Abstract

MANTILLA QUISPE, Raúl Vicente  and  TORRES VEGA, Fernando. Recurrence of tongue cancer analysis considering competing risks. Rev Med Hered [online]. 2008, vol.19, n.4, pp.145-151. ISSN 1018-130X.

Objective: To estimate the probability of recurrence of tongue cancer, according age, stage pathological of lymph node and treatment type, considering death before recurrence as competing event. Materials and methods: Retrospective cases series study of 290 patients with tongue cancer, who were treated at INEN between 1977 and 2000. Twenty-nine patients who were treated only with radiotherapy were excluded. Of the remaining 261 patients, 31 were treated only at the primary tumor site. Results: Recurrence was 36.8%, local recurrence was most frequent. Five year cumulative incidence of recurrence, using method of Kaplan Meier, was estimated at 44.7%; and according to the analysis of competing risks in 42.4%. In univariate analysis, using competitive risks analysis, estimated cumulative incidences were 56.8 y 38.9% in patients less than or equal to 45 years and older than 45 years of age, respectively (p=0.1556); 29.4 y 50.5% in patients with negative and positive pathological node, respectively (p=0.0002); 37.5% in patients with surgery, and 47.4% with surgery combined with radiotherapy, (p=0.03). In multivariate analysis, using competing risks regression, no difference was found between the types of treatment over recurrence (RR=1.146; p=0.620). Conclusions: The difference in results using Kaplan Meier method, and competing risks analysis was small, because there was a low rate of competitive event, and even more so when the cause of death was not related to the disease at hand. Recurrence rate was similar to those reported in other studies. Only significant difference was found in teh recurrence in the group with lymph node positive. Although the comparison with standard survival analysis methods shows similar results, competitive events should be taken into account.(Rev Med Hered 2008;19:145-151).

Keywords : Competing risks; cancer; tongue; recurrence.

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