• Title/Summary/Keyword: Kaplan Meier analysis

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Efficacy and Safety of the Safe Triangular Working Zone Approach in Percutaneous Vertebroplasty for Spinal Metastasis

  • Bi Cong Yan;Yan Feng Fan;Qing Hua Tian;Tao Wang;Zhi Long Huang;Hong Mei Song;Ying Li;Lei Jiao;Chun Gen Wu
    • Korean Journal of Radiology
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    • v.23 no.9
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    • pp.901-910
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    • 2022
  • Objective: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. Materials and Methods: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. Results: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). Conclusion: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

The Use of an Iliac Branch Device: Single-Center Study of Endovascular Preservation of Internal Iliac Artery Flow (장골 분지 장치 사용: 내장골동맥 흐름의 혈관내 보존에 대한 단일 기관의 경험)

  • Hyeseung Lee;Jeong-min Lee;Soongu Cho;JungUi Hong
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1339-1349
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    • 2023
  • Purpose To determine the efficacy and safety of iliac branch device (IBD) implantation and to evaluate its limitations based on 7 years of experience in a single center. Materials and Methods This single-center study included patients with bilateral common iliac artery aneurysms (CIAAs). We investigated follow-up CT and reviewed the internal iliac artery (IIA) patency and complications related to IBD. A retrospective analysis was performed and the overall survival rate and freedom from reintervention rate were reported according to the Kaplan-Meier method. Results Of the 38 patients with CIAAs, only 10 (12 CIAAs) were suitable for IBD treatment. Five patients underwent unilateral IBD insertion with contralateral IIA embolization, and three (60%) showed claudication; however, symptoms resolved within 6 months. The 7-year freedom from IBD-related reintervention rate was 77.8%. No procedure-related deaths occurred. Conclusion IBD has good technical success and long-term patency rates; however, anatomical factors frequently limit its application, particularly in Asians. Additionally, unilateral IIA embolization showed relatively mild complications and a good prognosis; therefore, it can be performed safely for anatomically complex aortoiliac aneurysms.

Prognostic Value of Early Postoperative Intraperitoneal Chemotherapy in Resectable Advanced Gastric Cancer (절제 가능한 진행위암에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치)

  • Yu Wansik;Chung Ho Young;Sugarbaker Paul H.
    • Journal of Gastric Cancer
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    • v.1 no.4
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    • pp.197-201
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    • 2001
  • Purpose: There are variants of gastric cancer assoclated with predominantly peritoneal spread of with haematogenous metastases. Perioperative intraperitoneal chemotherapy as an adjuvant to surgery is considered as a rational therapeutic modality to prevent peritoneal spread. We evaluated the influence of early postoperative intraperitoneal chemotherapy on the prognosis of resectable advanced gastric cancer. Materials and Methods: From 1990 to 1995, 246 patients with biopsy proven advanced gastric cancer were enrolled in the study. Among them 123 patients received early postoperative intraperitoneal mitomycin C and 5-fluorouracil. The survival rate was calculated using by the Kaplan-Meier method and was compared using the log-rank test according to 13 clinico-pathologic factors. Multivariate analysis was performed with the Coxproportional hazards model. Results: Gastric resection plusearly postoperative intraperitoneal chemotherapy showed an improved survival rate as compared to surgery alone ($54.1\%\;versus\;40.3\%;$ P=0.0325). Depth of tumor invasion, degree of regional lymph vode metastasis, distant metastasis, tumor size, tumor location, extent of gastric resection, and curability of surgery significantly influenced survival. When a multivariate analysis was performed, depth of tumor invasion, lymph node metastasis, early postoperative intraperitoneal chemotherapy, curability of surgery, and extent of gastric resection emerged as the statistically significant and independent prognostic factors. Conlusion: Early postoperative intraperitoneal chemotherapy is one of the independent prognostic indicators of resectable advanced gastric cancer.

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China's Brain Gain at the High End: An Assessment of Thousand Youth Talents Program

  • Sun, Yutao;Guo, Rongyu;Zhang, Shuai
    • Asian Journal of Innovation and Policy
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    • v.6 no.3
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    • pp.274-294
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    • 2017
  • While studies have viewed the effect of Chinese talent-attracting programs launched by government since reform and open door policy, little of them has assessed these programs empirically and pertinently. This article intends to assess an important program - the Thousand Youth Talents Program (TYTP). Frist, this paper proposed a transnational migration matrix of the academics to clarify the dynamic mechanism of academic brain gain at the high end. Then, the Kaplan-Meier analysis and Cox regression model are used to empirically analyze the policy effect of TYTP. The results show that, academic ability have double edged impacts on brain gain at the high end, some scholars whose last employer's academic ranking is world's Top100 have stronger willing to return, and the negative effect of academic ranking decreases with time passing; while scholars with a tenure-track position, a tenure position or a permanent position tend to stay overseas, and the hazard rate of staying increases with age. The older scholars have more intentions to go back China, while gender was not a significant factor influencing academic return at the high end. That is, the talent-attracting programs has partly succeeded in bringing back the academics at the high end.

Does Microinvasive Adenocarcinoma of Cervix Have Poorer Treatment Outcomes than Microinvasive Squamous Cell Carcinoma?

  • Ruengkhachorn, Irene;Hanamornroongruang, Suchanan;Leelaphatanadit, Chairat;Sangkarat, Suthi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4013-4017
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    • 2016
  • Background: To compare the pathological findings and oncologic outcomes of stage IA cervical carcinoma patients, between adenocarcinoma and squamous cell carcinoma cases. Materials and Methods: A total of 151 medical records of stage IA cervical carcinoma patients undergoing primary surgical treatment during 2006-2013 were reviewed. Information from pathological diagnosis and recurrence rates were compared with descriptive statistical analysis. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis. Results: The median age was 48.9 years. There was no significant difference in rates of lymph node, parametrium, uterine, vaginal, or ovarian metastasis, when comparing adenocarcinoma with squamous cell carcinoma. Overall recurrence rates of adenocarcinoma (5.7%) and squamous cell carcinoma (2.6%) were not statistically significant different, even when stratified by stage. When comparing progression free survival with squamous cell carcinoma, adenocarcinoma had an HR of 0.448 (0.073-2.746), p=0.386. Conclusions: Microinvasive adenocarcinoma of cervix has similar rate of extracervical involvement and oncologic outcomes to squamous cell carcinoma.

Survival of Colorectal Cancer in the Presence of Competing-Risks - Modeling by Weibull Distribution

  • Baghestani, Ahmad Reza;Daneshvar, Tahoura;Pourhoseingholi, Mohamad Amin;Asadzadeh, Hamid
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1193-1196
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    • 2016
  • Background: Colorectal cancer (CRC) is the commonest malignancy in the lower gastrointestinal tract in both men and women. It is the third leading cause of cancer-dependent death in the world. In Iran the incidence of colorectal cancer has increased during the last 25 years. Materials and Methods: In this article we analyzed the survival of 447 colorectal patients of Taleghani hospital in Tehran using parametric competing-risks models. The cancers of these patients were diagnosed during 1985 - 2012 and followed up to 2013. The purpose was to assess the association between survival of patients with colorectal cancer in the presence of competing-risks and prognostic factors using parametric models. The analysis was carried out using R software version 3.0.2. Results: The prognostic variables included in the model were age at diagnosis, tumour site, body mass index and sex. The effect of age at diagnosis and body mass index on survival time was statistically significant. The median survival for Iranian patients with colorectal cancer is about 20 years. Conclusions: Survival function based on Weibull model compared with Kaplan-Meier survival function is smooth. Iranian data suggest a younger age distribution compared to Western reports for CRC.

Survival and Clinical Aspects for Patients with Chronic Lymphocytic Leukemia in Kermanshah, Iran

  • Payandeh, Mehrdad;Sadeghi, Edris;Sadeghi, Masoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7987-7990
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    • 2015
  • Chronic lymphocytic leukemia (CLL)is the most common leukemia in adults in Western countries but is relatively rare in Asia. Immune hemolytic anemia, Evan's syndrome, lymphadenopathy, organomegaly and B symptoms are the main complaints of patients in CLL. The present retrospective analysis evaluated a group of 109 patients with CLL over a 9-year period, studying correlations between sex, age and overall survival. The patients were hospitalized in the Clinic of Hematology and Oncology, Kermanshah, Iran, between 2006 and 2014. Data analysis for sex and age was performed using IBM SPSS19 and overall survival was plotted by Kaplan-Meier plot, Log-rank test in Graph Pad prism 5 Software for five-year periods. The mean age of diagnosis for CLL patients was 60.73 years, 59.6% male. Survival rate patients was 64% and mean overall survival was 38.5 months. In the Rai system, fourteen patients (12.8%) had stage III and twenty eight patients (25.7%) had stage IV. Most frequent clinical features in patients with CLL were lymphadenopathy (38.7%) and organomegaly (34%), respectively. There is not relationship between sex and age in patients but overall survival rate in females was higher than in males. In Asian countries, CLL is more in male and in age above 60 years. Complaints about lymphadenopathy and virus infection are prevalent.

Factors Affecting Survival in Patients with Colorectal Cancer in Shiraz, Iran

  • Zare-Bandamiri, Mohammad;Khanjani, Narges;Jahani, Yunes;Mohammadianpanah, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.159-163
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    • 2016
  • Background: Colorectal cancer (CRC) is the third most common cancer in the world, and the fourth in Iran in both genders. The aim of this study was to find predictive factors for CRC survival. Materials and Methods: Medical records of 570 patients referred to the radiotherapy oncology department of Shiraz Namazi hospital from 2005 to 2010 were retrospectively analysed. Data were collected by reviewing medical records, and by telephone interviews with patients. Survival analysis was performed using the Cox's regression model with survival probability estimated with Kaplan-Meier curve. The log-rank test was used to compare survival between strata. Data was analyzed with Stata 12. Results: The five-year survival rate and the mean survival time after cancer diagnosis were 58.5% and $67{\pm}4months$. On multivariate analysis, age of diagnosis, disease stage and primary tumor site, lymphovascular invasion and type of treatment (in colon cancer) were significant factors for survival. Conclusions: Age of diagnosis and type of treatment (adjuvant therapy in patients with colon cancer) were two modifiable factors related to survival of CRC patients. Therefore earlier diagnosis might help increase survival.

Factors Predicting Survival of Patients with Gastric Cancer

  • Lin, Wen-Li;Sun, Jia-Ling;Chang, Shu-Chan;Wu, Pei-Hua;Huang, Wen-Tsung;Tsao, Chao-Jung
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5835-5838
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    • 2014
  • Background: Gastric cancer is one of the most common causes of cancer death in Taiwan. The literature has previously shown that age, tumor site, T categories, and number of metastatic nodes significantly affect prognosis. The aim of this study was to determine the long-term survival of patients with gastric cancer, as well as the effect of particular prognostic factors on survival. Materials and Methods: This was a survival analysis study with retrospective design. We reviewed the records of 64 patients with adenocarcinoma of the stomach who had undergone gastrectomy with curative intent between 2009 and 2012 at a teaching hospital in southern Taiwan. Data extracted from patient documents included age, gender distribution, tumor location, and pathological grading. Results: The median follow-up time was 4 years, and there were 31 deaths attributed to gastric cancer. Kaplan-Meier analysis revealed that retrieval of less than 15 lymph nodes from a patient was a significant predictor of survival. A significant predictor of poorer survival was higher pathological grading. Conclusions: Our results indicate that the number of lymph nodes retrieved and pathological grading could be viewed as crucial prognostic factors affecting the survival of individuals with gastric cancer.

Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis (상급종합병원 입원환자의 낙상 위험요인: 생존분석으로)

  • Cho, Young Shin;Lee, Young Ock;Youn, Young Sun
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.57-70
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    • 2019
  • Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.