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Many clinical research and studies evaluate a time-to-event data, illustrate survival curves, and conventionally report an estimated hazard ratio to express the magnitude of the treatment effect when comparing between groups. However, it may not be straightforward to interpret the hazard ratio clinically and statistically when the proportional hazards assumption is invalid. In some recent papers published in clinical journals, the use of restricted mean survival time(RMST)or t-year mean survival time is discussed as one of the alternative summary measures for the time-to-event data. The RMST is defined as the expected value of time-to-event limited to a specific time point corresponding to the area under the survival curve up to the specific time point. This article summarizes the necessary information to conduct statistical analysis using the RMST, including the definition and statistical properties of the RMST, and clinical and statistical meaning and interpretation as compared with other summary measures of time-to-event data by application examples.
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Prostate
September 2025
Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.
Background: Prostate cancer (PCa) is the only cancer in men to exhibit androgen sensitivity at diagnosis, which has allowed for the development of androgen deprivation therapy (ADT). However, outcomes in high-risk PCa (HRPCa) remain significantly worse than low risk disease and the use of ADT varies among treatment algorithms and medical specialties. In men treated with radiation, testosterone recovery after completing ADT has been associated with oncologic outcomes.
View Article and Find Full Text PDFBiom J
October 2025
Department of Medical Biometry, Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.
Hazards constitute key quantities for analyzing, interpreting, and understanding time-to-event data. Hazards and corresponding effect measures, such as the hazard ratio from the Cox proportional hazards model, have a valid causal interpretation if the hazard function is considered as a function in time rather than hazards at specific time points. In this comment, we would like to add two points: (1) The hazard ratio is also a useful population-level estimand with a valid causal interpretation.
View Article and Find Full Text PDFRadiother Oncol
September 2025
Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address:
Purpose: To predict metastasis-free survival (MFS) for patients with prostate adenocarcinoma (PCa) treated with androgen deprivation therapy (ADT) and external radiotherapy using clinical factors and radiomics extracted from primary tumor and node volumes in pre-treatment PSMA PET/CT scans.
Materials/methods: Our cohort includes 134 PCa patients (nodal involvement in 28 patients). Gross tumor volumes of primary tumor (GTVp) and nodes (GTVn) on CT and PET scans were segmented.
J Clin Epidemiol
September 2025
School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB.
Introduction: Trial attrition threatens the validity of randomised controlled trials (hereafter trials) and has implications for trial design, conduct and analysis. Few studies have examined how attrition rates change over follow-up nor the types of attrition reported. Therefore, we estimated attrition rates using individual participant data for a range of conditions.
View Article and Find Full Text PDFJMIR Cancer
September 2025
Department of Health Outcomes and Biomedical Informatics, University of Florida, 1889 Museum Road, Suite 7000, Gainesville, FL, 32611, United States, 1 352 294-5969.
Background: Disparities in cancer burden between transgender and cisgender individuals remain an underexplored area of research.
Objective: This study aimed to examine the cumulative incidence and associated risk factors for cancer and precancerous conditions among transgender individuals compared with matched cisgender individuals.
Methods: We conducted a retrospective cohort study using patient-level electronic health record (EHR) data from the University of Florida Health Integrated Data Repository between 2012 and 2023.