor than HER2 positive and HER2 negative. The likelihood of death in HER2 borderline is found high (15.06%) in comparison to HER2 positive (14.24%) and HER2 negative (6.49%) at the end of five years. Different types of metastasis like Bone, Brain, Liver, and Lung are also observed with the higher rate in HER2 borderline in comparison to HER2 negative.

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“…Statistical software helps to handle survival data. The fundamental assumption in survival analysis while estimating survival probabilities through KM method is that censoring should be independent of the event, which is being considered [15,16].…”

Section: Methodsmentioning

confidence: 99%

Bayesian competing risk analysis: An application to nasopharyngeal carcinoma patients data

et al. 2021

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Background The Cox proportional hazard (CPH) model is normally used to study the death event data. The presence of competing risk (CR) is often encountered in health data, hence it becomes difficult to manage time to event data in clinical study. Bayesian approach is considered to manage the CR events in clinical data. Objectives The objective of study is to find the predictors associated with overall survival of nasopharyngeal carcinoma (NPC) patients. Further, our purpose is to use a Bayesian model that can analyze time to event data in the presence of CR. Methods Total 245 patients with NPC were taken (https://www.ncbi.nlm.nih.gov/geo/). The sociodemographic and clinical variables were considered for analysis purposes. R software and openBUGS were used to overcome the computational problems of CPH and Bayesian models. The Markov chain Monte Carlo (MCMC) method was used to compute the regression coefficients of Bayesian model. Results The study shows that among NPC patients, the covariates chemotherapy, smoking, N‐stage, and tumor site are associated with the higher risk for the deaths occurring in the cancer patients. The posterior mean estimates of proposed Bayesian model for significant factors have been obtained. The posterior mean and standard deviation estimates help to improve the survival of patients in the presence of CR. Conclusions It is very difficult to use the CR model with Bayesian approach in health research for nonstatistical researcher due to lack of information. This paper is dedicated to the application of Bayesian approach for CR analysis on NPC data.

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Competing risk: An illustration with aspiration pneumonia in head and neck cancer patients undergoing radical radiotherapy: A biostatistician′s perspective

Cited by 7 publications

References 6 publications

Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana

Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana

Human epidermal growth factor receptor 2 borderline mortality in breast cancer patients: Evidence from surveillance, epidemiology, and end results program population-based study

Bayesian competing risk analysis: An application to nasopharyngeal carcinoma patients data

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