Simultaneous modeling of multiple recurrences in breast cancer patients

authors:

avatar Freshteh Osmani ORCID , avatar Aliakbar Rasekhi ORCID , avatar Ebrahim HajiZadeh ORCID , * , avatar Hamideh Akbari

Koomesh: Vol.22, issue 2; 359-364
published online: September 02, 2020
article type: Research Article
received: January 01, 2019
accepted: August 02, 2019

how to cite: Osmani F, Rasekhi A, HajiZadeh E, Akbari H . Simultaneous modeling of multiple recurrences in breast cancer patients. koomesh. 2020;22(2):e153189. 

Abstract

Introduction: Breast cancer is one of the most common recurrence cancers among women. There are several factors that can affect multiple recurrence of this disease. On the other hand, simultaneous examination of the types of relapses will make the results more accurate. The purpose of this study was to use a joint frailty model to model multiple recurrences of breast cancer patients. Materials and Methods: In this retrospective survival study,342 breast cancer patients whose records were registered at the Shohada Tajrish Hospital Cancer Research Center (Tehran, Iran) were investigated in 2005-2015. Patients were monitored for at least 6 months after diagnosis and their last condition was recorded in this study, the joint frailty survival model was used and data analysis was done in R software version 3.4.1. Results: The 3-year and 5-year survival rates were 0.79 and 0.68 respectively. According to the results of the fitted joint frailty model, it can be said that the risk of multiple recurrence is increased for patients with tumor grade greater than I. Also, tumor size (>20 mm) has a significant effect on the risk of recurrence and the risk of local and metastatic recurrence is more for HER2+ patients. Conclusion: According to the results of this study, the relationship between metastasis and local relapses was high in breast cancer patients, which has great importance in the process of recognizing and treating of this disease. Although in this study, in a large sample of patients, there was a positive correlation between multiple recurrences, but these results should be considered with caution with small number of recurrences.

References

  • 1.

    Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001; 94: 153-156.

  • 2.

    Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer in Iran: results of a multi-center study. Asian Pac J Cancer Prev 2004; 5: 24-27.

  • 3.

    Yaghmaei S, Bani Hashemi G, Ghorbani R. Survival rate following treatment of primary breast cancer in Semnan, Iran (1991-2002). Koomesh 2008; 19: 111-116. (Persian).

  • 4.

    Kluger HM. Is Catherin expression correlated with metastases.2005; 25: 452-457.

  • 5.

    Montagna E, Bagnardi V, Rotmensz N, Viale G, Renne G, Cancello G, et al. Breast cancer subtypes and outcome after local and regional relapse. Ann Oncol 2012; 23: 324-331.

  • 6.

    Hajihosseini M, Amini P, Shahdoust M, Faradmal J, Sadeghyfar M, Sedighi-Pashaki A. Application of log-normal parametric model in disability structure to predict metastasis and death due to breast cancer. Koomesh 2016;18: 95-101. (Persian).

  • 7.

    Kumar V, Abbas AK, Fausto N. Robbins y Cotran. Patologa estructural y funcional: Elsevier; 2005; p. 1120-1151.

  • 8.

    Aitken S, Thomas J, Langdon S, Harrison D, Faratian D. Quantitative analysis of changes in ER, PR and HER2 expression in primary breas cancer and paired nodal metastases. Ann Oncol 2010; 21: 1254-1261.

  • 9.

    Cook R J, Lawless JF. Analysis of repeated events. Stat Methods Med Res 2002; 11: 141-166.

  • 10.

    Osmani F, Hajizadeh E, Mansoori P. Estimation of seasonal effect on the psoriasis recurrence using time dependent coefficient rates model for recurrent events. J Dermatol Cosmetic 2015; 6: 23-30. (Persian).

  • 11.

    Liu L, Wolfe RA, Huang X. Shared frailty models for recurrent events and a terminal event. Biometrics 2004; 60: 747-756.

  • 12.

    R. L. Prentice, B. J. Williams, and A. V. Peterson, ''On the regression analysis of multivariate failure time data,'' Biometrika 1981; 68: 373-389.

  • 13.

    Osmani F, Hajizadeh E, Mansoori P. Use of smoothing methods for estimating the coefficients of time dependent rate models in survival analysis and its application in psoriasis disease. Iran J Epidemiol 2016; 12: 36-46.

  • 14.

    Mansouri P, Hajizadeh E, Osmani F. Analysis of risk factors for psoriasis recurrence using proportional rates model. J Skin Stem Cell 2014; 1. (Persian).

  • 15.

    Akbari ME, Mozaffar M, Heidari A, Zirakzadeh H, Akbari A, Akbari M, et al. Recurrence and survival effect in breast conserving surgery: what are the predictive and/or prognostic factors? Iran J Cancer Prev 2011; 4: 49-54. (Persian).

  • 16.

    Aalen O, Borgan O, Gjessing H. Survival and event history analysis: a process point of view: Springer; 2013.

  • 17.

    Osmani F, Hajizadeh E, Rasekhi A, Akbari M E. Multivariate Joint Frailty Models for Modeling Multiple Recurrent Events and Its Application in Breast Cancer. RJMS 2019; 25: 71-79. (Persian).

  • 18.

    Osmani F, Hajizadeh E, Rasekhi A. Association between multiple recurrent events with multivariate modeling: a retrospective cohort study. J Res Health Sci 2018; 18. (Persian).

  • 19.

    Heitz F, Rochon J, Harter P, Lueck HJ, Fisseler-Eckhoff A, Barinoff J, et al. Cerebral metastases in metastatic breast cancer: disease specific risk factors and survival. Ann Ancol 2011; 22: 1571-1581.

  • 20.

    Osmani F, Hajizadeh E, Mansoori P. Estimation of seasonal effect on the psoriasis recurrence using time dependent coefficient rates model for recurrent events. Dermatol Cosmetic 2015; 6. (Persian).

  • 21.

    Gohari MR, Mahmoudi M, Kazem M, Pasha E, Khodabakhshi R. Recurrence in breast cancer analysis with frailty model. Saudi Med J 2006; 27: 1187-1193.

  • 22.

    Mirzaei HR, Hajian S, Mofid B. The role of prognostic factors on breast cancer recurrence in patients at radiation oncology ward in imam hossain hospital. Iran J Breast Cancer 2008; 1. (Persian).

  • 23.

    Dawood S, Broglio K, Esteva F, Ibrahim N, Kau SW, Islam R, et al. Defining prognosis for women with breast cancer and CNS metastases by HER2 status. Ann Oncol 2008; 19: 1242-1248.

  • 24.

    Rondeau V, Mathoulin-Plissier S, Tanneau L, Sasco AJ, MacGrogan G, Debled M. Separate and combined analysis of successive dependent outcomes after breast-conservation surgery: recurrence, metastases, second cancer and death. BMC Cancer 2010; 10: 697-709.

  • 25.

    Gohari MR, Mahmoudi M, Mohammed K, Pasha E, Khodabakhshi R. Recurrence in breast cancer. Saudi Med J 2006; 27: 1187-1193.

  • 26.

    Mansouri P, Hajizadeh E, Osmani F. Analysis of risk factors for psoriasis recurrence using proportional rates model. J Skin Stem Cell 2014; 1. (Persian).

  • 27.

    Osmani F, Hajizadeh E, Rasekhi A, Akbari ME. Analyzing relationship between local and metastasis relapses with survival of patients with breast cancer: a study using joint frailty model. Int J Cancer Manag 2018. (Persian)##.