A Statistical Analysis of the Factors with Nonrandom Impact on the Survival Rate of Women with Breast Cancer, by Type of Medical Treatment

N. Kovtun, I. Motuziuk, O. M. Dumenko
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Abstract

A statistical analysis of the factors with nonrandom impact of the survival rate of women with breast cancer, by type of medical treatment in Ukraine, was made using data from the National Cancer Register. The complexity and ambiguity of the problem related with the choice of a special treatment type, i. e. surgical treatment or combined surgical treatment, was emphasize. The combined surgical treatment is available in two options: as a combination of surgical treatment and radiation therapy and a combination of surgical treatment, radiation therapy and chemical therapy. The data on female patients who had medical treatment in the National Institute of Cancer used for a statistical analysis to reveal positive and negative results from each type of special medical treatment.  The need for the assumption on proportionality was substantiated, with its testing based on a graphic analysis by grouping factors. The obtained results led to the conclusion that the model could be extended by the categorical factors: type of treatment (grouping factor), type of surgical operation, phase of decease. The assessment was made based on analyzing the factors’ impact by type of medical treatment. It was demonstrated that the model could be extended by interaction effects that would enable for estimating the relative risk depending on a combination of the treatment group and the respective factor. None of the effects included in the model could prove to be statistically significant. It means that no conclusions could be made about the factors’ interactions by type of the medical treatment. The interpretation of all the other factors that proved to be significant was applied to all the population. The strongest projection weight in the model was with the factor of decease phase, followed by the type of medical treatment and, in equal proportions, by the age and the type of surgical operation. The results of checking the global test could demonstrate the feasibility of predicting the survival rate for the overall model with the significance level equal to 0.05. It was proved that adjuvant and chemical therapies could reduce the risks of the recurrence, but this result had not an ultimate statistical validity. Despite of the positive non-recurrence result, the survival rate by groups still reduces, being an obvious effect of the abovementioned groups of medical treatment.
按治疗类型对乳腺癌妇女生存率的非随机影响因素的统计分析
利用国家癌症登记册的数据,对乌克兰按医疗类型划分的影响乳腺癌妇女存活率的非随机因素进行了统计分析。强调了与选择特殊治疗类型,即手术治疗或联合手术治疗有关的问题的复杂性和模糊性。联合手术治疗有两种选择:手术治疗和放射治疗的结合以及手术治疗、放射治疗和化学治疗的结合。在国家癌症研究所接受治疗的女性患者的数据用于统计分析,以揭示每种特殊医疗的阳性和阴性结果。比例假设的必要性得到证实,其检验基于分组因素的图形分析。所得结果表明,该模型可以通过治疗类型(分组因素)、手术类型、死亡阶段等分类因素进行扩展。在按医疗类型分析影响因素的基础上进行评价。结果表明,该模型可以通过相互作用效应进行扩展,从而能够根据治疗组和各自因素的组合来估计相对风险。模型中包含的效应都不能证明具有统计学意义。这意味着不能就不同类型的治疗得出因素之间的相互作用的结论。对所有其他被证明是重要的因素的解释适用于所有人口。模型中最强的投影权重与死亡阶段有关,其次是医疗类型,年龄和手术类型也占同样比例。检验全局检验的结果可以证明整体模型预测生存率的可行性,显著性水平为0.05。辅助治疗和化学治疗可以降低复发风险,但这一结果没有最终的统计效度。尽管不复发结果为阳性,但分组生存率仍然降低,是上述药物治疗组的明显效果。
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