Format

Send to

Choose Destination
Head Neck. 2017 Jan;39(1):56-62. doi: 10.1002/hed.24536. Epub 2016 Jul 20.

Competing risks analysis of cause-specific mortality in patients with oral squamous cell carcinoma.

Author information

1
Department of Mathematical Sciences, University of Oulu, Oulu, Finland.
2
Department of Otorhinolaryngology, Oulu University Hospital, Oulu, Finland.
3
PEDEGO Research Unit, University of Oulu, Oulu, Finland.
4
Medical Research Center of Oulu, Oulu, Finland.
5
Department of Dentistry, University of Oulu, Oulu, Finland.
6
Department of Oral and Maxillofacial Diseases, Oulu University Hospital, Oulu, Finland.

Abstract

BACKGROUND:

Survival studies on head and neck cancers are frequently reported with inadequate account for competing causes of death. Realistic descriptions and predictions of postdiagnosis mortality should be based on proper competing risks methodology.

METHODS:

Prognosis of patients with oral squamous cell carcinoma (OSCC) in terms of mortality from OSCC and from other causes, respectively, was analyzed according to recent methodological recommendations using cumulative incidence functions and models for cause-specific hazards and subdistribution hazards in 306 patients treated in a tertiary care center in Northern Finland.

RESULTS:

More coherent and informative descriptions and predictions of mortality by cause were obtained with state-of-the-art statistical methods for competing risks than using the prevalent but questionable practice to graph "disease-specific survival."

CONCLUSION:

From the patients' perspective, proper competing risks analysis offers more relevant prognostic scenarios than naïve analyses of "disease-specific survival"; therefore, it should be used in prognostic studies of head and neck cancers. © 2016 Wiley Periodicals, Head Neck 39: 56-62, 2017.

KEYWORDS:

cause-specific mortality; competing risks; cumulative incidence; prognosis; survival

PMID:
27437667
DOI:
10.1002/hed.24536
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center