Measuring the impact of COVID-19 on cancer survival using an interrupted time series analysis
Pascal LambertKatie GallowayAllison FeelyOliver BucherPiotr CzaykowskiPamela HebbardJulian O. KimMarshall PitzHarminder SinghMaclean ThiessenKathleen Decker
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Abstract Background Few studies have investigated the impact of the COVID-19 pandemic on cancer survival. Those studies that have included pandemic vs prepandemic comparisons can mask differences during different periods of the pandemic such as COVID-19 waves. The objective of this study was to investigate the impact of the COVID-19 pandemic on cancer survival using an interrupted time series analysis and to identify time points during the pandemic when observed survival deviated from expected survival. Methods A retrospective population-based cohort study that included individuals diagnosed with cancer between January 2015 and September 2021 from Manitoba, Canada, was performed. Interrupted time series analyses with Royston–Parmar models as well as Kaplan–Meier survival estimates and delta restricted mean survival times at 1 year were used to compare survival rates for those diagnosed before and after the pandemic. Analyses were performed for 11 cancer types. Results Survival at 1 year for most cancer types was not statistically different during the pandemic compared with prepandemic except for individuals aged 50-74 years who were diagnosed with lung cancer from April to June 2021 (delta restricted mean survival times = −31.6 days, 95% confidence interval [CI] = −58.3 to −7.2 days). Conclusions With the exception of individuals diagnosed with lung cancer, the COVID-19 pandemic did not impact overall 1-year survival in Manitoba. Additional research is needed to examine the impact of the pandemic on long-term cancer survival.Keywords:
Pandemic
Statistic
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Objective To explore influence of the prognostic factors on survival period in patients with Kassi procedure in children of biliary atresia. Methods The clinical data of 51 patients with congenital biliary atresia were analyzed retrospectively. Using Kapalarr-Meier survival curve to describe the survival rate. Several factors influencing survival were collected and Cox proportional hazard model was established to statistical analysis. Results Accumulation survival rate of 3,6 and 12 months after the operation were 69.15%,56.33% and 32.50% respectively,the median survival time was 8 months. The multivariate analysis showed that the volume of biliary drainage, whether or not long-term followed-up and active effective treatment were significant prognostic factors. The older of operative age, the shorter of midian-survival time. Conclusions The volume of biliary drainage,whether or not long-term followed-up and active effective treatment have great influence on the prognosis of the biliary atresia. Survival curve have great change according to their different age at the operation.
Biliary Drainage
Child survival
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Objective To understand the stomach cancer survival state and trends of Fuzhou in order to evaluate the effect of Ⅱ and Ⅲ prevention in the last 10 years.Methods Seven hundred and twenty-four stomach cancer cases diagnosed in 1992-1999 are investigated,survival rate,mean survival time and median survival time are calculated by life table method and Kaplan-Meier method,survival time are compared by Logrank Test.Results Survival rate of 1,3 and 5 years are 0 637?7,0.355?8 and 0.230?5,mean survival time and median survival time are 918.35 and 558 days.Difference among survival time of different year groups is statistically significant and survial rate of 1,3, and 5 years are increased with time.There are significant difference of survival time in age groups,survival time of the group of 75 years old is shorter than 35-70 group.Conclusion Ⅱ and Ⅲ prevention have initial effect,but stomach cancer survival rate is still not high.
Stomach cancer
Log-rank test
Cancer Survival
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Objective: To evaluate the clinical survival rates and influence factors of different types of resin-bonded fixed partial dentures (RBFPD) used in anterior missing teeth restoration. Methods: Ninety-three RBFPD were delivered to 92 patients [92 patients,43 males and 49 females, average age (46.1±12.8) years] who visited Peking University School and Hospital of Stomatology from January 2006 to December 2021 for restoration of 1 or 2 anterior missing teeth. Altogether 32 cases of glass fiber reinforced RBFPD, 39 cases of glass-based ceramic RBFPD and 22 cases of porcelain-fused-to-metal RBFPD were retrospectively analyzed. The complete survival rate, functional survival rate, patients' satisfaction and color matching of the restorations were recorded and evaluated every year since the replacement with RBFPD. The Kaplan-Meier survival curve method was used for survival analysis, and the Log-rank analysis was used to compare the effect of the number of missing teeth, position (maxillary or mandibular), cantilever or non-cantilever and gender on the survival rate of the restorations. Results: The overall survival time for the 93 RBFPD was 13.7 years (95%CI: 12.3-15.1 years). There was a decreasing trend in complete survival and functional survival for all three material RBFPD from year to year, but complete and functional survival rates exceeded 90% at year 5 and exceeded 80% at year 10. The complete survival rate of the glass-ceramic RBFPD was higher than the other two during the follow-up period, with a complete survival rate of 90% (35/39) at year 15. The porcelain-fused-to-metal RBFPD had a higher functional survival rate in years 1-8, but the complete and functional survival rates showed a substantial decrease after year 9. The single-factor Log-rank analysis showed that the success rate of porcelain-fused-to-metal RBFPD was significantly higher than that of glass fiber reinforced RBFPD (χ²=7.33, P=0.007), and the success rate of RBFPD with 1 missing tooth restored was significantly higher than that of RBFPD with 2 missing teeth restored (χ²=3.23, P=0.072). The differences in success rates between different restoration positions (maxillary and mandibular), cantilever or non-cantilever, and gender factors were not statistically significant (χ²=2.26, P=0.133; χ²=0.68, P=0.411; χ²=1.07, P=0.300). Conclusions: For the restoration of individual missing anterior teeth, both porcelain-fused-to-metal RBFPD and glass-based ceramic RBFPD achieve a high long-term clinical success rate, with glass-based ceramic RBFPD being more able to ensure long-term restorative result.目的： 评价粘接固定义齿（RBFPD）修复前牙缺失的长期临床应用效果并分析其影响因素。 方法： 对2006年1月至2021年12月于北京大学口腔医学院·口腔医院修复科就诊的1或2颗前牙缺失患者［92例，男性43例，女性49例，年龄（46.1±12.8）岁］的RBFPD（93件）进行回顾性分析，包括玻璃纤维增强树脂RBFPD（32件）、玻璃陶瓷RBFPD（39件）以及镍铬合金烤瓷RBFPD（22件）。统计修复后RBFPD的完全存活率和功能存活率，利用Kaplan-Meier生存曲线法进行生存分析，Log-rank检验比较缺牙数、修复位置（上颌或下颌）、单端或双端修复以及性别因素对修复体生存率的影响。 结果： 93件RBFPD的总体生存时间为13.7年（95%CI：12.3~15.1年）。3种材料RBFPD的完全存活率及功能存活率呈逐年下降趋势，但修复后5年完全存活率和功能存活率均超过90%，修复后10年完全存活率和功能存活率均超过80%。随访期间玻璃陶瓷RBFPD的完全存活率均高于其他两种RBFPD，修复后15年完全存活率为90%（35/39）。修复后1~8年镍铬合金烤瓷RBFPD功能存活率较高，但修复后9年镍铬合金烤瓷RBFPD完全存活率和功能存活率出现大幅度降低。单因素分析显示，镍铬合金烤瓷RBFPD的生存率显著大于玻璃纤维增强树脂RBFPD（χ²=7.33，P=0.007），修复1颗缺失牙的RBFPD生存率显著大于修复2颗缺失牙的RBFPD（χ²=3.23，P=0.072）；而修复位置（上颌或下颌）、单端或双端修复以及性别因素对生存率的影响差异无统计学意义（χ²=2.26，P=0.133；χ²=0.68，P=0.411；χ²=1.07，P=0.300）。 结论： 对于个别前牙缺失，镍铬合金烤瓷RBFPD和玻璃陶瓷RBFPD均可取得较长期的临床成功率，玻璃陶瓷RBFPD能保证长期修复效果。.
Anterior teeth
Log-rank test
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Objective To analyze survival condition of patients with digestive cancer and explore the influence of various factors to patients' survival time.The results will provide powerful evidence to prevent and recover from digestive cancer,prolong survival time and improve survival rate of patients.Methods 278 patients with digestive cancer received service of hospice from 2007 to 2009 were taken part in following up investigation and retrospective analysis.The median survival time and survival rate were calculated and the relationships among various factors were explored.Results The median survival time of all the patients died of cancer was 11 months and the average survival time was 20.4 months.The accumulated survival rate of 1 year was 0.478±0.031 and the accumulated survival rate of 5 year was 0.079±0.018.The gender,age,doing or not doing operation and the time of pain appearing influenced survival time statistically.Conclusion The most important measures of prolonging survival time of patients with digestive cancer were early found,early diagnosed,efficient operation and positive multiple intervention.
Cancer Survival
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Statistic
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Data from 10418 ostrich chicks hatched in the period from 2000 to 2008 were analyzed to determine the influence of fixed effects upon age specific survival. Age-specific survival was divided into the following intervals: 0 to 1 week survival, 0 to 3 week survival, 0 to 12 week survival, 0 to 24 week survival, 2 to 3 week survival, 4 to 12 week survival and 13 to 24 week survival. ASREML software was used to formulate a fixed effects model for each trait. Storage time only affected 0 to 3 week survival (P = 0.03), while incubator type had a significant effect on 0 to 3 week survival (P = 0.03), 0 to 12 week survival (P < 0.001), 0 to 24 week survival (P < 0.001), and 4 to 12 week survival (P < 0.001). At older ages (i.e. 0 to 24 weeks, 0 to 12 weeks, 4 to 12 weeks, and 13 to 24 weeks) females exhibited higher survival than males (P < 0.001; P = 0.010; P < 0.001; P < 0.001). Hen age was found to have a significant influence on almost all traits (i.e. 0 to 3 week survival, 0 to 12 week survival, 0 to 24 week survival, 2 to 3 week survival and 4 to 12 week survival) except for survival during the first week, and survival from 13 to 24 weeks post-hatch (P = 0.020; P = 0.002; P = 0.036; P = 0.017; P = 0.014). Exhibiting a significant environmental component, ostrich chick survival to 6 months post-hatch can be optimized by manipulating certain environmental factors like the age of the breeding female as well as the type of incubator used.
Child survival
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<i>Background:</i> Survival statistics commonly reflect survival from the time of diagnosis but do not take into account survival already achieved after a diagnosis. The objective of this study was to provide conditional survival estimates for brain tumor patients as a more accurate measure of survival for those who have already survived for a specified amount of time after diagnosis. <i>Methods:</i> Data on primary malignant and nonmalignant brain tumor cases diagnosed from 1985–2005 from selected SEER state cancer registries were obtained. Relative survival up to 15 years postdiagnosis and varying relative conditional survival rates were computed using the life-table method. <i>Results:</i> The overall 1-year relative survival estimate derived from time of diagnosis was 67.8% compared to the 6-month relative conditional survival rate of 85.7% for 6-month survivors (the probability of surviving to 1 year given survival to 6 months). The 10-year overall relative survival rate was 49.5% from time of diagnosis compared to the 8-year relative conditional survival rate of 79.2% for 2-year survivors. Conditional survival estimates and standard survival estimates varied by histology, behavior, and age at diagnosis. The 5-year relative survival estimate derived from time of diagnosis for glioblastoma was 3.6% compared to the 3-year relative conditional survival rate of 36.4% for 2-year survivors. For most nonmalignant tumors, the difference between relative survival and the corresponding conditional survival estimates were minimal. Older age groups had greater numeric gains in survival but lower conditional survival estimates than other age groups. Similar findings were seen for other conditional survival intervals. <i>Conclusions:</i> Conditional survival is a useful disease surveillance measure for clinicians and brain tumor survivors to provide them with better ‘real-time’ estimates and hope.
Relative survival
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To study the present survival status of nephroblastoma(Wilms'tumor,WT) and the relationship between pathologic classification,clinicopathologic stage and WT.A total of 59 patients between Jan. 1996 and Dec.2002 with WT were analyzed retrospectively,with stageⅠ,21 cases;stageⅡ,14 cases;stage Ⅲ,16 cases;stage Ⅳ,5 cases;stage Ⅴ,3 cases according to NWTS-5 clinicopathologic staging. There are 7 cases (13.2%) with unfavorable histology (UH) type and 46 cases (86.8%) with favorable histology (FH) type among 53 patients treated with tumorectomy.Kaplan-Meier method was used to analyzed survival.Fifty-one patients have been followed up with follow-up rate 86.4%(51/59).Among these 51 cases, 14(24.5%) cases died, 37(72.5%) cases were still alive.1-,2-,and 5-year survival rates were 87.0%?80.0%和70.0% respectively.2-,5-year survival rates in FH type were higher than those in UH type (P=0.008).Declining trend in survival rate with the increasing of clinicopathologic stage was found.[Conclusion]The 5-year survival rate is 70.0% in this group according to Kaplan-Meier analysis.Pathologic classification and clinicopathologic stage have influence on survival of WT.
Histology
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Objectives: To investigate the recurrence rate of cholesteatoma using Kaplan-Meier survival analysis. Study Design: Retrospective study. Setting: Tertiary referral center. Patients: Three hundred forty-five patients with middle ear cholesteatoma operated on by the same surgeon between 1987 and 2002. Methods: The cumulative recurrence rate of cholesteatoma during a 5-year follow-up period was calculated using Kaplan-Meier survival analysis. Results: The overall 5-year recurrence rate was 11.8%. The recurrence rate increased with the follow-up time. The 5-year recurrence rate was 3.9% in patients treated with canal wall down tympanoplasty (CWDT) and 16.7% in patients treated with intact canal wall tympanoplasty (ICWT) or canal wall reconstruction (CWR) after CWDT with a significant difference (p < 0.01). The 5-year recurrence rate was 26.0% in patients operated on between 1987 and 1996 and 0.7% in patients operated on between 1997 and 2002, again with a significant difference (p < 0.001). Conclusion: Kaplan-Meier survival analysis should be used for calculating the recurrence rate of cholesteatoma. Although this analytic method further demonstrates that CWDT is a more reliable surgical method than ICWT/CWR in reducing cholesteatoma recurrence, clinical judgment should be exercised, and we continue to recommend that a flexible approach should be adopted in deciding whether to perform CWDT or ICWT/CWR for individual cases.
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