Long‐term survival with non‐proportional hazards: results from the Dutch Gastric Cancer Trial | Zendy

Putter H. | Zendy; Sasako M. | Zendy; Hartgrink H. H. | Zendy; van de Velde C. J. H. | Zendy; van Houwelingen J. C. | Zendy

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Long‐term survival with non‐proportional hazards: results from the Dutch Gastric Cancer Trial

Author(s) -

Putter H.,

Sasako M.,

Hartgrink H. H.,

van de Velde C. J. H.,

van Houwelingen J. C.

Publication year - 2005

Publication title -

statistics in medicine

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.996

H-Index - 183

eISSN - 1097-0258

pISSN - 0277-6715

DOI - 10.1002/sim.2143

Subject(s) - proportional hazards model , term (time) , cancer , survival analysis , medicine , oncology , statistics , mathematics , physics , quantum mechanics

Randomized clinical trials with long‐term survival data comparing two treatments often show Kaplan–Meier plots with crossing survival curves. Such behaviour implies a violation of the proportional hazards assumption for treatment. The Cox proportional hazards regression model with treatment as a fixed effect can therefore not be used to assess the influence of treatment of survival. In this paper we analyse long‐term follow‐up data from the Dutch Gastric Cancer Trial, a randomized study comparing limited (D1) lymph node dissection with extended (D2) lymph node dissection. We illustrate a number of ways of dealing with survival data that do not obey the proportional hazards assumption, each of which can be easily implemented in standard statistical packages. Copyright © 2005 John Wiley & Sons, Ltd.

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