• Journal of Gastric Cancer
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• v.16 no.2
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• pp.78-84
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• 2016

Purpose: The aim of this study was to determine whether surgical resection of the primary tumor contributes to survival in patients with metastatic gastric cancer. Materials and Methods: A total of 288 patients with metastatic gastric cancer from the Akdeniz University, Antalya Training and Research Hospital, and the Meram University of Konya database were retrospectively analyzed. The effect of primary tumor resection on survival of patients with metastatic gastric cancer was investigated using the log-rank test. Kaplan-Meier survival estimates were calculated. Multivariate analysis was performed using Cox proportional hazards regression modeling. Results: The median overall survival was 12.0 months (95% confidence intewrval [CI], 10.4~13.6 months) and 7.8 months (95% CI, 5.5~10.0 months) for patients with and without primary tumor resection, respectively (P<0.001). The median progression-free survival was 8.3 months (95% CI, 7.1~9.5 months) and 6.2 months (95% CI, 5.8~6.7 months) for patients with and without primary tumor resection, respectively (P=0.002). Conclusions: Non-curative gastrectomy in patients with metastatic gastric cancer might increase their survival rate regardless of the occurrence of life-threatening tumor-related complications.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5081-5086
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• 2012

Background: The liver is one of the most common metastatic sites of breast cancer, hepatic metastases developing in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim of this study was to analyze the survival and clinical characteristics of patients with hepatic metastases from breast cancer of different molecular subtypes and to investigate the prognostic and predictive factors that effect clinical outcome. Methods: We retrospectively studied the charts of 104 patients with breast cancer hepatic metastases diagnosed at Sun Yat-sen University Cancer Center from December 1990 to June 2009. Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN). Prognostic factor correlations with clinical features and treatment approaches were assessed at the diagnosis of hepatic metastases. Results: The median survival time was 16.0 months, and the one-, two- three-, four-, five-year survival rates were 63.5%, 31.7%, 15.6%, 10.8%, and 5.4%, respectively. Median survival periods after hepatic metastases were 19.3 months (luminal A), 13.3 months (luminal B), 18.9 months (HER2-enriched), and 16.1 months (TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis, treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy could improve the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4 months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy did significantly better than the Luminal A group of patients treated without endocrine therapy (median survival of 48.9 vs. 13.8 months, P=0.003). Conclusions: Breast cancer subtypes were not associated with survival after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7359-7363
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• 2015

Background: As a result of significant progress made in treatment of many types of cancers during the last few decades, there have been an increased number of patients who do not experience mortality. We refer to these observations as cure or immune and models for survival data which include cure fraction are known as cure rate models or long-term survival models. Materials and Methods: In this study we used the data collected from 438 female patients with breast cancer registered in the Cancer Research Center in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The patients had been diagnosed from 1992 to 2012 and were followed up until October 2014. We had to exclude some because of incomplete information. Phone calls were made to confirm whether the patients were still alive or not. Deaths due to breast cancer were regarded as failure. To identify clinical, pathological, and biological characteristics of patients that might have had an effect on survival of the patients we used a non-mixture cure rate model; in addition, a Weibull distribution was proposed for the survival time. Analyses were performed using STATA version 14. The significance level was set at $P{\leq}0.05$. Results: A total of 75 patients (17.1%) died due to breast cancer during the study, up to the last follow-up. Numbers of metastatic lymph nodes and histologic grade were significant factors. The cure fraction was estimated to be 58%. Conclusions: When a cure fraction is not available, the analysis will be changed to standard approaches of survival analysis; however when the data indicate that the cure fraction is available, we suggest analysis of survival data via cure models.

• Journal of Korean Traditional Oncology
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• v.24 no.2
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• pp.1-11
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• 2019

Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

• Journal of Gastric Cancer
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• v.18 no.4
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• pp.368-378
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• 2018

Purpose: Fibrinogen and platelets have been reported to play important roles in tumorigenesis and cancer progression. The aim of this research was to investigate the combination of functions of fibrinogen, platelets, and mean platelet volume (MPV) in predicting the survival of patients with gastric cancer (GC). Materials and Methods: A retrospective study was conducted with 1,946 patients with GC and 299 patients with benign gastric tumor to analyze their fibrinogen, platelet, and MPV levels, and other clinicopathological characteristics along with their prognoses. Several indicators were evaluated along with fibrinogen, platelets, and MPV and their prognostic abilities were assessed. Univariate and multivariate survival analyses were conducted to determine the independent risk factors for overall survival. Results: Increased levels of fibrinogen, platelets, and MPV were observed with the progress of the GC stages. Elevated fibrinogen, platelets, and the combined indicators, including fibrinogen*MPV (FM), platelet*fibrinogen*MPV (PFM), fibrinogen/MPV (FMR), platelet*fibrinogen (PF), platelet*fibrinogen/MPV (PFMR), platelet*MPV (PM), and platelet/MPV (PMR), foreboded poor prognosis. Meanwhile fibrinogen and FMR can be considered as independent risk factors for overall survival in patients with non-metastatic GC. But these indicators can hardly predict survival of patients in stage IV. Conclusions: Elevated fibrinogen, platelets, and MPV levels were in accordance with advanced stages, and fibrinogen, platelet, and MPV, in combination, can be used to predict survival of patients with non-metastatic GC. FMR was an independent prognostic factor for overall survival of patients with GC.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.4049-4054
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• 2014

Background: Race and ethnicity are significant factors in predicting survival time of breast cancer patients. In this study, we applied advanced statistical methods to predict the survival of White non-Hispanic female breast cancer patients, who were diagnosed between the years 1973 and 2009 in the United States (U.S.). Materials and Methods: Demographic data from the Surveillance Epidemiology and End Results (SEER) database were used for the purpose of this study. Nine states were randomly selected from 12 U.S. cancer registries. A stratified random sampling method was used to select 2,000 female breast cancer patients from these nine states. We compared four types of advanced statistical probability models to identify the best-fit model for the White non-Hispanic female breast cancer survival data. Three model building criterion were used to measure and compare goodness of fit of the models. These include Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC). In addition, we used a novel Bayesian method and the Markov Chain Monte Carlo technique to determine the posterior density function of the parameters. After evaluating the model parameters, we selected the model having the lowest DIC value. Using this Bayesian method, we derived the predictive survival density for future survival time and its related inferences. Results: The analytical sample of White non-Hispanic women included 2,000 breast cancer cases from the SEER database (1973-2009). The majority of cases were married (55.2%), the mean age of diagnosis was 63.61 years (SD = 14.24) and the mean survival time was 84 months (SD = 35.01). After comparing the four statistical models, results suggested that the exponentiated Weibull model (DIC= 19818.220) was a better fit for White non-Hispanic females' breast cancer survival data. This model predicted the survival times (in months) for White non-Hispanic women after implementation of precise estimates of the model parameters. Conclusions: By using modern model building criteria, we determined that the data best fit the exponentiated Weibull model. We incorporated precise estimates of the parameter into the predictive model and evaluated the survival inference for the White non-Hispanic female population. This method of analysis will assist researchers in making scientific and clinical conclusions when assessing survival time of breast cancer patients.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.584-597
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• 2023

Purpose: This study aimed to investigate the impact of different types of complications on long-term survival following total gastrectomy for gastric cancer. Materials and Methods: A total of 926 patients who underwent total gastrectomy between 2008 and 2016 were included. Patients were divided into the morbidity and no-morbidity groups, and long-term survival was compared between the 2 groups. The prognostic impact of postoperative morbidity was assessed using a multivariate Cox proportional hazard model, which accounted for other prognostic factors. In the multivariate model, the effects of each complication on survival were analyzed. Results: A total of 229 patients (24.7%) developed postoperative complications. Patients with postoperative morbidity showed significantly worse overall survival (OS) (5-year, 65.0% vs. 76.7%, P<0.001) and cancer-specific survival (CSS) (5-year, 74.2% vs. 83.1%, P=0.002) compared to those without morbidity. Multivariate analysis adjusting for other prognostic factors showed that postoperative morbidity remained an independent prognostic factor for OS (hazard ratio [HR], 1.442; 95% confidence interval [CI], 1.136-1.831) and CSS (HR, 1.463; 95% CI, 1.063-2.013). There was no significant difference in survival according to the severity of complications. The following complications showed a significant association with unfavorable long-term survival: ascites (HR, 1.868 for OS, HR, 2.052 for CSS), wound complications (HR, 2.653 for OS, HR, 2.847 for CSS), and pulmonary complications (HR, 2.031 for OS, HR, 1.915 for CSS). Conclusions: Postoperative morbidity adversely impacted survival following total gastrectomy for gastric cancer. Among the different types of complications, ascites, wound complications, and pulmonary complications exhibited significant associations with long-term survival.

• Journal of Gastric Cancer
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• v.14 no.4
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• pp.266-270
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• 2014

Purpose: Palliative gastrectomy and chemotherapy are important options for peritoneal seeding of gastric cancer. The treatment stage IV gastric cancer patient who respond to induction chemotherapy, is converted to gastrectomy (conversion therapy or conversion surgery). This study explored the clinical outcomes of gastric cancer patients with peritoneal seeding who had undergone conversion therapy. Materials and Methods: Between 2003 and 2012, gastric cancer patients with peritoneal seeding, as determined by preoperative or intraoperative diagnosis were reviewed retrospectively. Clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. Results: Forty-three patients were enrolled. Eighteen patients had undergone conversion surgery and 25 patients continued conventional chemotherapy. Among the 18 conversion patients, 10 received clinically curative resection. The median follow-up period was 28.5 months (range 8 to 60 months) and the total 3-year survival rate was 16.3%. The median survival time of the patients who received clinically curative conversion therapy was 37 months, and the 3-year survival rate was 50%. The median follow-up for non-curative gastrectomy patients was 18 months. No patient treated using chemotherapy survived to 3 years; the median survival time was 8 months. The differences in survival time between the groups was statistically significant (P<0.001). Conclusions: In terms of survival benefits for gastric cancer patients with peritoneal seeding, clinically curative conversion therapy resulted in better clinical outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1579-1582
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• 2012

Objective: To assess differences in serum proteins in esophageal squamous cell carcinoma patients. Methods: 144 esophageal squamous cell carcinoma patients and 50 healthy volunteers were included in this study, with surface-enhanced laser desorption-ionization time-of-flight mass spectrometry and weak cation exchange magnetic beads. Follow-up allowed the relations between serum proteins and prognosis to be analyzed. Results: A total of 93 protein peaks were detected (molecular weight range: 1500-30000), 10 demonstrating statistically significant differences. There were no differences in protein peaks between 92 patients with a survival more than 2 years and 52 patients with survival less than 2 years. There were two significantly different protein peaks between 45 stage II patients with a survival more than 2 years and 14 stage II patients with survival less than 2 years. There was one significantly different protein peak between 22 stage III patients with a survival more than 2 years and 29 stage III patients with survival less than 2 years. Conclusion: Differences of serum proteins in esophageal squamous cell carcinoma are related to prognosis of patients. The protein fingerprint can be helpful for clinical diagnosis and treatment.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.686-695
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• 1993

A total of eighty one patients with resected stage II and IIIA non-small cell lung cancer treated with postoperative adjuvant radiation therapy between Jan. 1971 and Dec. 1990 were retrospectively analysed to evaluate whether postoperative radiation therapy improves survival. Patterns of failure and prognostic factors were also analysed. The 5 year overall and disease free survival rate were 40.5%, 43.4% and median survival 30 months. The 5 year actuarial survival rates by stage II and IIIA were 53.9% and 36.2%. Loco-regional failure rate was 14.7% and distant metastasis rate was 33.3% and both 4%. Statistically significant prognostic factor affecting survival was presence of mediastinal lymph node metastasis[N2]. This retrospective study suggests that postoperative radiation therapy in resected stage II and IIIA non-small cell lung cancer can reduce loco-regional recurrence and may improve survival rate as compared with other studies which were treated by surgery alone.