Survival Analysis for Melanoma Brain Metastasis in the Presence of Competing Risks

• Activity Number: 525
• Type: Contributed
• Date/Time: Wednesday, August 1, 2012 : 10:30 AM to 12:20 PM
• Sponsor: International Chinese Statistical Association
• Author(s): Meng Qian*+ and Michelle Ma and Iman Osman and Yongzhao Shao
• Companies: New York University and New York University and New York University and New York University
• Keywords: survival anlysis ; competing risk ; cohort

Abstract

Brain metastatic melanoma patients have a high mortality rate with a short median survival time of less than 6 months. It is thus important to identify among early-stage primary melanoma patients who have high risk to metastasize to the brain. There are two types Melanoma Brain Metastasis according to the first occurrence site. Metastases develop in other visceral sites and finally arrive at the brain in some patients; while in other patients, metastases develop in the brain as the first visceral site. Using two prospectively collected melanoma databases at NYU School of Medicine, we evaluated the clinical risk factors for brain metastasis accounting for competing risk. The main event of interest is time to brain metastasis as first visceral site since the pathological diagnosis. The competing events include time to first metastasis site which is non-brain and death before metastasis due to reasons other than melanoma. We compared the cumulative incidence functions between groups stratified by each prognostic factors using Gray's test. We also conducted multivariate evaluation of the prognostic factors by fitting competing risk Cox models.