Long-term survival with non-proportional hazards: results from the Dutch Gastric cancer Trial

被引：52
|
作者：
Putter, H
Sasako, M
Hartgrink, HH
van de Velde, CJH
van Houwelingen, JC
机构：
[1] Leiden Univ, Med Ctr, Dept Med Stat & Bioinformat, NL-2300 RC Leiden, Netherlands
[2] Natl Canc Ctr, Dept Surg, Tokyo, Japan
[3] Leiden Univ, Med Ctr, Dept Surg, NL-2300 RC Leiden, Netherlands
来源：
STATISTICS IN MEDICINE | 2005年 / 24卷 / 18期
关键词：
long-term survival; non-proportional hazards; time-dependent covariate effects;
D O I：
10.1002/sim.2143
中图分类号：
Q [生物科学];
学科分类号：
07 ; 0710 ; 09 ;
摘要：
Randomized clinical trials with long-term survival data comparing two treatments often show Kaplan-Meier plots with crossing survival curves. Such behaviour implies a violation of the proportional hazards assumption for treatment. The Cox proportional hazards regression model with treatment as a fixed effect can therefore not be used to assess the influence of treatment of survival. In this paper we analyse long-term follow-up data from the Dutch Gastric Cancer Trial, a randomized study comparing limited (D1) lymph node dissection with extended (D2) lymph node dissection. We illustrate a number of ways of dealing with survival data that do not obey the proportional hazards assumption, each of which can be easily implemented in standard statistical packages. Copyright (C) 2005 John Wiley & Sons, Ltd.
引用
收藏
页码：2807 / 2821
页数：15
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