→ mrliang:這篇有多少錢啊嘿嘿 03/01 23:47
時間:96年3月9日(星期五)上午10:40~11:30
地點:交大綜合一館427室
主講人 黃維婷教授(University of Pennsylvania School of Medicine, USA)
講題 Analysis of Local Recurrence and Distant Metastases in Early-Stage
Breast Cancer Using a Mixture Markov Model
摘要
The role of local recurrence (LR) in the risk of distant metastases (DM)
and survival has been a controversial topic. It is uncertain whether an LR
indicates a more biologically aggressive tumor that had been established at
inception or it is responsible for an increase in the rate of DM through
secondary dissemination. Such knowledge is important in determining the
salvage treatment for local recurrence which impacts survival outcomes.
Several studies based on large databases have shown evidence to support both
explanations. It is likely that such observations were a consequence of mixed
patient or tumor subtypes in the population. Therefore, we propose a mixture
model of two independent continuous-time multi-state Markov processes to
incorporate population heterogeneity. Transition and mixing probabilities
will be estimated by the method of maximum likelihood. We will focus on the
probability of metastatic dissemination. Extension to examine covariate
effects will be included. The methodology is applied using data from 1291
women with Stage I-II breast carcinoma treated with breast-conserving therapy
(BCT) at Hospital of University of Pennsylvania between 1977 and 1995. The
median follow-up was 8.5 years (range, 1.5-24 years).
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