59: The Impact of Lymphovascular Invasion on 2-Year Survival in HNSC: A Copula Regression Approach

Music City Center 

Lymphovascular invasion (LVI) significantly impacts the survival of head and neck squamous cell carcinoma cancer. Traditional two-stage analyses risk biasing the estimate of the effect of the LVI on patient survival because of endogeneity. To address these issues, we propose a joint approach using a bivariate recursive copula model to estimate the effect of LVI status on two-year survival while controlling for potential endogeneity. This framework separates the joint model from the marginal distributions, offering a flexible dependence structure.
Using data from The Cancer Genome Atlas (TCGA), we integrate miRNA expression, clinical covariates, and demographic factors to estimate LVI's average treatment effect (ATE) on survival. Key miRNAs (e.g., hsa-miR-203a-3p, hsa-miR-194-5p, hsa-miR-337-3p) were analyzed for their association with survival outcomes. Results indicate that LVI significantly reduces 2-year survival, with an ATE of -47%. Age at diagnosis exhibits a nonlinear effect on survival outcomes. This study highlights the utility of copula models in addressing endogeneity and provides insights into the interplay between LVI, molecular biomarkers, and survival outcomes.

Lymphovascular invasion

survival analysis

copula regression

endogeneity

miRNA 

Biometrics Section