• Smart Media Journal
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• v.9 no.4
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• pp.126-133
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• 2020

The treatment policy and prognosis are determined based on the final stage of lung cancer patients. The final stage of lung cancer patients is determined based on the T, N, and M stage classification table provided by the American Cancer Society (AJCC). However, the final stage of AJCC has limitations in its use for various fields such as patient treatment, prognosis and survival days prediction. In this paper, clustering algorithm which is one of non-supervised learning algorithms was assessed in order to check whether using only T, N, M stages with a data science method is effective for classifying the group of patients in the aspect of survival days. The final stage groups and T, N, M stage clustering groups of lung cancer patients were compared by using the cox proportional hazard model. It is confirmed that the accuracy of prediction of survival days with only T, N, M stages becomes higher than the accuracy with the final stages of patients. Especially, the accuracy of prediction of survival days with clustering of T, N, M stages improves when more or less clusters are analyzed than the seven clusters which is same to the number of final stage of AJCC.

• Journal of Gastric Cancer
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• v.21 no.1
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• Journal of East-West Nursing Research
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• v.29 no.2
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• pp.106-116
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• 2023

Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.11-16
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• 2017

Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{\pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${\geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.289-294
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• 2016

Background: The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ${\geq}96$ hours). Methods: We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results: The patients' mean age was $65.1{\pm}14.1$ years and 70.6% were male. The mean ICU and hospital length of stay was $21.9{\pm}19.7$ and $39.4{\pm}39.1$ days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was $2.3{\pm}1.8$, with significant differences between nonsurvivors and survivors ($2.7{\pm}2.1$ vs. $2.1{\pm}1.7$, p<0.05). The area under the curve of receiver-operating-characteristics curve for WIC was 0.593 (95% confidence interval [CI], 0.523-0.661; p<0.05). Based on Kaplan-Meier curves of 60-day survival, WIC ${\geq}5$ had statistically lower survival than WIC <5 (logrank test, p<0.05). In a multivariate Cox proportional hazard model, WIC ${\geq}5$ was associated with poor prognosis (hazard ratio, 1.901; 95% CI, 1.140-3.171; p<0.05). The mortality rate of patients with WIC ${\geq}5$ was 54.2%. Conclusion: Our study showed a WIC score ${\geq}5$ might be helpful in predicting 60-day mortality in PAMV patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.2979-2986
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• 2014

Background: Recently, peroxiredoxin3 (PRDX3) was identified as a novel molecular marker for the progression of hepatocellular carcinoma (HCC). However, its potential clinical application as a serum marker for the early diagnosis and prognosis of HCC has not been investigated. Methods: PRDX3, alpha-fetaprotein (AFP), and other biochemical parameters were measured in serum samples from 297 Chinese patients, including 96 with HCC, 98 with liver cirrhosis (LC), and 103 healthy controls (HCs). Correlations between serum PRDX3 expression and clinicopathological variables and the relationship between serum PRDX3 expression and prognosis were analyzed. Results: Serum PRDX3 was significantly higher in HCC patients than in the LC and HC groups. The sensitivity and specificity of serum PRDX3 for the diagnosis of HCC were 85.9% and 75.3%, respectively, at a cutoff of 153.26 ng/mL, and the area under the curve was 0.865. Moreover, serum PRDX3 expression was strongly associated with AFP level, tumor diameter, TNM stage, and portal vein invasion. Kaplan-Meier curve analysis revealed that HCC patients with high serum PRDX3 expression had a shorter median survival time than those with low PRDX3 expression. Moreover, serum PRDX3 expression was an independent risk factor for overall survival. The inverse correlation between serum PRDX3 and patient survival remained significant in patients with early-stage HCC and in those with normal serum AFP levels. Conclusions: Serum PRDX3 can be used as a noninvasive biomarker for the diagnosis and/or prognosis of HCC.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.691-694
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• 2014

Background: Tumor length in patients with esophageal cancer (EC) has recently received great attention. However, its prognostic role for EC is controversial. The purpose of our study was to characterize the prognostic value of tumor length in EC patients and offer the optimum cut-off point of tumor length by reliable statistical methods. Materials and Methods: A retrospective analysis was conducted on 71 consecutive patients with EC who underwent surgery. ROC curve analysis was used to determine the optimal cut-off point for tumor length, measured with a handheld ruler after formalin fixation. Correlations between tumor length and other factors were surveyed, and overall survival (OS) rates were compared between the two groups. Potential prognostic factors were evaluated by univariate Kaplan-Meier survival analysis. A P value less than 0.05 was considered significant. Results: There were a total of 71 patients, with a male/female divide of 43/28 and a median age of 59. Characteristics were as follows: squamous/adenocarcinoma, 65/6; median tumor length, 4 (0.9-10); cut-off point for tumor length, 4cm. Univariate analysis prognostic factors were tumor length and modality of therapy. One, three and five year OS rates were 84, 43 and 43% for tumors with ${\leq}4cm$ length, whereas the rates were 75, 9 and 0% for tumors >4 cm. There was a significant association between tumor length and age, sex, weight loss, tumor site, histology, T and N scores, differentiation, stage, modality of therapy and longitudinal margin involvement. Conclusions: Future studies for modification of the EC staging system might consider tumor length too as it is an important prognostic factor. Further assessment with larger prospective datasets and practical methods (such as endoscopy) is needed to establish an optimal cut-off point for tumor length.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.2
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• pp.65-72
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• 2014

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1369-1373
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• 2014

Objectives: To study application of the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) with $^{18}F$-FDG PET/CT for predicting prognosis of esophageal squamous cell cancer (ESC) patients. Methods: Eighty-six patients with ESC staged from I to IV were prospectively enrolled. Cisplatin-based chemoradiotherapy (CCRT) or palliative chemoradiotherapy were the main treatment methods and none received surgery. $^{18}F$-FDG PET/CT scans were performed before the treatment. SUVmax, MTV, and TLG were measured for the primary esophageal lesion and regional lymph nodes. Receiver operating characteristic curves (ROCs) were generated to calculate the P value of the predictive ability and the optimal threshold. Results: MTV and TLG proved to be good indexes in the prediction of outcome for the ESC patients. An MTV value of 15.6 ml and a TLG value of 183.5 were optimal threshold to predict the overall survival (OS). The areas under the curve (AUC) for MTV and TLG were 0.74 and 0.70, respectively. Kaplan-Meier analysis showed an MTV less than 15.6 ml and a TLG less than 183.5 to indicate good media survival time (p value <0.05). In the stage III-IV patient group, MTV could better predict the OS (P < 0.001), with a sensitivity and specificity of 0.80 and 0.67, respectively. Conclusions: Pre-treatment MTV and TLG are useful prognostic factors in nonsurgical ESC.