Prognostic Factor Studies

Authored by: Martin Schumacher , Norbert Holländer , Guido Schwarzer , Harald Binder , Willi Sauerbrei

Handbook of Statistics in Clinical Oncology

Print publication date:  March  2012
Online publication date:  March  2012

Print ISBN: 9781439862001
eBook ISBN: 9781439862018
Adobe ISBN:

10.1201/b11800-30

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Abstract

Besides investigations on etiology, epidemiology, and the evaluation of therapies, the identification and assessment of prognostic factors constitutes one of the major tasks in clinical cancer research. Studies on prognostic factors attempt to determine survival probabilities, or, more generally, a prediction of the course of the disease for groups of patients defined by the values of prognostic factors, and to rank the relative importance of various factors. In contrast to therapeutic studies, however, where statistical principles and methods are well developed and generally accepted, this is not the case for the evaluation of prognostic factors. Although some efforts toward an improvement of this situation have been undertaken (Infante-Rivard et al. 1989; McGuire 1991; Clark 1992; Simon and Altman 1994; Altman and Lyman 1998), most of the studies investigating prognostic factors are based on historical data lacking precisely defined selection criteria. Furthermore, sample sizes are often far too small to serve as a basis for reliable results. As far as the statistical analysis is concerned, a proper multivariate analysis simultaneously considering the influence of various potential prognostic factors on overall or event-free survival (EFS) of the patients is not always attempted. Missing values in some or all of the prognostic factors constitute a serious problem which is often underestimated.

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