Landmark Prediction of Survival for Breast Cancer Patients: A Case Study in Tehran, Iran

Breast cancer is the first non-cutaneous malignancy in women and the second cause of death due to cancer all over the world. There are situations where researchers are interested in dynamic prediction of survival of patients where traditional models might fail to achieve this goal. We aimed to use a dynamic prediction model in analyzing survival of breast cancer patients.

We used a data set originates from a retrospective cohort (registry-based) study conducted in 2014 in Tehran, Iran, information of 550 patients were available analyzed. A method of landmarking was utilized for dynamic prediction of survival of the patients. The criteria of time-dependent area under the curve and prediction error curve were used to evaluate the performance of the model.

An index of risk score (prognostic index) was calculated according to the available covariates based on Cox proportional hazards. Therefore, hazard of dying for a high-risk patient with breast cancer within the next five years was 2.69 to 3.04 times of that for a low-risk patient. The value of the dynamic C-index was 0.89 using prognostic index as covariate.

Generally, the landmark model showed promising performance in predicting survival or probability of dying for breast cancer patients in this study in a predefined window. Therefore, this model can be used in other studies as a useful model for investigating the survival of breast cancer patients.