• 제목/요약/키워드: Prognosis Factors

검색결과 1,080건 처리시간 0.027초

The Role of Imaging in Current Treatment Strategies for Pancreatic Adenocarcinoma

  • Hyungjin Rhee;Mi-Suk Park
    • Korean Journal of Radiology
    • /
    • 제22권1호
    • /
    • pp.23-40
    • /
    • 2021
  • In pancreatic cancer, imaging plays an essential role in surveillance, diagnosis, resectability evaluation, and treatment response evaluation. Pancreatic cancer surveillance in high-risk individuals has been attempted using endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI). Imaging diagnosis and resectability evaluation are the most important factors influencing treatment decisions, where computed tomography (CT) is the preferred modality. EUS, MRI, and positron emission tomography play a complementary role to CT. Treatment response evaluation is of increasing clinical importance, especially in patients undergoing neoadjuvant therapy. This review aimed to comprehensively review the role of imaging in relation to the current treatment strategy for pancreatic cancer, including surveillance, diagnosis, evaluation of resectability and treatment response, and prediction of prognosis.

승모판막 치환술후 조기사망의 술전 및 술중 위험인자에 대한 임상적 고찰 (A Clinical Study for Pre- and Intraoperative Risk Factors of Hospital Mortality after Mitral Valve Replacement)

  • 박승규
    • Journal of Chest Surgery
    • /
    • 제23권2호
    • /
    • pp.236-244
    • /
    • 1990
  • To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

  • PDF

갑상선암의 외과적 치료 - 예후인자와 생존율의 관계 (Surgical Treatment of Thyroid Carcinoma - A Relation between Prognostic Factors and Survival Rate -)

  • 김재홍;오상훈;김상효;백낙환
    • 대한두경부종양학회지
    • /
    • 제13권2호
    • /
    • pp.187-199
    • /
    • 1997
  • Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

  • PDF

ABO Blood Group, Epstein-Barr virus Infection and Prognosis of Patients with Non-metastatic Nasopharyngeal Carcinoma

  • Zhang, Ya-Xiong;Kang, Shi-Yang;Chen, Gang;Fang, Wen-Feng;Wu, Xuan;You, Hua-Jing;He, Da-Cheng;Cao, Ya-Lin;Liang, Wen-Hua;Zhang, Li
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권17호
    • /
    • pp.7459-7465
    • /
    • 2014
  • Background: A prior study showed blood type A/AB to be associated with an increased risk of nasopharyngeal carcinoma (NPC) compared to subjects with blood type O. However, the relationship between ABO blood groups and prognosis of NPC patients is still questionable. In addition, whether Epstein-Barr virus (EBV) infection is associated with prognosis of NPC patients with different ABO blood groups is unclear. Materials and Methods: We conducted univariate and multivariable Cox regression analyses based on a consecutive cohort of 1,601 patients to investigate the above issues. Results: There was no significant difference in overall survival (OS) between different ABO blood groups (p=0.629), neither between A vs. non-A blood groups (p=0.895) nor AB vs. non-AB blood group (p=0.309) in univariate analyses and after adjusting for other factors. Interaction tests revealed that high immunoglobulin A against Epstein-Barr virus viral capsid antigen (VcA-IgA) level was associated with a favorable prognosis in male patients with UICC stage II disease who had an A blood type (p=0.008), compared with those with non-A blood type. In addition, male patients with an A blood group with a high blood lymphocyte level showeda tendency towards better survival in UICC stage III (p=0.096). Conclusions: ABO blood group status is not associated with the prognosis of patients with NPC. Additionally, blood group A male NPC patients with high VcA-IgA level or high blood lymphocyte counts might be correlated with a favorable prognosis in UICC stage II or III, respectively.

중환자 가족의 요구 요인 분석 연구 (Factor Analysis of the Seriously-ill Patient인s Family Needs)

  • 권성복;이미라
    • 대한간호학회지
    • /
    • 제17권2호
    • /
    • pp.122-136
    • /
    • 1987
  • A group of studies revealed that family members of the seriously ill patient had some needs during the period of patient's hospitalization. Needs of the seriously-ill patient family could be classified into three aspect, i. e. needs on the prognosis of patient, needs on the well-being of family members themselves and needs on hospital environment. Several instrument were developed to measure the needs of the seriously ill patient, but their content tended to overemphasize the aspect of the prognosis of patient. The purpose of this study was to develop a new instrument to measure the needs in the aspect of the seriously ill patient's family themselves in details to increase the cummulative Percentage of the scale. Subjects were 134 family members of the seriously-ill patients, who were bung cared in ICU of seven university hospitals and data were collected from march 16, 1987 to April 11, 1987. The instrument used in this study was made by the author on the basis of results of literature review. Content valitity of the instrument was tested by a professor majoring in nursing and reliability by calculation of Cronbach's α with data of the respondents. Data was analyzed as follows, using SAS, computer system. Factor structures of the seriously ill patients' family needs were elicited by factor analysis. The programme was the Principal Component Factor Analysis Method of factoring employing Varimax Orthogonal Rotation. The influences of the demographic variables on the degree of the seriously-ill patients' family need were analyzed by t-test and P-test. Results were as follows. 1. Needs of the seriously-ill patients' family elicited and their cummulative percentage were: Needs to be supported emotionally, 29.2% Needs to be informed on facilities available, 9.6% Needs to be informed on the patient's prognosis, 7.7%. Needs to be supported spiritually, 5.1%. Needs to be informed on hospital environment, 4.2%. Needs to be helped to spare time, 3.9%. Needs to be informed on their role, 3.5%. Needs to be present near patient, 3.3%. 2. Educational background was found to influence on some factors. College-graduate group had higher Bevel of needs to be . informed on facilities available to be informed on the patient's prognosis, needs to be supported spiritually, needs to be helped to spare time, needs to be informed on their role than high school graduate group. 3. Among the parents, sons and daughters and the relative groups, the parents of the seriously ill patient had highest level of needs to be present near patient. Suggestions for further studies were as follows. 1. As the instruments used in the previous studies had high cummulative percentages in the aspect of the prognosis of patient and that in this study in the aspect of the prognosis of patient and that in this study in the aspect of the seriously ill patient's family themselves, development of a new instrument which combined the items of both of them is needed. 2. A study to clarify the influence of type and number of admission on need to be supported emotionally is needed.

  • PDF

p53 변이, bc12 발현, Ki67 인덱스, E-cadherin의 발현 등이 식도암의 예후에 미치는 영향에 대한 연구 (Influences of p53 Mutation, Expression of bc12, Ki67 Index and Expression of E-Cadherin on the Prognosis of the Esophageal Cancer)

  • 이해원;박선후;이승숙;박종호
    • 대한기관식도과학회지
    • /
    • 제9권2호
    • /
    • pp.36-43
    • /
    • 2003
  • Background and objectives; Esophageal cancer is one of the most malignant tumors and has a poor prognosis. Many clinical studies have been tried for improving prognosis of esophageal cancer. Some clinical studies used molecular markers as the predictor of prognosis & the indicator for the choice of multimodality treatments. We investigated the relationship between some molecular markers, including p53 mutation, expression of bc12, Ki67 index, expression of E-Cadherin and the prognosis of esophageal cancer, Materials and Method; The materials used in this study were the tumor specimens from 72 esophageal cancer patients who underwent esophagectomy from 1987 to 2002 in our institute. The mutation of p53, expression of bc12, Ki67 index, and expression of E-cadherin were examined by using the tissue array and immunohistochemical staining method. The patients were subgrouped into higher Ki67 index group if the index was higher than 30. The patients were also subgrouped into grade 1(>90%), grade 2(50∼90%), grade 3 (10∼50%), and grade 4(<10%) according to the rate of E-Cadherin expression. We studied the relationship between the rates of immunohistochemical staining and the survival rate. Results: Seventy two tumor specimens from 72 patients were studied. (mean age ; 59.6 years, male female = 69 : 3) The histologic type of the specimens was all squamous cell carcinoma. The patient's number of stage IIA, IIB, and Ⅳ was 30, 37, and 7 respectively, Thirty patients were alive and overall 5 year-survival rate was 28%. The mutation of p53 was shown in 54.2% of the patients. Five year survival rates of negative and positive groups were 29% and 28% respectively.(p=0.4) Expression of bc12 gene was found in 13.9% of the specimens. Five year survival rates of negative and positive groups were 30% and 21%.(p=0.3) Higher Ki67 index was correlated to poorer differentiation.(p=0.05) Five year survival rates of higher and lower groups of Ki67 index were 47% and 30%.(p=0.15) Higher expression rate of E-Cadherin showed better differentiation.(p=0.04). However we couldn't find any survival differences between these 4 groups.(p=0.23) Conclusion; We could not find any molecular markers meaningful in the prognosis of esophageal cancer patients. We just found the tumor markers correlated to the differentiation of esophageal cancer. However, we knew that we need further study with some more samples to stratify other important prognostic factors of esophageal cancer.

  • PDF

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
    • /
    • 제33권49호
    • /
    • pp.327.1-327.10
    • /
    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

일개 대학생의 흡연행태에 영향을 미치는 요인 (Factors Influencing Smoking Behavior among Undergraduate Students)

  • 윤경순;조숙희
    • 동서간호학연구지
    • /
    • 제29권1호
    • /
    • pp.59-67
    • /
    • 2023
  • Purpose: This study aims to investigate the factors affecting smoking behavior in undergraduate students. Methods: The participants were 240 undergraduate students. A descriptive survey design was used. Data were collected from March to April 2022 and were analyzed using binominal logistic regression. Results: The result showed that smoking had a significant correlation with depression, life stress, and smoking-related self-efficacy. The factors affecting the smoking behavior were sex, department, depression, life stress, and smoking-related self-efficacy. The factors explained 72.9% of undergraduate students' smoking behavior. Conclusion: The development and application of prevention education to reduce depression and stress and improve smoking-related self-efficacy may be a strategy for a good prognosis for undergraduate students.

Clinical Efficacy and Prognosis Factors for Advanced Hepatoblastoma in Children: A 6-year Retrospective Study

  • Zhang, Yi;Zhang, Wei-Ling;Huang, Dong-Sheng;Hong, Liang;Wang, Yi-Zhuo;Zhu, Xia;Hu, Hui-Min;Zhang, Pin-Wei;Yi, You;Han, Tao
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권8호
    • /
    • pp.4583-4589
    • /
    • 2013
  • Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP), and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.

Prognostic Values of Various Clinical Factors and Genetic Subtypes for Diffuse Large B-cell lymphoma Patients: A Retrospective Analysis of 227 Cases

  • Zhou, De;Xie, Wan-Zhuo;Hu, Ke-Yue;Huang, Wei-Jia;Wei, Guo-Qing;He, Jing-Song;Shi, Ji-Min;Luo, Yi;Li, Li;Zhu, Jing-Jing;Zhang, Jie;Lin, Mao-Fang;Ye, Xiu-Jin;Cai, Zhen;Huang, He
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권2호
    • /
    • pp.929-934
    • /
    • 2013
  • Aim: To analyze the significance of different clinical factors for prognostic prediction in diffuse large B-cell lymphoma (DLBCL) patients. Methods: Two hundred and twenty-seven DLBCL patients were retrospectively reviewed. Patients were managed with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen or rituximab plus the CHOP (RCHOP) regimen. Results: Lactate dehydrogenase (LDH), ${\beta}2$-microglobulin (${\beta}2$-M), B symptoms, Ann Arbor stage and genetic subtypes were statistically relevant in predicting the prognosis of the overall survival (OS). In the CHOP group, the OS in patients with germinal center B-cell-like (GCB)(76.2%) was significantly higher than that of the non-GCB group (51.9%, P=0.032). With RCHOP management, there was no statistical difference in OS between the GCB (88.4%) and non-GCB groups (81.9%, P=0.288). Conclusion: Elevated LDH and ${\beta}2$-M levels, positive B symptoms, Ann Arbor stage III/IV, and primary nodal lymphoma indicate an unfavorable prognosis of DLBCL patients. Patients with GCB-like DLBCL have a better prognosis than those with non-GCB when treated with the CHOP regimen. The RCHOP treatment with the addition of rituximab can improve the prognosis of patients with DLBCL.