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BMJ No 7119 Volume 315 Letters Saturday 22 November 1997
New method for expressing survival in cancerEditor,Vaidya and Mittra(1) have proposed an innovative method for expressing survival in cancer wherein both age at diagnosis and normal remaining life expectancy are incorporated into a modified calculation of actuarial survival curves. Even though other methods have previously been published in which a "lifetime" perspective was introduced in the survival analysis of oncologic(2)(3)(4) and non-oncologic(5) patients, the method of Vaidya and Mittra implies a fundamental change in the perspective of the analysis and, for this reason, seems to be particularly interesting. However, a few points in the article of Vaidya and Mittra need clarification. For example, the authors fail to specify if a long duration of follow-up (20 years of follow-up after diagnosis in their example on patients with breast cancer) is always required to convert standard actuarial survival curves into "real life expectancy" actuarial curves. In addition, further information would be helpful concerning the database of the 1,134 patients reported as an example because on the one hand the authors state that the capability of taking account of age at diagnosis is a key feature of their method, but on the other they fail to present the mean age (with SD and range) of the 1,134 patients presented in their example.
A Messori
Drug Information Centre,
Reference
1 Vaidya J S, Mittra I. Fraction of normal remaining life span:
a new method for expressing survival in cancer. BMJ 1997;
314:1682-4. (7 June.)
2 Messori A, Trippoli S, Becagli P, Tendi E. Pharmacoeconomic profile of paclitaxel as first-line treatment for patients with advanced ovarian cancer: a lifetime cost-effectiveness analysis. Cancer 1996;78:2366-73.
3 Messori A, Bonistalli L, Costantini M, Alterini R. Cost-effectiveness of autologous bone marrow transplantation in patients with relapsed non-Hodgkin’s Iymphoma. Bone Marrow Transplant 1997;19:275-281.
4 Messori A, Cecchi M, Becagli P, Trippoli S. Pharmacoeconomic profile of paclitaxel as first-line treatment for patients with advanced ovarian cancer: a lifetime cost-effectiveness analysis (Letter). Cancer 1997;79:2264-2265.
5 Beck J R, Pauker S G, Gottlieb J E, Klein K, Kassirer J P. A convenient approximation of life expectancy (the "DEALE"): use in medical decision-making. Am J Med 1982;73:883-97.
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