Cure mixture model based on hazard modeling nonproportional, application to esophageal cancer

Background Aim: Esophageal cancer is one of the main common causes of death. The high prevalence of esophageal cancer in northern Iran is an important public health problem. The main aim of this paper was to assess the factors affecting survival of patients with esophageal cancer in neighbor provinces around the Caspian Sea using Weibull mixture cure model and mixture cure model based on a non-proportional hazard. Methods Materials: This prospective study was designed to gather data of esophageal cancer from the Babol cancer registry, Iran, registered during 1990 to 1991. The study cases were also followed for a period of 15 years up to 2006. Mixture cure model via non-proportional hazard modeling was used to calculate cure fraction and investigate the factors responsible for the cure probability of patients. Estimates were obtained by maximization of the likelihood via SAS proc NLMIXED. Results: The median survival time was about 9 months and survival probability in 1, 3, and 5 years following diagnosis were 23%, 15% and 13%, respectively. The family history affected the cured fraction independently of its effect on the early outcome. In addition, it had significant effect on the probability of uncured state in the both models. Conclusion: The results demonstrated the great potential in cure modeling survival data via nonproportional hazard model compared to Weibull mixture cure model.