# Landmark and milestone survival (5-year survival, median follow-up)

Source: https://onco.cc/terms/landmark-survival/  
OnCo record `landmark-survival` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The percentage of patients alive (or progression-free) at a fixed time point such as 2, 5 or 10 years, read off a Kaplan-Meier survival curve. With immunotherapy the 'tail of the curve', the fraction still alive years later, often matters more than the median.

## Summary

Kaplan-Meier curves show the proportion of patients event-free over time; the median is the point where the curve crosses 50%, and landmark rates are read at fixed times. Medians can mislead when curves plateau (a durable tail after checkpoint inhibitors or CAR-T) or cross (delayed immunotherapy benefit), so milestone rates and restricted mean survival time supplement hazard ratios. Landmark analyses also compare outcomes from a fixed time conditional on status at that time (e.g. survival by MRD status at 12 months), avoiding immortal-time bias. Median follow-up indicates how mature the data are; 5-year rates need at least 5 years of follow-up in a reasonable number of patients to be reliable.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: landmark analysis; milestone survival; milestone analysis; 5-year survival; five-year survival; 5-year OS; 5-year PFS; 5-year survival rate; 10-year survival; 2-year survival; 3-year survival; 1-year survival; survival rate; survival rates; median follow-up; median follow up; long-term survival; long-term survivors; tail of the curve; Kaplan-Meier; Kaplan–Meier; survival curve; survival curves; curves separate; curves cross; restricted mean survival time; RMST; long-term survivor

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Kaplan%E2%80%93Meier_estimator
- Wikipedia: https://en.wikipedia.org/wiki/Kaplan%E2%80%93Meier_estimator

## Connected records

- terms: [Absolute versus relative benefit (number needed to treat)](https://onco.cc/terms/absolute-benefit/), [Data maturity (immature vs mature survival data)](https://onco.cc/terms/data-maturity/), [Hazard ratio (HR)](https://onco.cc/terms/hazard-ratio/), [Interim analysis, readout and data cut-off](https://onco.cc/terms/interim-analysis/), [Kaplan-Meier curve, censoring and proportional hazards](https://onco.cc/terms/kaplan-meier-curve/), [Overall survival (OS)](https://onco.cc/terms/os/), [Progression-free survival (PFS)](https://onco.cc/terms/pfs/), [Quality-adjusted survival (QALYs and Q-TWiST)](https://onco.cc/terms/quality-adjusted-survival/)
- fronts: [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/)
- trials: [CheckMate 067](https://onco.cc/trials/checkmate-067/), [KEYNOTE-024 & KEYNOTE-189](https://onco.cc/trials/keynote-024-189/)

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