Regression modeling for cure factors on uterine cancer data using the reparametrized defective generalized Gompertz distribution

TL;DR

This paper introduces a reparametrized defective generalized Gompertz distribution model incorporating covariates and cure factors, using Bayesian inference, to analyze long-term survival in uterine cancer patients.

Contribution

It develops a novel reparametrized DGGD model with covariate effects and Bayesian estimation, advancing survival analysis with cured subpopulations.

Findings

Surgical intervention significantly improves survival.

Age over 50 increases risk of mortality.

Metastatic diagnosis and chemotherapy are associated with higher risk.

Abstract

Recent advances in medical research have improved survival outcomes for patients with life-threatening diseases. As a result, the existence of long-term survivors from these illnesses is becoming common. However, conventional models in survival analysis assume that all individuals remain at risk of death after the follow-up, disregarding the presence of a cured subpopulation. An important methodological advancement in this context is the use of defective distributions. In the defective models, the survival function converges to a constant value $p \in (0,1)$ as a function of the parameters. Among these models, the defective generalized Gompertz distribution (DGGD) has emerged as a flexible approach. In this work, we introduce a reparametrized version of the DGGD that incorporates the cure parameter and accommodates covariate effects to assess individual-level factors associated with long-term survival. A Bayesian model is presented, with parameter estimation via the Hamiltonian Monte Carlo algorithm. A simulation study demonstrates good asymptotic results of the estimation process under vague prior information. The proposed methodology is applied to a real-world dataset of uterine cancer patients. Our results reveal statistically significant protective effects of surgical intervention, alongside elevated risk associated with age over 50, diagnosis at the metastatic stage, and treatment with chemotherapy.