ArticleBMJ open2020
Moving beyond the Cox proportional hazards model in survival data analysis: a cervical cancer study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Epidemiology, outcomes of treatment, and survival of cervical cancer in Kazakhstan: a nationwide population-based study.Frontiers in oncology · 2026Article
- Predictors of survival among cervical cancer patients in Swaziland (Eswatini): A population-based analysis in a resource-limited setting (2016-2024).PLOS global public health · 2026Article
- Dynamic survival prediction using longitudinal AGR in unresectable locally advanced esophageal squamous cell carcinoma.Frontiers in immunology · 2026Article
- Article
- Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017.Cancer causes & control : CCC · 2024Article
- Effect of marital status on the survival outcomes of cervical cancer: a retrospective cohort study based on SEER database.BMC women's health · 2024Article
- Individual dynamic prediction and prognostic analysis for long-term allograft survival after kidney transplantation.BMC nephrology · 2022Article
- Dynamic risk prediction of BK polyomavirus reactivation after renal transplantation.Frontiers in immunology · 2022Article
- Development and application of a dynamic prediction model for esophageal cancer.Annals of translational medicine · 2021Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study explored the prognostic factors and developed a prediction model for Chinese-American (CA) cervical cancer (CC) patients. We compared two alternative models (the restricted mean survival time (RMST) model and the proportional baselines landmark supermodel (PBLS model, producing dynamic prediction)) versus the Cox proportional hazards model in the context of time-varying effects. SETTING AND DATA SOURCES: A total of 713 CA women with CC and available covariates (age at diagnosis, International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis and radiation) from the Surveillance, Epidemiology and End Results database were included.
designWe applied the Cox proportional hazards model to analyse the all-cause mortality with the proportional hazards assumption. Additionally, we applied two alternative models to analyse covariates with time-varying effects. The performances of the models were compared using the C-index for discrimination and the shrinkage slope for calibration.
resultsOlder patients had a worse survival rate than younger patients. Advanced FIGO stage patients showed a relatively poor survival rate and low life expectancy. Lymph node metastasis was an unfavourable prognostic factor in our models. Age at diagnosis, FIGO stage and lymph node metastasis represented time-varying effects from the PBLS model. Additionally, radiation showed no impact on survival in any model. Dynamic prediction presented a better performance for 5-year dynamic death rates than did the Cox proportional hazards model.
conclusionsWith the time-varying effects, the RMST model was suggested to explore diagnosis factors, and the PBLS model was recommended to predict a patient's
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