Conditional survival and the choice of conditioning set for patients with colon cancer: An analysis of NSABP trials C-03 through C-07

Beth A. Zamboni, Greg Yothers, Mehee Choi, Clifton D. Fuller, James J. Dignam, Peter C. Raich, Charles Thomas, Michael J. O'Connell, Norman Wolmark, Samuel Wang

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Purpose: Colon cancer overall survival (OS) is usually computed from the time of diagnosis. Survival gives the initial prognosis but does not reflect how prognosis changes with changing hazard rates over time. Conditional survival (probability of surviving y additional years given they have survived x years [CS or OS|OS]) is an alternative measure that accounts for elapsed time since diagnosis, providing more relevant prognostic information. We extend the concept of CS to condition on the set of patients alive, recurrence-free, and second primary cancer-free (disease-free survival [OS|DFS]). Patients and Methods: Using data from National Surgical Adjuvant Breast and Bowel Project trials C-03 through C-07, 5-year OS|DFS was calculated on patients who were disease free up to 5 years after diagnosis, stratified by age, stage, nodal status, and performance status (PS). Results: For stage II, OS|DFS improved from 87% to 92% at 5 years. For stage III, OS|DFS improved from 69% to 88%. Patients younger than 50 years showed OS|DFS improvement from 79% to 95%; those older than 70 years showed no sustained increase in OS|DFS. Node-negative patients with ≥ 12 nodes resected showed little change (89% to 94%); those with more than four positive nodes showed an improvement (57% to 86%). Patients with a PS of 0 or 1 demonstrated a small improvement; those with a PS of 2 did not (64% to 58%). Conclusion: Prognosis improves over time for almost all groups of patients with colon cancer, especially those with positive nodes. OS|DFS is a more relevant measure of prognosis for those who have already survived disease free a period of time after diagnosis.

Original languageEnglish (US)
Pages (from-to)2544-2548
Number of pages5
JournalJournal of Clinical Oncology
Volume28
Issue number15
DOIs
StatePublished - May 20 2010
Externally publishedYes

Fingerprint

Colonic Neoplasms
Survival
Second Primary Neoplasms
Disease-Free Survival
Breast
Recurrence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Conditional survival and the choice of conditioning set for patients with colon cancer : An analysis of NSABP trials C-03 through C-07. / Zamboni, Beth A.; Yothers, Greg; Choi, Mehee; Fuller, Clifton D.; Dignam, James J.; Raich, Peter C.; Thomas, Charles; O'Connell, Michael J.; Wolmark, Norman; Wang, Samuel.

In: Journal of Clinical Oncology, Vol. 28, No. 15, 20.05.2010, p. 2544-2548.

Research output: Contribution to journalArticle

Zamboni, BA, Yothers, G, Choi, M, Fuller, CD, Dignam, JJ, Raich, PC, Thomas, C, O'Connell, MJ, Wolmark, N & Wang, S 2010, 'Conditional survival and the choice of conditioning set for patients with colon cancer: An analysis of NSABP trials C-03 through C-07', Journal of Clinical Oncology, vol. 28, no. 15, pp. 2544-2548. https://doi.org/10.1200/JCO.2009.23.0573
Zamboni, Beth A. ; Yothers, Greg ; Choi, Mehee ; Fuller, Clifton D. ; Dignam, James J. ; Raich, Peter C. ; Thomas, Charles ; O'Connell, Michael J. ; Wolmark, Norman ; Wang, Samuel. / Conditional survival and the choice of conditioning set for patients with colon cancer : An analysis of NSABP trials C-03 through C-07. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 15. pp. 2544-2548.
@article{b340beabfde14bcb95f844d4083e1c97,
title = "Conditional survival and the choice of conditioning set for patients with colon cancer: An analysis of NSABP trials C-03 through C-07",
abstract = "Purpose: Colon cancer overall survival (OS) is usually computed from the time of diagnosis. Survival gives the initial prognosis but does not reflect how prognosis changes with changing hazard rates over time. Conditional survival (probability of surviving y additional years given they have survived x years [CS or OS|OS]) is an alternative measure that accounts for elapsed time since diagnosis, providing more relevant prognostic information. We extend the concept of CS to condition on the set of patients alive, recurrence-free, and second primary cancer-free (disease-free survival [OS|DFS]). Patients and Methods: Using data from National Surgical Adjuvant Breast and Bowel Project trials C-03 through C-07, 5-year OS|DFS was calculated on patients who were disease free up to 5 years after diagnosis, stratified by age, stage, nodal status, and performance status (PS). Results: For stage II, OS|DFS improved from 87{\%} to 92{\%} at 5 years. For stage III, OS|DFS improved from 69{\%} to 88{\%}. Patients younger than 50 years showed OS|DFS improvement from 79{\%} to 95{\%}; those older than 70 years showed no sustained increase in OS|DFS. Node-negative patients with ≥ 12 nodes resected showed little change (89{\%} to 94{\%}); those with more than four positive nodes showed an improvement (57{\%} to 86{\%}). Patients with a PS of 0 or 1 demonstrated a small improvement; those with a PS of 2 did not (64{\%} to 58{\%}). Conclusion: Prognosis improves over time for almost all groups of patients with colon cancer, especially those with positive nodes. OS|DFS is a more relevant measure of prognosis for those who have already survived disease free a period of time after diagnosis.",
author = "Zamboni, {Beth A.} and Greg Yothers and Mehee Choi and Fuller, {Clifton D.} and Dignam, {James J.} and Raich, {Peter C.} and Charles Thomas and O'Connell, {Michael J.} and Norman Wolmark and Samuel Wang",
year = "2010",
month = "5",
day = "20",
doi = "10.1200/JCO.2009.23.0573",
language = "English (US)",
volume = "28",
pages = "2544--2548",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "15",

}

TY - JOUR

T1 - Conditional survival and the choice of conditioning set for patients with colon cancer

T2 - An analysis of NSABP trials C-03 through C-07

AU - Zamboni, Beth A.

AU - Yothers, Greg

AU - Choi, Mehee

AU - Fuller, Clifton D.

AU - Dignam, James J.

AU - Raich, Peter C.

AU - Thomas, Charles

AU - O'Connell, Michael J.

AU - Wolmark, Norman

AU - Wang, Samuel

PY - 2010/5/20

Y1 - 2010/5/20

N2 - Purpose: Colon cancer overall survival (OS) is usually computed from the time of diagnosis. Survival gives the initial prognosis but does not reflect how prognosis changes with changing hazard rates over time. Conditional survival (probability of surviving y additional years given they have survived x years [CS or OS|OS]) is an alternative measure that accounts for elapsed time since diagnosis, providing more relevant prognostic information. We extend the concept of CS to condition on the set of patients alive, recurrence-free, and second primary cancer-free (disease-free survival [OS|DFS]). Patients and Methods: Using data from National Surgical Adjuvant Breast and Bowel Project trials C-03 through C-07, 5-year OS|DFS was calculated on patients who were disease free up to 5 years after diagnosis, stratified by age, stage, nodal status, and performance status (PS). Results: For stage II, OS|DFS improved from 87% to 92% at 5 years. For stage III, OS|DFS improved from 69% to 88%. Patients younger than 50 years showed OS|DFS improvement from 79% to 95%; those older than 70 years showed no sustained increase in OS|DFS. Node-negative patients with ≥ 12 nodes resected showed little change (89% to 94%); those with more than four positive nodes showed an improvement (57% to 86%). Patients with a PS of 0 or 1 demonstrated a small improvement; those with a PS of 2 did not (64% to 58%). Conclusion: Prognosis improves over time for almost all groups of patients with colon cancer, especially those with positive nodes. OS|DFS is a more relevant measure of prognosis for those who have already survived disease free a period of time after diagnosis.

AB - Purpose: Colon cancer overall survival (OS) is usually computed from the time of diagnosis. Survival gives the initial prognosis but does not reflect how prognosis changes with changing hazard rates over time. Conditional survival (probability of surviving y additional years given they have survived x years [CS or OS|OS]) is an alternative measure that accounts for elapsed time since diagnosis, providing more relevant prognostic information. We extend the concept of CS to condition on the set of patients alive, recurrence-free, and second primary cancer-free (disease-free survival [OS|DFS]). Patients and Methods: Using data from National Surgical Adjuvant Breast and Bowel Project trials C-03 through C-07, 5-year OS|DFS was calculated on patients who were disease free up to 5 years after diagnosis, stratified by age, stage, nodal status, and performance status (PS). Results: For stage II, OS|DFS improved from 87% to 92% at 5 years. For stage III, OS|DFS improved from 69% to 88%. Patients younger than 50 years showed OS|DFS improvement from 79% to 95%; those older than 70 years showed no sustained increase in OS|DFS. Node-negative patients with ≥ 12 nodes resected showed little change (89% to 94%); those with more than four positive nodes showed an improvement (57% to 86%). Patients with a PS of 0 or 1 demonstrated a small improvement; those with a PS of 2 did not (64% to 58%). Conclusion: Prognosis improves over time for almost all groups of patients with colon cancer, especially those with positive nodes. OS|DFS is a more relevant measure of prognosis for those who have already survived disease free a period of time after diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=77956413529&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956413529&partnerID=8YFLogxK

U2 - 10.1200/JCO.2009.23.0573

DO - 10.1200/JCO.2009.23.0573

M3 - Article

C2 - 20406942

AN - SCOPUS:77956413529

VL - 28

SP - 2544

EP - 2548

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 15

ER -