JOINT MODELING OF A RECURRENT EVENT IN PROSTATE CANCER AND TIME TO TERMINATE OF PATIENTS IN TIKUR ANBESSA SPECIALIZED HOSPITAL

Abstract

Background: The prostate gland, an organ found in the male reproductive system, is where prostate cancer typically originates. Prostate cancer ranks fourth among malignancies diagnosed in men behind lung, colorectal, and stomach cancers worldwide. Recurring occurrences of the same or different kinds of events for specific people or units across time are referred to as recurrent events such as prostate cancer which is an important clinical indicator and the leading cause of prostate cancer mortality. The major aim of this study was to investigating predictors of prostate cancer recurrence and terminal events (death) due to prostate recurrence. Methodology: to reach the aim, 222 prostate cancer patients, between the study period January 1, 2018 to January 30, 2021, who were registered with detailed, comprehensive personal and medical information were include. The retrospective longitudinal study design was applied and the data were analyzed using joint frailty model on prostate CA and death that are recorded in the oncology department of Tikur Anbessa specialized hospital. To investigate determining factors of prostate cancer recurrence and death, a joint frailty model of the recurrent event and terminal event proposed by Liu and others i.e., the joint frailty proportional hazards model was used alongside reduced models for prostate CA recurrence and terminal event (death). Result: From the total of 432 recurrent observation, about 210 (61.1%) of them experienced recurrence of prostate cancer, 192 of the experienced death (terminated) event and 222 (38.9%) were censored. The shared gamma joint frailty model was chosen as the best fit for the prostate cancer data set based on the value of Likelihood cross validation criterion. From the result of shared gamma joint frailty model smoking, stage of prostate cancer, distance metastasize and Gleason score were significantly associated with recurrence of prostate cancer and death. Conclusion and recommendation: The result of shared gamma joint frailty model shows that the stage (III, IV), smoking, distance metastasize (metastasized tumor) and Gleason score were significantly increases the risk of recurrence of prostate cancer and death. While, quitting smoking may improve patients overall prognosis. Timely detection and management of metastasis in prostate cancer patients are crucial, necessitating focused treatment and surveillance. It is recommended that policy maker, ministry of health and Tikur Anbessa Specialized Hospital are expected to make intervention to improve the management and care of prostate cancer patients, ultimately enhancing their quality of life and prognosis.