Assessment of prognostic factors in patients with primary ocular adnexal lymphoma when considering competing risk elements

Jing Zeng ^1,2, Xian-Fen Cao ^1,3, Jian Chen ¹

⁰Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Clinical & Experimental Ophthalmology +

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August 1, 2024

View abstract on PubMed

Summary

Competing risk models provide more accurate prognostic factors for primary ocular adnexal lymphoma (POAL) than traditional methods. This study highlights their importance for reliable survival analysis in POAL patients.

Area Of Science

Oncology
Ophthalmology
Biostatistics

Background

Accurate prognostic factors for primary ocular adnexal lymphoma (POAL) are limited.
Traditional survival models may produce statistical errors by not accounting for competing risks.
This study addresses the need for precise prognostic assessment in POAL.

Purpose Of The Study

To accurately assess prognostic factors in POAL patients using competing risk models.
To compare the accuracy of competing risk models against the traditional COX proportional hazards model for POAL prognosis.

Main Methods

Retrospective analysis of 846 B-cell POAL patients from the SEER program (2010-2015).
Utilized cumulative incidence function, Gray's test, Fine-Gray subdistribution hazard model, cause-specific model, and traditional COX model.
Multivariate analysis was performed using competing risk and COX models.

Main Results

Competing risk models identified age, laterality, histology subtype, AJCC stage T, and radiotherapy as independent predictors of cause-specific survival.
High consistency was observed between the two competing risk models.
The COX model demonstrated misestimations in statistical significance and hazard ratios compared to competing risk models.

Conclusions

Competing risk models offer a more accurate method for assessing prognostic factors in POAL.
These models provide a statistically sound approach, unlike traditional methods that neglect competing risk factors.
The findings emphasize the clinical utility of competing risk analysis for POAL patient outcomes.

Keywords:

Fine‐Gray SEER competing risk primary ocular adnexal lymphoma prognostic factors