A Markov model for analyzing the evolution of bladder carcinoma

A Markovian approach to analyze different states of the superficial vesical carcinoma is considered, taking into account up to two recurrences and the possibility of progression. So, three transient states are considered: free of disease, first, and second recurrence; and an absorbent state, the progression. A methodology based in phase-type distributions is also used, that allows the usual quantities of interest in survival studies to be expressed in a well-structured form. This type of distribution has shown its utility in queue theory, and has the advantage that mathematical expressions can be presented in a closed form that allows algebraic treatment. (C) 2009 Elsevier Ltd. All rights reserved.