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A popular choice in cancer research when comparing survival between treatments is to consider the log-rank test. It has been well-established that it is the most powerful non-parametric test to compare survival functions when the hazards are proportional over time. However, in the case of non-proportional hazards, the log-rank test may no longer be optimal. While a number of statistical approaches have been invertigated to compare treatment effects on survival when the hazards are not proportional, they are still underused. This lack of application can be explained by the fact that it is currently unclear which approach should be used to design and analyze studies comparing cancer treatments. In this study, a particular focus is on immunotherapy treatments. The issue of how to compare treatment effects when the hazards are likely non-proportional is of major interest for contemporary cancer research due to the groundbreaking achievements of immunotherapy, which is typically characterized by a delayed treatment effect. The aim of this present master thesis was to compare the classical logrank test and methods designed to deal with non-proportional hazards. We reviewed the statistical properties of different approaches to deal with non-proportional hazards including the logrank test, methods based on the restricted mean survival time, generalized pairwise comparison, weighted log-rank and weighted Kaplan-Meier tests. We also performed an extensive simulation study to investigate their size under various scenarios. Finally, all methods are illustrated on the real EORTC 18991 trial outcome data.
Survival analysis --- non-proportional hazards --- comparison of surival methods --- logrank --- restricted mean survival time --- generalised pairwise comparison --- weighted logrank --- weighted Kaplan-Meier --- immunotherapy --- Physique, chimie, mathématiques & sciences de la terre > Mathématiques
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Oncology. Neoplasms --- Neoplasms --- Prognosis. --- Neoplasm Staging. --- Survival Rate. --- Cancer --- -Cancers --- Carcinoma --- Malignancy (Cancer) --- Malignant tumors --- Tumors --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- TNM Classification --- TNM Staging --- TNM Staging System --- Cancer Staging --- Staging, Neoplasm --- Tumor Staging --- Classification, TNM --- Classifications, TNM --- Staging System, TNM --- Staging Systems, TNM --- Staging, Cancer --- Staging, TNM --- Staging, Tumor --- System, TNM Staging --- Systems, TNM Staging --- TNM Classifications --- TNM Staging Systems --- Nomograms --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognoses --- Prognostic Factor --- diagnosis. --- Prognosis --- -diagnosis. --- Diagnosis. --- -Mean Survival Time --- Cancers
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Hodgkin Disease --- Prognosis. --- Survival Rate. --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- Prognoses --- metabolism. --- mortality. --- drug therapy. --- Theses --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognostic Factor --- Prognosis --- Survival Rate --- metabolism --- mortality --- drug therapy
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Heart Transplantation --- Waiting Lists. --- Survival Rate. --- Kidney Transplantation --- Tissue and Organ Procurement --- Tissue Donors --- #GBIB:CBMER --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- List, Waiting --- Lists, Waiting --- Waiting List --- mortality. --- physiology. --- organization & administration. --- supply & distribution. --- Theses --- Waiting Lists --- Survival Rate --- mortality --- physiology --- organization & administration --- supply & distribution --- Grafting, Kidney --- Renal Transplantation --- Transplantation, Kidney --- Transplantation, Renal --- Kidney Grafting --- Kidney Transplantations --- Renal Transplantations --- Transplantations, Kidney --- Transplantations, Renal --- Kidney --- transplantation
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Child. --- Infant. --- Liver Transplantation. --- Prognosis. --- Survival Rate. --- Mean Survival Time --- Cumulative Survival Rate --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognoses --- Prognostic Factor --- Grafting, Liver --- Hepatic Transplantation --- Transplantation, Hepatic --- Transplantation, Liver --- Hepatic Transplantations --- Liver Grafting --- Liver Transplantations --- Transplantations, Hepatic --- Transplantations, Liver --- Liver --- Infants --- Children --- Minors --- transplantation --- Theses --- Liver Transplant --- Liver Transplants --- Transplant, Liver --- Child --- Infant --- Liver Transplantation --- Prognosis --- Survival Rate
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Cancer --- Continuity of Patient Care. --- Neoplasms --- Quality of Health Care. --- Survival Rate. --- Survivors. --- Cancer. --- Treatment --- Patients --- therapy. --- Patients. --- Treatment. --- Cancer survivors --- Survivors, Cancer --- Cancers --- Carcinoma --- Malignancy (Cancer) --- Malignant tumors --- Long-Term Survivors --- Long Term Survivors --- Long-Term Survivor --- Survivor --- Survivor, Long-Term --- Survivors, Long-Term --- Mean Survival Time --- Cumulative Survival Rate --- Survivorship --- Cumulative Survival Rates --- Mean Survival Times --- Rate, Cumulative Survival --- Rate, Survival --- Rates, Cumulative Survival --- Rates, Survival --- Survival Rate, Cumulative --- Survival Rates --- Survival Rates, Cumulative --- Survival Time, Mean --- Survival Times, Mean --- Time, Mean Survival --- Times, Mean Survival --- Quality of Care --- Quality of Healthcare --- Care Qualities --- Care Quality --- Health Care Quality --- Healthcare Quality --- Continuity of Care --- Continuum of Care --- Care Continuity --- Care Continuity, Patient --- Care Continuum --- Patient Care Continuity --- Therapy --- Tumors --- Pharmacy Audit --- Audit, Pharmacy --- Pharmacy Audits --- Kanker. --- Overleving. --- Health Sciences --- Clinical Medicine --- Survival (emergency). --- Oncology
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