Cureit:应用于脂肪肉瘤数据的端到端混合治愈模型实施流程

IF 3.3 Q2 ONCOLOGY
Karissa Whiting, Teng Fei, Samuel Singer, Li-Xuan Qin
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引用次数: 0

摘要

目的:在肿瘤学研究中,当有一部分患者不会发生相关事件时,治愈模型是 Cox 比例危险度模型的一种有效替代方法。虽然有软件可用于拟合治愈模型,但评估、报告和可视化模型结果的工具却很有限。本文介绍了 cureit R 软件包--一种用于构建混合治愈模型的端到端管道,并展示了其在原发性四肢和躯干脂肪肉瘤患者数据集中的应用:为了评估1982年7月至2017年9月期间在纪念斯隆-凯特琳癌症中心接受治疗的脂肪肉瘤组织学亚型与疾病特异性死亡(DSD)之间的关联,使用cureit软件包拟合并评估了混合治愈模型。脂肪肉瘤组织学亚型被定义为分化良好型、去分化型、肌样型、圆形细胞型和多形性:结果:在治愈模型中,与分化良好的脂肪肉瘤相比,所有其他分析的脂肪肉瘤组织学亚型都与较高的DSD显著相关。在多变量模型中,与分化良好的患者相比,类肌瘤(几率比[OR],6.25[95% CI,1.32至29.6])和圆形细胞(OR,16.2[95% CI,2.80至93.2])脂肪肉瘤的DSD发生率较高。相比之下,低分化脂肪肉瘤与DSD的潜伏期有关(危险比为10.6 [95% CI, 1.48 to 75.9])。多形性脂肪肉瘤在发病率和DSD潜伏期方面的风险都明显更高(P < .0001)。Brier评分表明,治愈模型和Cox模型的预测准确性相当:我们开发了 cureit 管道来拟合和评估混合治愈模型,并证明了其在脂肪肉瘤疾病环境中的临床实用性,揭示了亚型与发病率和/或潜伏期的特异性关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cureit: An End-to-End Pipeline for Implementing Mixture Cure Models With an Application to Liposarcoma Data.

Purpose: Cure models are a useful alternative to Cox proportional hazards models in oncology studies when there is a subpopulation of patients who will not experience the event of interest. Although software is available to fit cure models, there are limited tools to evaluate, report, and visualize model results. This article introduces the cureit R package, an end-to-end pipeline for building mixture cure models, and demonstrates its use in a data set of patients with primary extremity and truncal liposarcoma.

Methods: To assess associations between liposarcoma histologic subtypes and disease-specific death (DSD) in patients treated at Memorial Sloan Kettering Cancer Center between July 1982 and September 2017, mixture cure models were fit and evaluated using the cureit package. Liposarcoma histologic subtypes were defined as well-differentiated, dedifferentiated, myxoid, round cell, and pleomorphic.

Results: All other analyzed liposarcoma histologic subtypes were significantly associated with higher DSD in cure models compared with well-differentiated. In multivariable models, myxoid (odds ratio [OR], 6.25 [95% CI, 1.32 to 29.6]) and round cell (OR, 16.2 [95% CI, 2.80 to 93.2]) liposarcoma had higher incidences of DSD compared with well-differentiated patients. By contrast, dedifferentiated liposarcoma was associated with the latency of DSD (hazard ratio, 10.6 [95% CI, 1.48 to 75.9]). Pleomorphic liposarcomas had significantly higher risk in both incidence and the latency of DSD (P < .0001). Brier scores indicated comparable predictive accuracy between cure and Cox models.

Conclusion: We developed the cureit pipeline to fit and evaluate mixture cure models and demonstrated its clinical utility in the liposarcoma disease setting, shedding insights on the subtype-specific associations with incidence and/or latency.

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来源期刊
CiteScore
6.20
自引率
4.80%
发文量
190
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