Survival analysis for breast cancer
Date
2010-09-21T17:30:45Z
Authors
Liu, Yongcai
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Abstract
This research carries out a survival analysis for patients with breast cancer. The influence of clinical and pathologic features, as well as molecular markers on survival time are investigated. Special
attention focuses on whether the molecular markers can provide additional information in helping predict clinical outcome and guide therapies for breast cancer patients. Three outcomes, breast cancer specific survival (BCSS), local relapse survival (LRS) and distant relapse survival (DRS), are
examined using two datasets, the large dataset with missing values in markers (n=1575) and the small (complete) dataset consisting of patient records without any missing values (n=910). Results show
that some molecular markers, such as YB1, could join ER, PR and HER2 to be integrated
into cancer clinical practices. Further clinical research work is needed to identify the importance of CK56.
The 10 year survival probability at the mean of all the covariates (clinical variables and markers) for BCSS, LRS, and DRS is 77%, 91%, and 72% respectively. Due to the presence of a large portion of missing values in the dataset, a sophisticated multiple imputation method is needed to estimate the missing values so that an unbiased and more reliable analysis can be achieved. In this study, three multiple imputation (MI) methods, data augmentation
(DA), multivariate imputations by chained equations (MICE) and AREG, are employed and compared.
Results shows that AREG is the preferred MI approach. The reliability of MI results are demonstrated using various techniques. This work will hopefully shed light on the determination of appropriate MI
methods for other similar research situations.
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Keywords
Survival analysis, Breast cancer, Multiple imputation, Molecular marker