• Title/Summary/Keyword: Median survival time

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The Prognostic Value of Oligo-Recurrence Following Esophagectomy for Esophageal Cancer

  • Minsang Kang;Woojung Kim;Chang Hyun Kang;Kwon Joong Na;Samina Park;Hyun Joo Lee;In Kyu Park;Young Tae Kim
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.403-411
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    • 2023
  • Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy as Treatment Options for Peritoneal Metastasis of Advanced Gastric Cancer

  • Kim, Dong-Wook;Park, Dong-Guk;Song, Sanghyun;Jee, Ye Seob
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.296-304
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    • 2018
  • Purpose: This study aimed to examine the outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis (PM) of advanced gastric cancer (AGC). Materials and Methods: Between May 2015 and June 2017, 38 CRS and HIPEC procedures were performed in patients with PM of AGC at the Dankook University Hospital. We prospectively collected and analyzed data regarding PM grade, morbidity and mortality rates, and short-term follow-up results (median, 13.5 months). Results: The mean peritoneal cancer index was 15 (range, 0-39). Complete cytoreduction was achieved in 21 patients (55.2%), whereas complications occurred in 16 (42.1%) and 2 (5.7%) patients died. The overall median patient survival time was 19 months. The patients who underwent complete cytoreduction had a median survival time of 26 months, which was significantly longer than the median survival time of 16 months in the patients who did not undergo complete cytoreduction (P=0.006). Conclusions: CRS with HIPEC may have a beneficial effect in patients with PM of AGC. However, the rates of complications and mortality associated with this combined therapeutic approach are high. Therefore, this treatment should be performed only in selected patients by surgeons experienced in the field of gastric cancer with PM.

Surgical Resutls of Stage IV Non-Small Cell Lung Cancer(NSCLC) (제4기 비소세포성 폐암 환자의 수술 결과)

  • 맹대현;정경영;김길동;김도균
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.301-305
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    • 2000
  • Background: The surgical indications of stage IV non-small cell lung cancer(NSCLC) are extremely limited with its controversial results. We analyzed the surgical results and survival in selected patients with resectable stage IV NSCLC. Material and Method: We reviewed the medical records of 21 patients who underwent operation for stage IV NSCLC from Jan. 1992 to Sep. 1999. Result: The mean age of patients was 55.6 years(range: 35 to 78). Sixteen were men and 5 were women. Tissue types were squamous cell carcinoma in 10(45.5%), adenocarcinoma in 9(40.9%), large cell carcinoma in 1 and carcinosarcoma in 1. Distant metastatic lesions were ipsilateral other lobe of lung in 18, brain in 2 and adrenal gland in 1. Pneumonectomy was performed in 16 patients, bilobectomy in 3, and lobectomy in 2 who underwent previous operatin for brain metastasis. Mean follow-up duration was 21.2$\pm$17.7 months. During follow-up period, 13 patients died. Three-and 5-year survival of patients were 38.0% and 19.0%, the median survival time was 19.1$\pm$7.8 months. In the group with ipsilateral pulonary metastasis(PM, n=18), 3- and 5-year survival of patients with N0 and N1(n=9) disease were 64.8% and 32.4%, median survival time was 55.3$\pm$27.2 months. Three-year survival of patients with N2(n=9) disease was 11.1%, median survival time was 10.6$\pm$0.3 months. The survival of N0 and N1 disease group was significantly better than that of N2 disease group(p=0.042). Also the disease free survival of N0 and N1 was significantly better than that of N2 disease in overall group(53.3 months vs 12.1 months, p=0.036) and ipsilateral PM group(63.4 months vs 8.8 months, p=0.001). Conclusion: We suggest that surgical treatment is worthful modality in well selected patients with stage IV NHSCLC especially with ipsilateral PM and N0 or N1 disease,. Nevertheless our study indicate questions that will need to be experienced further in larger studies.

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Surgical Management of Metastatic Lung cancer (전이성 폐암의 외과적 고찰)

  • Kim, Gil-Dong;Jeong, Gyeong-Yeong
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.281-286
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    • 1994
  • From 1973 through June 1993, 25 patients underwent pulmonary resection for pulmonary metastases from carcinoma or sarcoma at our institution. There were 11 carcinomas and 14 sarcomas. 24 patients[96% complete] could follow-up and the median follow-up time was 20 months with a range of 4 months to 271 months and total follow-up period was 1105 months-patients. In our patients, actuarial 5-year survival rate was 49%, mean survival time was 66.6$\pm$12.6 months and median survival time was 84 months. Patients with sarcoma, more than 24 months of the tumor-free interval, postoperative adjuvant therapy had a better survival than did those with carcinoma, less than 24 months of the tumor-free interval, no postoperative adjuvant therapy. But there were no statistical differences between two groups[P>0.05]. This results recommend more aggressive surgical treatment for pulmonary metastases.

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Confidence Intervals for the Median Survival Time under Proportional Censorship

  • Jeong, Seong-Hwa;Cho, Kil-Ho
    • Communications for Statistical Applications and Methods
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    • v.9 no.1
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    • pp.261-270
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    • 2002
  • In this paper, we demonstrate the more accurate confidence intervals for median survival time under the simple proportional hazard model of Koziol and Green (1976) via the Edgeworth expansion for the distribution of the studentized ACL estimator derived in Jeong (2000). The numerical results show that the intervals, so-called test-based and reflect intervals (Slud et al., 1984), outperform normal approximating method in the small sample sizes and/or heavy censoring.

Termiticidal Activities of Chamaecyparis obtusa Endl. Heartwood (편백재의 흰개미 살충활성에 관한 연구)

  • Choi, In-Gyu;Kang, Ha-Young
    • Applied Biological Chemistry
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    • v.43 no.1
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    • pp.67-71
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    • 2000
  • Termiticidal activities of Chamaecyparis obtusa were quantitatively evaluated, and the activity differences between supporting materials such as woodmeal and filter paper or between species were defined based on the termiticidal activity value(TAV). It was found that TAV was high in the following order ; C. obtusa>Litsea coreana>C. obtusa var. formosensis>Ternstroemia gymnanthera. In particular, termiticidal activity of C. obtusa heartwood was stronger by 5 to 9 times than that of other three species. Median survival dosage(MSD) of C. obtusa was 108.8 mg. In case of woodmeal or filter paper tests with C. obtusa, termiticidal activities were inversely proportional to logarithms values of an added sample weight and median survival time(MST). The difference of termiticidal activities between woodmeal and filter paper in the methanol extracts was small, but that in the neutral fraction was enormous as 3.21 times. However, termiticidal activity of neutral fraction was corresponded to 17 to 53% of original woodmeal, and 47 to 83% of termiticidal activity was considered as a loss in test process.

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A Retrospective Study on Canine Epilepsy: Etiological Distribution, Therapeutic Outcome, and Survival Time

  • Park, Seo-Yeon;Jeong, Yoonsoo;Yun, Taesik;Jung, Dong-In;Chang, Dong-Woo;Kang, Ji-Houn;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • Journal of Veterinary Clinics
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    • v.36 no.3
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    • pp.150-154
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    • 2019
  • The purpose of this study was to investigate the etiological distribution, therapeutic outcome, and survival time in canine epilepsy. The medical records of 57 epileptic dogs were reviewed for the evaluation of etiological distribution. Among them, 27 dogs (47%) and 30 dogs (52%) had idiopathic epilepsy (IdE) and structural epilepsy (StE), respectively. Twenty-nine dogs (IdE: 16 dogs, StE: 13 dogs) were evaluated for therapeutic outcome and survival time. The incidence of generalized epileptic seizure (IdE, 56% vs. StE, 44%; P = 0.043) and the median seizure frequency at the time of first presentation (IdE, 2.0/month vs. StE, 13.3/month; P < 0.01) were significantly different between the two groups. Although pre-treatment seizure frequency and duration were not different, the median duration of seizure in the IdE group (0.5 min) was significantly shorter than that in the StE group (3 min) after treatment (P < 0.01). In addition, the median frequency of seizure was relatively lower in the IdE group (0.25/month) compared to the StE group (2.00/month) following antiepileptic therapy (P = 0.053). The median survival time of the IdE group (1.5 years [95% CI, 1.0-2.3 years]) was significantly longer than that of the StE group (0.4 year [95% CI, 0.2-1.3 years]) (P < 0.01). The information on etiological data and intracranial lesions may be useful for predicting treatment response and prognosis in epileptic dogs.

A Confidence Interval for Median Survival Time in the Additive Risk Model

  • Kim, Jinheum
    • Journal of the Korean Statistical Society
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    • v.27 no.3
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    • pp.359-368
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    • 1998
  • Let ξ$_{p}$(z$_{0}$) be the pth quantile of the distribution of the survival time of an individual with time-invariant covariate vector z$_{0}$ in the additive risk model. We propose an estimator of (ξ$_{p}$(z$_{0}$) and derive its asymptotic distribution, and then construct an approximate confidence interval of ξ$_{p}$(z$_{0}$) . Simulation studies are carried out to investigate performance of the proposed estimator far practical sample sizes in terms of empirical coverage probabilities. Also, the estimator is illustrated on small cell lung cancer data taken from Ying, Jung, and Wei (1995) .d Wei (1995) .

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Logistic Regression Method in Interval-Censored Data

  • Yun, Eun-Young;Kim, Jin-Mi;Ki, Choong-Rak
    • The Korean Journal of Applied Statistics
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    • v.24 no.5
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    • pp.871-881
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    • 2011
  • In this paper we propose a logistic regression method to estimate the survival function and the median survival time in interval-censored data. The proposed method is motivated by the data augmentation technique with no sacrifice in augmenting data. In addition, we develop a cross validation criterion to determine the size of data augmentation. We compare the proposed estimator with other existing methods such as the parametric method, the single point imputation method, and the nonparametric maximum likelihood estimator through extensive numerical studies to show that the proposed estimator performs better than others in the sense of the mean squared error. An illustrative example based on a real data set is given.

The Results and Prognostic Factors of Chemo-radiation Therapy in the Management of Small Cell Lung Cancer (항암화학요법과 방사선 치료를 시행한 소세포폐암 환자의 치료 성적 -생존율과 예후인자, 실패양상-)

  • Kim Eun-Seog;Choi Doo-Ho;Won Jong-Ho;Uh Soo-Taek;Hong Dae-Sik;Park Choon-Sik;Park Hee-Sook;Youm Wook
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.433-440
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    • 1998
  • Purpose : Although small ceil lung cancer (SCLC) has high response rate to chemotherapy and radiotherapy (RT), the prognosis is dismal. The authors evaluated survival and failure patterns according to the prognostic factors in SCLC patients who had thoracic radiation therapy with chemotherapy. Materials and Methods : One hundred and twenty nine patients with SCLC had received thoracic radiation therapy from August 1985 to December 1990. Seventy-seven accessible patients were evaluated retrospectively among 87 patients who completed RT. Median follow-up period was 14 months (2-87months). Results : The two years survival rate was 13$\%$ with a median survival time of 14 months. The two year survival rates of limited disease and extensive disease were 20$\%$ and 8$\%$, respectively, with median survival time of 14 months and 9 months, respectively. Twenty two patients (88$\%$) of limited disease showed complete response (CR) and 3 patients (12$\%$) did partial response (PR). The two year survival rates on CR and PR groups were 24$\%$ and 0$\%$, with median survival times of 14 months and 5 months. respectively (p=0.005). No patients with serum sodium were lower than 135 mmol/L survived 2years and their median survival time was 7 months (p=0.002). Patients whose alkaline phophatase lower than 130 IU/L showed 26$\%$ of 2 year survival rate and showed median survival time of 14 months and those with alkaline phosphatase higher than 130 IU/L showed no 2 year survival and median survival time of 5 the months, respectively (p=0.019). No statistical differences were found according to the age, sex, and performance status. Among the patients with extensive disease, two rear survivals according to the metastatic sites were 14$\%$, 0$\%$, and 7$\%$ in brain, liver, and other metastatic sites, respectively, with median survival time of 9 months, 9 months, and 8 months, respectively (p>0.05). Two year survivals on CR group and PR group were 15$\%$ and 4$\%$, respectively, with a median survival time of 11 months and 7 months, respectively (p=0.01). Conclusion : For SCLC, complete response after chemoradiotherapy was the most significant prognostic tactor. To achieve this goal. there should be further investigation about hyperfractionation, dose escalation, and compatible chemo-radiation schedule such as concurrent chemo-radiation and early radiation therapy with chemotherapy.

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