Strategic Survival Analysis of Gastric Cancer Patients for Augmented Reality: A Comparison of the Cox Proportional Hazard and Accelerated Failure Time

Introduction

Gastric cancer is a condition in which malignant (cancerous) cells grow in the stomach lining (A. Alim.et al.,(2020)).It is a challenging condition that can be treated if caught early enough, although it is seldom cured. Although the global incidence of stomach cancer has reduced, it is still the world's fifth most prevalent cancer. In 2018, there were 1,033,701 new cancer cases and 782,685 deaths worldwide (F. Bray, et al., (2018)).These cancers account for 5.7% of all new cancer cases and 8.2% of all cancer deaths in 2018 (H. Sung,et al., (2018)).Furthermore, according to GLOBOCAN 2020, there are 1,089,103 new cases of stomach cancer each year, accounting for 5.6% of all cancers worldwide. These cancers account for 5.7% of all new cancer cases and 7.7% cases of all cancer deaths (M.C.S. Wong,et al (2021)). Although there are signs that the incidence of this cancer is decreasing, it remains the world's leading cause of death (Dadheech, Pankaj, et al.(2022)).

Despite improvements in incidence and mortality worldwide, stomach cancer remains the world's second most frequent malignancy (L.A. Torre,et al.(2015)). According to many studies, the prognosis of stomach cancer is dismal, with a 5-year survival rate of 15–29 percent (M. Balakrishnan,et al.(2017)). In Ethiopia, the postoperative death rate was estimated to be 18.6 percent (O. Johnson,et al.(2000)). Because it is frequently detected at advanced stages, gastric cancer has a low survival rate, and due to its rare symptoms at an early stage, gastric cancer is difficult to treat (V. Catalano, et al.(2009)).

According to various literature;age, diet, and stomach infections can affect the risk of developing gastric cancer (S. Tsugane,et al.(2007)). Different studies also reported that the most common causes of stomach cancer are smoking, alcohol intake, smoked and flavored foods, helicobacter pylori infection, hemolytic anemia, protracted atrophic gastritis, intestinal metaplasia, prior gastric surgeries, and inherited diffuse gastric cancer syndrome(S. Tsugane,et al.(2007)). Furthermore, advanced tumor size, advanced stage of disease, older age, and complementary treatment patients took initially were reported as a risk factor or for the survival of gastric cancer patients (Y. Hu,et al.(2014)). In addition, obesity, red meat, and a low socioeconomic position are all reported to be key risk factorsfor stomach cancer (P. Rawla,et al.(2019)).

To examine the effects of numerous determinants on gastric cancer patient survival, various statistical approaches are available. The two most common types of models in survival analysis are proportional hazards (PH) and accelerated failure-time (AFT).Although proportional hazards (PH) models are commonly used to analyze survival data, the assumption that the hazards are proportional is rarely realized (P. Hougaard,(2012)). When there are many predictors and all predictors in a multivariate analysis must meet the PH assumption, the problem becomes even worse. When the proportional hazard model is not acceptable, estimates from the Cox regression model will result in an improper fitting of the model and misleading inferences. In such cases, AFT models are very crucial (A.D. Tsodikov,et al.(2003)).Because these models use a parametric distribution for the survival times, statistical inference is more precise and the model is properly fitted.Parametric AFT models likeexponential, Weibull, log-logistic, lognormal, and Generalized Gamma are some of the most often utilized AFT models. Among these parametric models, exponential & Weibull parametric models can be used in both PH and AFT metrics (C. Cox,et al.(2007)).