• 제목/요약/키워드: Disease-specific survival rate

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골육종에서 수술 전 항암 약물치료가 생존에 미치는 영향 (Effect of Preoperative Chemotherapy on Survival in High-grade Localized Osteosarcoma of the Extremity)

  • 최은석;한일규;조환성;김한수
    • 대한골관절종양학회지
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    • 제18권2호
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    • pp.59-65
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    • 2012
  • 목적: 본 연구는 수술 전 항암 약물 치료가 전이가 없는 골육종 환자의 생존율과 전이에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 1984년부터 2010년까지 사지에 발생한, 전이가 없는 원발성 골육종으로 수술적 절제술과 수술 후 항암 약물 치료를 시행한 30세 미만의 환자 225명을 후향적으로 분석하였다. 평균 연령은 14.4세, 평균 추시기간은 9.1년이었다. 수술 후에만 항암 약물 치료를 시행한 군과 수술 전, 후 약물 치료를 시행했던 두군의 임상적 특성과 생존율을 비교하였다. 결과: 전체 225예 중 수술 후 약물 치료 군은 32예, 수술 전후 약물 치료 군은 193예였다. 수술 후 약물 치료 군은 절단 수술과(p<0.001), 전이의 빈도가 유의하게(p=0.004) 높았으며, 전이 발생시기도 빨랐다. 수술 후 약물 치료 군에서는 5년 생존율 51%로 수술 전후 약물 치료 군의 84%보다 낮았다(p=0.001). 국소재발은 유의한 차이가 없었다. 결론: 사지에 발생한 골육종 환자에서 수술 전 항암 약물 치료는 전이의 억제와 생존율 향상에 도움이 된다.

Retrospective study on factors affecting the prognosis in oral cancer patients who underwent surgical treatment only

  • Kim, Byeong-Guk;Kim, Jun-Hwa;Kim, Myung-In;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.3.1-3.9
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    • 2016
  • Background: This study was performed to evaluate their 5-year survival rates and identify the factors affecting the prognosis of oral cancer patients who had undergone surgical treatment only. Methods: Among 130 patients who were diagnosed with malignant tumor of oral, maxillofacial, and surgical treated in the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital within a period from January 2000 to December 2010, for 11 years, 84 patients were investigated who were followed up for more than 5 years after radical surgery; oral cancer is primary and received only surgical treatment. The survival rate according to gender, age, type and site of cancer, TNM stage, cervical lymph node metastasis and its stage, recurrence or metastasis, time of recurrence and metastasis, and differentiation were investigated and analyzed. Results: Overall, 5-year survival rate in patients who received only surgical treatment was 81.2 %, and disease-specific 5-year survival rate was 83.1 %. The disease-specific 5-year survival rate based on TNM stage, metastasis of cervical lymph node, N stage, and presence of recurrence/metastasis was a significant difference (p < 0.05). The disease-specific 5-year survival rate based on sex, age, type of tumor, primary site, and differentiation was not a significant difference (p > 0.05). Conclusions: These results suggest that good survival rate can be obtained with surgical treatment only, and stage of oral cancer, cervical lymph node metastasis and stage, recurrence or metastasis, time of recurrence, and metastasis have a significant effect on survival rate in oral cancer patients.

Prognostic Factors in Stage IIB Non-Small Cell Lung Cancer according to the 8th Edition of TNM Staging System

  • Shin, Jin Won;Cho, Deog Gon;Choi, Si Young;Park, Jae Kil;Lee, Kyo Young;Moon, Youngkyu
    • Journal of Chest Surgery
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    • 제52권3호
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    • pp.131-140
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    • 2019
  • Background: The purposes of this study were to evaluate the appropriateness of the stage migration of stage IIA non-small cell lung cancer (NSCLC) in the seventh edition of the tumor, node, and metastasis classification for lung cancer to stage IIB lung cancer in the eighth edition, and to identify prognostic factors in patients with eighth-edition stage IIB disease. Methods: Patients with eighth-edition stage IIB disease were subclassified into those with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease, and their recurrence-free survival and disease-specific survival rates were compared. Risk factors for recurrence after curative resection were identified in all included patients. Results: Of 122 patients with eighth-edition stage IIB NSCLC, 101 (82.8%) had seventh-edition stage IIA disease and 21 (17.2%) had seventh-edition stage IIB disease. Nonsignificant differences were observed in the 5-year recurrence-free survival rate and the 5-year disease-specific survival rate between the patients with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease. Visceral pleural invasion was a significant risk factor for recurrence in patients with eighth-edition stage IIB NSCLC. Conclusion: The stage migration from seventh-edition stage IIA NSCLC to eighth-edition stage IIB NSCLC was appropriate in terms of oncological outcomes. Visceral pleural invasion was the only prognostic factor in patients with eighth-edition stage IIB NSCLC.

Epidemiology of PAH in Korea: An Analysis of the National Health Insurance Data, 2002-2018

  • Albert Youngwoo Jang;Hyeok-Hee Lee;Hokyou Lee;Hyeon Chang Kim;Wook-Jin Chung
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.313-327
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    • 2023
  • Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

Effect of Neurotrophic Factors on Neuronal Stem Cell Death

  • KimKwon, Yun-Hee
    • BMB Reports
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    • 제35권1호
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    • pp.87-93
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    • 2002
  • Neural cell survival is an essential concern in the aging brain and many diseases of the central nervous system. Neural transplantation of the stem cells are already applied to clinical trials for many degenerative neurological diseases, including Huntington's disease, Parkinson's disease, and strokes. A critical problem of the neural transplantation is how to reduce their apoptosis and improve cell survival. Neurotrophic factors generally contribute as extrinsic cues to promote cell survival of specific neurons in the developing mammalian brains, but the survival factor for neural stem cell is poorly defined. To understand the mechanism controlling stem cell death and improve cell survival of the transplanted stem cells, we investigated the effect of plausible neurotrophic factors on stem cell survival. The neural stem cell, HiB5, when treated with PDGF prior to transplantation, survived better than cells without PDGF. The resulting survival rate was two fold for four weeks and up to three fold for twelve weeks. When transplanted into dorsal hippocampus, they migrated along hippocampal alveus and integrated into pyramidal cell layers and dentate granule cell layers in an inside out sequence, which is perhaps the endogenous pathway that is similar to that in embryonic neurogenesis. Promotion of the long term-survival and differentiation of the transplanted neural precursors by PDGF may facilitate regeneration in the aging adult brain and probably in the injury sites of the brain.

Prognostic Factors and the Role of Adjuvant Chemotherapy in Post-curative Surgery for Dukes B and C Colon Cancers and Survival Outcomes: a Malaysian Experience

  • Hassan, Astrid Sinarti;Naicker, Manimalar;Yusof, Khairul Hazdi;Ishak, Wan Zamaniah Wan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2237-2243
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    • 2015
  • Background: Adjuvant chemotherapy improves survival in Dukes C colon cancers post-curative resection. However, the evidence for a role with Dukes B lesions remains unproven despite frequent use for disease characterized by poor prognostic features. In view of limited Asia-specific data, this study aimed to determine survival outcomes and identify prognostic factors in a tertiary teaching hospital in Malaysia. Materials and Methods: A total of 116 subjects who underwent curative surgery with and without adjuvant chemotherapy for Duke B and C primary colon adenocarcinomas diagnosed from 2004-2009 were recruited and data were collected retrospectively. Five-year overall survival (OS) and disease free survival (DFS) were analysed using Kaplan-Meier survival analysis and log-rank (Mantel-Cox) test. Prognostic factors were determined using Cox proportional hazards regression with both univariate and multivariate analyses. Results: The survival analysis demonstrated a 5-year OS of 74.0% for all patients, with 74.9% for Dukes C subjects receiving chemotherapy compared to 28.6% in those not receiving chemotherapy (p=0.001). For Dukes B disease, the 5-year survival rate was 82.6% compared to 75.0% for subjects receiving and not receiving chemotherapy, respectively (p=0.17). Independent prognostic factors identified included a CEA level more than 3.5 ng/ml (hazard ratio (HR)=4.78; p=0.008), serosal involvement (HR=3.75; p=0.028) and completion of chemotherapy (HR= 0.20; p=0.007). Conclusions: In a regional context, this study supports current evidence from the West that adjuvant chemotherapy improves survival in Dukes C colon cancers post curative surgery. However, although a clear benefit has yet to be proven for Dukes B disease, our results suggest survival improvement in selected cases.

Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients with Comorbidities

  • Natsagdorj, Enerelt;Kim, Sang Gyun;Choi, Jinju;Kang, Seungkyung;Kim, Bokyung;Lee, Eunwoo;Chung, Hyunsoo;Cho, Soo-Jeong
    • Journal of Gastric Cancer
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    • 제21권3호
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    • pp.258-267
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    • 2021
  • Purpose: As the rate of endoscopic resection for early gastric cancer (EGC) has increased in patients with comorbid diseases, it is necessary to elucidate the efficacy of endoscopic submucosal dissection (ESD) for EGC in patients with comorbidities. This study aimed to analyze the clinical outcomes of ESD for EGC in patients with comorbidities. Materials and Methods: A total of 969 patients with 1,015 lesions who underwent ESD for EGC at Seoul National University Hospital between 2010 and 2014 were analyzed. The short- and long-term clinical outcomes were evaluated according to the comorbidity status. Results: Comorbidities were observed in 558 patients (57.6%). The comorbidity group had a higher proportion of patients using antithrombotic agents (29.5% vs. 0.9%; P<0.0001). Although procedure-related complications (bleeding and perforation) were not significantly different between the two groups, the length of hospital stay was significantly longer (1.8 vs. 1.4 days, P=0.023), while survival was significantly shorter in the comorbidity group (5-year overall survival rate: 90.5% vs. 97.2%, P<0.0001; 5-year disease-specific survival rate: 97.9% vs. 100%, P=0.018; 5-year disease-free survival rate: 83.4% vs. 89.2%, P=0.007). Conclusions: Gastric ESD can be performed in patients with comorbidities without increasing the risk of complications.

성문상부암에서의 경구강 $CO_2$ 레이저 수술과 동시경부청소술 (Simultaneous Neck Dissection in Transoral $CO_2$ Laser Surgery for Supraglottic Cancer)

  • 김성원;이강대
    • 대한두경부종양학회지
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    • 제25권1호
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    • pp.18-23
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    • 2009
  • Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

내과적 문제로 수술이 불가능한 조기 비소세포성 폐암에서의 방사선치료 (Radiotherapy in Medically Inoperable Early Stage Non-small Cell Lung Cancer)

  • 김보경;박찬일
    • Radiation Oncology Journal
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    • 제18권4호
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    • pp.257-264
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    • 2000
  • 목적 : 조기 비소세포성 폐암의 경우 수술이 최선의 치료법으로 생각 되고있다. 환자가 내과적인 질환으로 수술이 불가능한 경우, 혹은 수술을 거부한 경우 방사선치료가 수술의 대체적 치료로 사용 가능하다. 근치적방사선치료를 시행 받은 환자에서의 치료성적 및 이에 영향을 미치는 요인의 분석을 통하여 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 대상 및 방법 : 서울대학교병원 치료방사선과에서 1987년 6월부터 1997년 6월 사이에 치료를 시행 받은 조직학적으로 진단된 조기 비소세포성 폐암 환자 32명을 대상으로 하였다. 수술이 불가능했던 이유로는 폐질환이 21명으로 가장 많았다. 대상환자의 중간 연령은 68세였으며, 조직학적으로는 편평상피암이 24명으로 가장 많았다. 임상 병기는 T1, T2, T3가 각각 5명, 25명, 2명이었으며, 진단시의 종양의 크기는 3$\~$5 cm가 13명으로 가장 많았다. 방사선치료는 6 MV또는 10 MV 선형가속기를 이용하여, 종양부위에 54.0$\~$68.8 Gy (중앙값; 61.2 Gy)를 조사하였고 12명의 환자에서는 동시분할조사를 시행하였다. 추적관찰기간은 2개월에서 93개월 (중앙값; 23개월)이었고, 생존기간은 치료개시일을 기준으로 산정하였다. 결과 : 전체생존률은 코년, 5년이 각각 44.6$\%$, 24.5$\%$이었으며, 무병생존률은 38.9$\%$, 28.3$\%$, 중앙생존기간은 23개월이었다. 전체환자 32명중 최종 추적관찰 시 25명이 사망하였으며, 이중 7명이 페암이외의 질환으로 사망하였다. 단변량분석 상 종양의 크기는 전체생존률과 무병생존률에 통계적으로 유의한 영향을 주는 요인으로 판정되었고 (p=0.0015, p=0.0022), T 병기는 전체생존률에 의미있는 요인으로 판정되었다(p=0.0395). 다변량분석 상 종양의 크기는 무병생존률에 통계적으로 의미있는 요인으로 판정되었으며(p=0.0317), 전체생존률에 영향을 주는 경향을 보였다 (p=0.0649). 종격동의 방사선조사 여부는 생존률에 영향을 주지 않았다. 결론 : 근치적방사선치료는 조기 비소세포성 폐암 환자로 내과적인 질환으로 수술 불가능한 경우나 환자가 수술을 거부한 경우, 특히 T1 또는 3 cm 이하의 종양에서는 수술적치료를 대치할 수 있는 치료법이다. 그러나 종양의 크기가 5 cm를 넘는 경우에는 방사선치료만으로는 장기생존자가 거의 없었으며, 따라서 이러한 환자의 치료에 있어 과분할조사나 기관지내 추가조사, 방사선감작제의 사용, 입체조형방사선치료, 강도변조방사선치료 등의 이용을 고려해야 할 것이다.

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Evaluation of feed types based on growth performance, survival, hematology, and resistance in celebes rainbow (Marosantherina ladigesi)

  • Amrullah;Wahidah;Khusnul Khatimah;Ardiansyah;Eka Rosyida;Imam Taufik
    • Fisheries and Aquatic Sciences
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    • 제26권10호
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    • pp.583-592
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    • 2023
  • Celebes rainbow (Marosantherina ladigesi) is one of Indonesia's exported ornamental fish commodities, but the exploitation of this fish only relies on wild catches. The rise of unlimited fishing, especially those using poison, has changed the aquatic environment, threatening sustainability and causing fish extinction. This study aimed to evaluate the effectiveness of several types of feed in improving the absolute growth rate (AGR), specific growth rate (SGR), survival rate (SR), feed conversion ratio (FCR), feed efficiency (FE), hematology, and immune response of Celebes rainbow. The fish used in this study were male ornamental Celebes rainbow (M. ladigesi) weighing 1.32 ± 0.21 g/ind, reared in 54 L-aquariums at a stocking density of 30 individuals/aquarium for six weeks. The fish were fed according to the test diet consisting of live Tubifex sp worms, dry Tubifex sp worms, Spirulina platensis, and crumble pellets. The parameters observed were AGR, SGR, SR, FCR, FE, hematology, intestinal histology, liver histology, and a challenge test with the pathogenic bacteria Aeromonas hydrophila. The results showed that fish-fed live Tubifex sp worms had better AGR, SGR, SR, FCR, FE, hematology, and disease resistance compared to all other treatments. These results indicate that live Tubifex sp worms are the best feed for rearing Celebes rainbow.