• 제목/요약/키워드: Proportional hazards

검색결과 276건 처리시간 0.027초

Fatty Acid Synthesis Pathway Genetic Variants and Clinical Outcome of Non-Small Cell Lung Cancer Patients after Surgery

  • Jin, Xin;Zhang, Ke-Jin;Guo, Xu;Myers, Ronald;Ye, Zhong;Zhang, Zhi-Pei;Li, Xiao-Fei;Yang, Hu-Shan;Xing, Jin-Liang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7097-7103
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    • 2014
  • Over-expression of de novo lipogenesis (DNL) genes is associated with the prognosis of various types of cancers. However, the effects of single nucleotide polymorphisms (SNPs) in these genes on recurrence and survival of non-small cell lung cancer (NSCLC) patients after surgery are still unknown. In this study, a total of 500 NSCLC patients who underwent surgery treatment were included. Eight SNPs in 3 genes (ACACA, FASN and ACLY) of the DNL pathway were examined using the Sequenom iPLEX genotyping system. Multivariate Cox proportional hazards regression and Kaplan-Meier curves were used to analyze the association of SNPs with patient survival and tumour recurrence. We found that two SNPs in the FASN gene were significantly associated with the recurrence of NSCLC. SNP rs4246444 had a significant association with lung cancer recurrence under additive model (hazard ratio [HR], 0.82; 95% confidence interval [95%CI], 0.67-1.00; p=0.05). Under the dominant model, rs4485435 exhibited a significant association with recurrence (HR, 0.75; 95%CI, 0.56-1.01; p=0.05). Additionally, SNP rs9912300 in ACLY gene was significantly associated with overall survival in lung cancer patients (HR, 1.41; 95%CI, 1.02-1.94, p=0.04) under the dominant model. Further cumulative effect analysis showed moderate dose-dependent effects of unfavorable SNPs on both survival and recurrence. Our data suggest that the SNPs in DNL genes may serve as independent prognostic markers for NSCLC patients after surgery.

Cigarette Smoking and other Risk Factors for Kidney Cancer Death in a Japanese Population: Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC study)

  • Washio, Masakazu;Mori, Mitsuru;Mikami, Kazuya;Miki, Tsuneharu;Watanabe, Yoshiyuki;Nakao, Masahiro;Kubo, Tatsuhiko;Suzuki, Koji;Ozasa, Kotaro;Wakai, Kenji;Tamakoshi, Akiko
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6523-6528
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    • 2013
  • Background: Cigarette smoking is the largest single recognized cause of human cancers. In Western countries, many epidemiologists have reported risk factors for kidney cancer including smoking. However, little is known about the Japanese population. Materials and Methods: We evaluated the association of smoking with the risk of kidney cancer death in the Japan Collaborative Cohort (JACC) Study. Participants included 46,395 males and 64,190 females. The Cox proportional hazards model was used to determine age-and-sex adjusted relative risks. Results: A total of 62 males and 26 females died from kidney cancer during the follow-up of 707,136 and 1,025,703 person-years, respectively. Heavy smokers (Brinkman index >1200), fondness of fatty foods, hypertension, diabetes mellitus (DM), and obesity were suggested to increase the risk of renal cell carcinoma while walking was suggested to decrease the risk. Even after controlling for age, sex, alcohol drinking and DM, heavy smoking significantly increased the risk. Conclusions: The present study suggests that six factors including smoking may increase and/or reduce the risk of kidney cancer in the Japanese population. Because of the small number of outcomes, however, we did not evaluate these factors after adjusting for all possible confounding factors. Further studies may be needed to confirm the findings in this study.

수소가스사고의 피해범위 (Hazard Distance from Hydrogen Accidents)

  • 조영도
    • 한국가스학회지
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    • 제16권1호
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    • pp.15-21
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    • 2012
  • 수소가스의 제트 누출에 의한 확산, 화재, 그리고 폭발에 의한 위험 범위를 분석하고, 안전거리 기준을 설정하기 위한 위험거리를 확산, 화재, 그리고 폭발에 대한 단순한 예측 식들을 제시하였다. 핀홀에 의한 누출과 같은 소량 수소가스 누출속도에 있어서 피해거리는 제트누출 확산에 의한 피해거리가 제트화재에 의한 피해거리보다 크며, 압력의 제곱근에 그리고 누출 홀의 직경에 비례하고 이는 수 십 미터에 이른다. 배관의 완전 파손 또는 저장 탱크의 큰 홀 발생과 같은 대량의 수소가스 누출속도에서는 제트화재의 피해거리가 개방공간의 가스운 폭발에 의한 피해거리보다 크며, 수 백 미터에 이른다. 수소충전소와 건물과의 최소이격거리 즉 안전거리 설정 기준을 대량 수소가스누출 사고시나리오를 기반으로 한다면, 도심지에 수소충전소는 안전거리 기준을 만족시키기 어려울 것이다. 따라서 대량의 수소가스 누출사고를 안전장치들을 통하여 예방하고, 안전거리 기준을 소량의 수소가스누출사고 기준으로 설정 할 수 있다. 그러나 대량누출 가능성이 있는 경우 학교와 병원 등 인구밀집 건물은 수 백 미터의 안전거리를 유지하여야 한다.

3기 위암환자에서 시행한 술 후 보조항암화학요법들의 생존율 비교 (The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients)

  • 김은미;김세원;김상운;송선교
    • Journal of Yeungnam Medical Science
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    • 제23권2호
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    • pp.193-204
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    • 2006
  • Purpose: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. Materials and Methods: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Results: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. Conclusion: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.

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Use of an Artificial Neural Network to Construct a Model of Predicting Deep Fungal Infection in Lung Cancer Patients

  • Chen, Jian;Chen, Jie;Ding, Hong-Yan;Pan, Qin-Shi;Hong, Wan-Dong;Xu, Gang;Yu, Fang-You;Wang, Yu-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5095-5099
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    • 2015
  • Background: The statistical methods to analyze and predict the related dangerous factors of deep fungal infection in lung cancer patients were several, such as logic regression analysis, meta-analysis, multivariate Cox proportional hazards model analysis, retrospective analysis, and so on, but the results are inconsistent. Materials and Methods: A total of 696 patients with lung cancer were enrolled. The factors were compared employing Student's t-test or the Mann-Whitney test or the Chi-square test and variables that were significantly related to the presence of deep fungal infection selected as candidates for input into the final artificial neural network analysis (ANN) model. The receiver operating characteristic (ROC) and area under curve (AUC) were used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. Results: The prevalence of deep fungal infection from lung cancer in this entire study population was 32.04%(223/696), deep fungal infections occur in sputum specimens 44.05%(200/454). The ratio of candida albicans was 86.99% (194/223) in the total fungi. It was demonstrated that older (${\geq}65$ years), use of antibiotics, low serum albumin concentrations (${\leq}37.18g/L$), radiotherapy, surgery, low hemoglobin hyperlipidemia (${\leq}93.67g/L$), long time of hospitalization (${\geq}14$days) were apt to deep fungal infection and the ANN model consisted of the seven factors. The AUC of ANN model($0.829{\pm}0.019$)was higher than that of LR model ($0.756{\pm}0.021$). Conclusions: The artificial neural network model with variables consisting of age, use of antibiotics, serum albumin concentrations, received radiotherapy, received surgery, hemoglobin, time of hospitalization should be useful for predicting the deep fungal infection in lung cancer.

Combined Detection of CEA, CA 19-9, CA 242 and CA 50 in the Diagnosis and Prognosis of Resectable Gastric Cancer

  • Tian, Shu-Bo;Yu, Jian-Chun;Kang, Wei-Ming;Ma, Zhi-Qiang;Ye, Xin;Cao, Zhan-Jiang;Yan, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6295-6300
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    • 2014
  • Our aim was to investigate the value of combined detection of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 242 and CA 50 in diagnosis and assessment of prognosis in consecutive gastric cancer patients. Clinical data including preoperative serum CEA, CA 19-9, CA 242, and CA 50 values and information on clinical pathological factors were collected and analyzed retrospectively. Univariate and multivariate survival analyses were used to explore the relationship between tumor markers and survival. Positive rates of tumor markers CEA, CA 19-9, CA 242 and CA 50 in the diagnosis of gastric cancer were 17.7, 17.1, 20.4 and 13.8%, respectively, and the positive rate for all four markers combined was 36.6%. Patients with elevated preoperative serum concentrations of CEA, CA 19-9, CA 242 and CA 50, had late clinical tumor stage and significantly poorer overall survival. Five-year survival rates in patients with elevated CEA, CA 19-9, CA 242 and CA 50 were 28.1, 25.8, 27.0 and 24.1%, respectively, compared with 55.0, 55.4, 56.4 and 54.5% in patients with these markers at normal levels (p<0.01). In multivariate Cox proportional hazards analyses, an elevated CA 242 level was determined to be an independent prognostic marker in gastric cancer patients. Combined detection of four tumor markers increased the positive rate for gastric cancer diagnosis. CA 242 showed higher diagnostic value and CA 50 showed lower diagnostic value. In resectable gastric carcinoma, preoperative CA 242 level was associated with disease stage, and was found to be a significant independent prognostic marker in gastric cancer patients.

Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

  • Sipetic-Grujicic, Sandra Branko;Murtezani, Zafir Hajdar;Neskovic-Konstatinovic, Zora Borivoje;Marinkovic, Jelena Milutin;Kovcin, Vladimir Nikola;Andric, Zoran Gojko;Kostic, Sanja Vladeta;Ratkov, Isidora Stojan;Maksimovic, Jadranka Milutin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권7호
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    • pp.3233-3238
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    • 2014
  • Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was $64.3{\pm}10.5$ years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ${\leq}2cm$, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Tumors: Analysis from a Single-institution

  • Zeng, Yu-Jie;Liu, Lu;Wu, Heng;Lai, Wei;Cao, Jie-Zhi;Xu, He-Yang;Wang, Jie;Chu, Zhong-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5775-5781
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    • 2013
  • Background: The gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common type of neuroendocrine neoplasm. We summarized data in our centre to investigate the clinicopathological features, diagnostic methods, therapeutic approaches and prognosis for this neoplasm to increase knowledge of this disease in Asian populations. Method: A total of 122 patients treated at Sun Yet-san Memorial Hospital of Sun Yat-sen University between January 2000 and December 2011 were analyzed retrospectively. Results: Pancreas was the most common site of involvement (65/122, 53.3%); this disease has no special symptoms; positive rates of chromogranin A (CgA) and synaptophysin (Syn) were 81.1% and 87.7%, respectively. The positive rate of Syn had statistical difference among the three grades, but not CgA. Some 68 patients had G1 tumors, 32 G2 tumors and 22 G3 tumors, and Chi-square test showed that higher grading was correlated with worse prognosis (${\chi}^2=32.825$, P=0.0001). A total of 32 patients presented with distant metastasis, and 8 cases emerged during following up. Cox proportional hazards regression modeling showed that the tumor grade (P=0.01), lymphatic metastasis (P=0.025) and distant metastasis (P=0.031) were predictors of unfavorable prognosis. The overall 5-year survival rate was 39.6%, the 5-year survival rate of G1 was 55.7%, and the G2 and G3 were 34.2% and 0%, respectively. Conclusions: The incidence of gastroenteropancreatic neuroendocrine tumors has risen over the last 12 years. All grades of these diseases metastasize readily, and further research regarding the treatment of patients after radical surgery is needed to prolong disease-free survival.

Prognostic Factors Influencing Clinical Outcomes of Malignant Glioblastoma Multiforme: Clinical, Immunophenotypic, and Fluorescence in Situ Hybridization Findings for 1p19q in 816 Chinese Cases

  • Qin, Jun-Jie;Liu, Zhao-Xia;Wang, Jun-Mei;Du, Jiang;Xu, Li;Zeng, Chun;Han, Wu;Li, Zhi-Dong;Xie, Jian;Li, Gui-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권3호
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    • pp.971-977
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    • 2015
  • Malignant glioblastoma multiforme (GBM) is the most malignant brain tumor and despite recent advances in diagnostics and treatment prognosis remains poor. In this retrospective study, we assessed the clinical and radiological parameters, as well as fluorescence in situ hybridization (FISH) of 1p19q deletion, in a series of cases. A total of 816 patients with GBM who received surgery and radiation between January 2010 and May 2014 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patient progression free survival (PFS) and overall survival (OS). Age at diagnosis, preoperative Karnofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 and MMP9 expression level and adjuvant chemotherapy were statistically significant factors (p<0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ${\leq}50$ years, preoperative KPS score ${\geq}80$, KPS score change after operation ${\geq}0$, involvement of single frontal lobe, deep structure involvement, low Ki-67 and MMP9 expression and adjuvant chemotherapy were independent favorable factors (p<0.05) for patient clinical outcomes.

Comorbidity Relationship to Outcome of Radical Cystectomy in Chinese: a Single Institution Study with the ACE-27 Comorbidity Index

  • Xuan, Zhu;Zhong, Zhao-Hui;Zhang, Xuan-Zhi;Zhang, Lei;Zhao, Xiao-Kun;Lv, Chen;Xu, Ran;Ren, Wei-Gang;Li, Song-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.827-831
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    • 2012
  • To determine the relationship between comorbidity and outcome after radical cystectomy in Chinese patients by using the Adult Comorbidity Evaluation (ACE)-27 index. Two-hundred-and-forty-six patients treated with radical cystectomy at the Second Xiangya Hospital of Central South University, Hunan Province, China between 2000 and 2010 were retrospectively analyzed. Medical records were reviewed for age, gender, delayed time of radical cystectomy, urinary diversion type, pelvic lymphadenectomy status, TNM stage, and pathological grade. Comorbidity information was assessed by the ACE-27 index. The outcome measurement was overall survival. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the association between comorbidity and outcome. The study population consisted of 215 (87.40%) males and 31 (12.60%) females with a mean age of $62{\pm}11$ years. Median duration of follow-up was $47{\pm}31$ months. A total of 151 (61.38%) patents died during follow-up. Of those, 118 (47.97%) had at least one comorbidity. According to the ACE-27 scores, 128 (52.03%) patients had no comorbidity, 79 (32.11%) had mild, 33 (13.41%) had moderate, and 6 (2.45%) had severe comorbidities. Multivariate analysis indicated that moderate (p=0.002) and severe (p<0.001) comorbidity was significantly associated with decreased overall survival. In addition, age ${\geq}70$ years (p=0.002), delayed time of radical cystectomy >12 weeks (p=0.044), pelvic lymphadenectomy status (p=0.014), and TNM stage >T3 (p<0.001) were determined to be independent risk factors of overall survival. Increasing severity of comorbidity statistically correlated with decreased overall survival after radical cystectomy.