• Title/Summary/Keyword: Prognostic models

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Identification of Heterogeneous Prognostic Genes and Prediction of Cancer Outcome using PageRank (페이지랭크를 이용한 암환자의 이질적인 예후 유전자 식별 및 예후 예측)

  • Choi, Jonghwan;Ahn, Jaegyoon
    • Journal of KIISE
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    • v.45 no.1
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    • pp.61-68
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    • 2018
  • The identification of genes that contribute to the prediction of prognosis in patients with cancer is one of the challenges in providing appropriate therapies. To find the prognostic genes, several classification models using gene expression data have been proposed. However, the prediction accuracy of cancer prognosis is limited due to the heterogeneity of cancer. In this paper, we integrate microarray data with biological network data using a modified PageRank algorithm to identify prognostic genes. We also predict the prognosis of patients with 6 cancer types (including breast carcinoma) using the K-Nearest Neighbor algorithm. Before we apply the modified PageRank, we separate samples by K-Means clustering to address the heterogeneity of cancer. The proposed algorithm showed better performance than traditional algorithms for prognosis. We were also able to identify cluster-specific biological processes using GO enrichment analysis.

Treatment Modality Based Survival in Gastric Carcinoma Patients with Stand-Alone Peritoneal Metastasis: a Case-Control Study

  • Jeong, Oh;Jung, Mi Ran;Kang, Ji Hoon
    • Journal of Gastric Cancer
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    • v.21 no.2
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    • pp.122-131
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    • 2021
  • Purpose: To date, there are no promising treatments for gastric carcinoma with peritoneal metastasis. Some researchers have suggested a survival benefit of gastrectomy in select patients. This study investigated the survival of gastric carcinoma patients with stand-alone peritoneal metastasis according to the type of treatment modality. Materials and Methods: We reviewed the data of 132 patients with gastric carcinoma and stand-alone peritoneal metastasis. We performed gastrectomy when the primary tumor was deemed resectable and systemic chemotherapy was administered. We analyzed patient survival according to the type of treatment, and the prognostic value of gastrectomy was evaluated in univariate and multivariate models. Results: Among all patients, 70 underwent gastrectomy plus chemotherapy, 20 underwent gastrectomy alone, 36 underwent chemotherapy alone, and 6 received supportive care. The median patient survival was 13 months. Patients who underwent gastrectomy had significantly longer survival than those who did not undergo gastrectomy (14 vs. 8 months, P<0.001). Patients who received chemotherapy showed significantly longer survival than those who did not (13 vs. 7 months, P=0.032). Patients who underwent gastrectomy plus chemotherapy showed better survival than those who underwent other treatments. In multivariate analysis, gastrectomy was found to be an independent prognostic factor (hazard ratio, 0.52; 95% confidence interval, 0.33-0.82) in addition to chemotherapy. Conclusions: Our study showed that patients who underwent gastrectomy plus chemotherapy had the best survival. Although the survival benefit of gastrectomy remains uncertain, it is a favorable prognostic indicator in patients with stand-alone peritoneal metastasis.

Immunotherapeutic Approach for Better Management of Cancer - Role of IL-18

  • Kuppala, Manohar Babu;Syed, Sunayana Begum;Bandaru, Srinivas;Varre, Sreedevi;Akka, Jyothy;Mundulru, Hema Prasad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5353-5361
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    • 2012
  • Interleukin-18 (IL-18) is an immune-stimulatory cytokine with antitumor activity in preclinical models. It plays pivotal roles in linking inflammatory immune responses and tumor progression and is a useful candidate in gene therapy of lymphoma or lymphoid leukemia. A phase I study of recombinant human IL-18 (rhIL-18) in patients with advanced cancer concluded that rhIL-18 can be safely given in biologically active doses to patients with advanced cancer. Some viruses can induce the secretion of IL-18 for immune evasion. The individual cytokine activity might be potentiated or inhibited by combinations of cytokines. Here we focus on combinational effects of cytokines with IL-18 in cancer progression. IL-18 is an important non-invasive marker suspected of contributing to metastasis. Serum IL-18 may a useful biological marker as independent prognostic factor of survival. In this review we cover roles of IL-18 in immune evasion, metastasis and angiogenesis, applications for chemotherapy and prognostic or diagnostic significance.

Prognostic Factors of Hemifacial Spasm after Microvascular Decompression

  • Kim, Hong-Rae;Rhee, Deok-Joo;Kong, Doo-Sik;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.336-340
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    • 2009
  • Objective : The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. Methods : From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni- and multivariate analyses were performed using logistic regression models. Results : A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni- and multivariate analyses revealed that the symptoms at postoperative 3 months (p<0.001) and indentation of the root exit zone (p=0.036) were associated with good outcomes. Conclusion : The intraoperative finding of root exit zone indentation will help physicians determine the prognosis in patients with HFS. To predict the prognosis of HFS, a regular follow-up period of at least 3 months following MVD should be required.

A Numerical Modeling Study on the Seasonal Variability in the Gulf of Alaska (알라스카 만의 계절변화에 대한 수치모형 실험)

  • Bang, In-Kweon;Zygmunt Kowlik
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.6 no.3
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    • pp.309-325
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    • 1994
  • Ocean circulation in the Gulf of Alaska is remarkably constant throughout the year despite of being forced by one of the largest seasonal wind stresses in the world. To explain the small seasonal changes in the transport of Alaska Stream. a set of numerical models is employed. First a diagnostic approach is applied to reproduce circulation from the observed density structure. The results reveals the very small seasonal changes in the Alaska Stream transport. Next a series of the prognostic models is used: a barotropic model. a flat bottom baroclinic model, and baroclinic model with topography. These models reveal the influence of topography and baroclinicity on the ocean's response to the seasonal wind forcing. The intercomparisons of the various model results suggest that the seasonal response of the baroclinic ocean is primary barotropic and the resultant barotropic circulation is weakened by the scattering effect of the bottom topography.

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Prognostic Model in Patients with Early-stage Squamous Cell Carcinoma of the Uterine Cervix: A Combination of Invasive Margin Pathological Characteristics and Lymphovascular Space Invasion

  • Khunamornpong, Surapan;Lekawanvijit, Suree;Settakorn, Jongkolnee;Sukpan, Kornkanok;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6935-6940
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    • 2013
  • Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamous cell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamous cell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. In addition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type of invasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also included in the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction of recurrence and decreased survival was selected. Results: The model with the best performance was composed of a combined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reaction and stromal desmoplasia (total score =10). Compared to those with score ${\leq}8$, the patients with score 9-10 had a significantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy (p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition, the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-free survival was significantly lower in the patients with score 9-10 than those with score ${\leq}8$ among the overall patients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy (p=0.047). Conclusions: In this study, a prognostic model based on a combination of pathological characteristics of invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survival in patients with early-stage cervical squamous cell carcinoma.

Analysis on the Characteristics and Prognosis of Pulmonary Neuroendocrine Tumors

  • Wu, Bai-Shou;Hu, Yi;Sun, Jing;Wang, Jin-Liang;Wang, Peng;Dong, Wei-Wei;Tao, Hai-Tao;Gao, Wen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2205-2210
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    • 2014
  • Objective: To retrospectively review the clinical characteristics and analyze the prognostic factors of Chinese patients with pulmonary neuroendocrine tumors. Materials and Methods: The clinical data of 176 patients with pulmonary neuroendocrine tumors in Chinese PLA General Hospital from Mar., 2000 to Oct., 2012 were retrospectively analyzed. The parameters were evaluated by univariate and multivariate analysis, including the gender, age, smoking history, family history, TNM staging, localization (central or peripheral), tumor size, nodal status, histological subtype and treatment (operation or non-operation). Results: There were 23 patients with typical carcinoids (TC) (13.1%), 41 with atypical carcinoids (AC) (23.3%), 10 with large cell neuroendocrine carcinoma (LCNEC) (5.7%) and 102 with small cell lung cancer (SCLC) (57.9%). The median follow-up time was 64.5 months for AC, 38 months for LCNEC and 27 months for SCLC. The typical carcinoid censored data was 18 (more than 50% of the patients), so the median follow-up time was not obtained, and actuarial 5-year survivals for TC, AC, LCNEC and SCLC were 75.1%, 51.7%, 26.7% and 38.8%, respectively. COX univariate analysis revealed that the age (P=0.001), histological subtype (P=0.005), nodal status (P=0.000), treatment (P=0.000) and TNM staging (P=0.000) were the prognostic factors of the patients with pulmonary neuroendocrine tumors, whereas its multivariate analysis showed that only the age(P=0.001), TNM staging (P=0.002) and treatment (P=0.000) were independent prognostic factors. Conclusions: Radical surgery remains the treatment of choice, and is the only curative option. The age, TNM staging and treatment are confirmed to be the independent prognostic factors in multivariable models for pulmonary neuroendocrine tumors.

The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children (소아청소년 개방안구손상 환자에서의 시력예후와 안외상 점수와의 연관성)

  • Park, Su Jin;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1062-1070
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    • 2018
  • Purpose: We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS). Methods: We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity. Results: By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (${\geq}20/32$). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems. Conclusions: Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.

Development and Validation of a Prognostic Nomogram Based on Clinical and CT Features for Adverse Outcome Prediction in Patients with COVID-19

  • Yingyan Zheng;Anling Xiao;Xiangrong Yu;Yajing Zhao;Yiping Lu;Xuanxuan Li;Nan Mei;Dejun She;Dongdong Wang;Daoying Geng;Bo Yin
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.1007-1017
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    • 2020
  • Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitals were retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in the training cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in the validation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, or death. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. A nomogram was constructed based on the combination of clinical and CT features, and its prognostic performance was externally tested in the validation group. The predictive value of the combined model was compared with models built on the clinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohort experienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67-6.71; p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04-0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03-4.48; p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76-0.88), and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82-0.96). The combined model provided the best performance over the clinical or radiological model (p < 0.050). Conclusion: Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverse outcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19.

Prognostic Value of Coronary CT Angiography for Predicting Poor Cardiac Outcome in Stroke Patients without Known Cardiac Disease or Chest Pain: The Assessment of Coronary Artery Disease in Stroke Patients Study

  • Sung Hyun Yoon;Eunhee Kim;Yongho Jeon;Sang Yoon Yi;Hee-Joon Bae;Ik-Kyung Jang;Joo Myung Lee;Seung Min Yoo;Charles S. White;Eun Ju Chun
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1055-1064
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    • 2020
  • Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.