• Title/Summary/Keyword: hazard ratio

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Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

  • Ma, K.K.;Chau, Wai Wang;Wong, Connie H.N.;Wong, Kerry;Fung, Nicholas;Lee, J.T. Andrea;Choi, L.Y. Catherine;Suen, Dacita T.K.;Kwong, Ava
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2109-2114
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    • 2012
  • Background: Ethnic variation in tumor characteristics and clinical presentation of breast cancer is increasingly being emphasized. We studied the tumor characteristics and factors which may influence the presentation and prognosis of triple negative breast cancers (TNC) in a cohort of Chinese women. Methods: A prospective cohort of 1800 Chinese women with breast cancer was recruited in a tertiary referral unit in Hong Kong between 1995 and 2006 and was followed up with a median duration of 7.2 years. Of the total, 216 (12.0%) had TNC and 1584 (88.0%) had non-TNC. Their clinicopathological variables, epidemiological variables and clinical outcomes were evaluated. Results: Patients with TNC had similar age of presentation as those with non-TNC, while presenting at earlier stages (82.4% were stage 1-2, compared to 78.4% in non-TNC, p=0.035). They were likely to be associated with grade 3 cancer (Hazard Ratio(HR)=5.8, p<0.001). TNC showed higher chance of visceral relapse (HR=2.69, p<0.001), liver metastasis (HR=1.7, p=0.003) and brain metastasis (HR=1.8, p=0.003). Compared with non-TNC group, TNC had similar 10-year disease-free survival (82% vs 84%, p=0.148), overall survival (78% vs 79%, p=0.238) and breast cancer-specific mortality (18% vs 16%, p=0.095). However, TNC showed poorer 10-year stage 3 and 4 specific survival (stage 3: 53% vs. 67%, p=0.010; stage 4: 0% vs. 40%, p=0.035). Conclusions: Chinese women with triple negative breast cancer do not have less aggressive biological behavior compared to the West and presentation at a later stage results in worse prognosis compared with those with non triple negative breast cancer.

Gamma Knife Radiosurgery for Brain Metastases from Breast Cancer

  • Jo, Kyung Il;Im, Young-Hyuck;Kong, Doo Sik;Seol, Ho Jun;Nam, Do-Hyun;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.54 no.5
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    • pp.399-404
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    • 2013
  • Objective : The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods : Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan- Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results : Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) ${\geq}70$ (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were $89.5{\pm}4.5%$ and $70.5{\pm}6.9%$ at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (${\leq}3$) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion : The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery.

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

  • Ni, Xiao-Chun;Yi, Yong;Fu, Yi-Peng;He, Hong-Wei;Cai, Xiao-Yan;Wang, Jia-Xing;Zhou, Jian;Fan, Jia;Qiu, Shuang-Jian
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10713-10718
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    • 2015
  • Purpose: To investigate the prognostic value of serum amyloid A (SAA) in patients with hepatocellular carcinoma (HCC) undergoing surgery. Materials and Methods: Preoperative serum samples of 328 patients with HCC who underwent curative resection and of 47 patients with benign liver lesion were assayed. Serum levels of SAA were measured by enzyme-linked immunosorbent assay and its correlations with clinicopathological characteristics and survival were explored. Results: Levels of SAA were significantly higher in patients with HCC than those with benign liver lesion. There were strong correlations between preoperative serum SAA level and tumor size and more advanced BCLC stage. On univariate analysis, elevated SAA was associated with reduced disease-free survival and overall survival (p=0.001 and 0.03, respectively). Multivariate analyses showed that serum SAA level was an independent prognostic factor for overall survival (hazard ratio 2.80, p=0.01). Conclusions: High SAA serum level is a novel biomarker for the prognosis of HCC patients.

Lack of Effects of HER-2/neu on Prognosis in Colorectal Cancer: a Meta-analysis

  • Han, Jun;Meng, Qing-Yang;Liu, Xiao;Xi, Qiu-Lei;Zhuang, Qiu-Lin;Wu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5551-5556
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    • 2014
  • Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.

Prognostic Impact of Histology in Patients with Cervical Squamous Cell Carcinoma, Adenocarcinoma and Small Cell Neuroendocrine Carcinoma

  • Intaraphet, Suthida;Kasatpibal, Nongyao;Siriaunkgul, Sumalee;Sogaard, Mette;Patumanond, Jayanton;Khunamornpong, Surapan;Chandacham, Anchalee;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5355-5360
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    • 2013
  • Background: Clarifying the prognostic impact of histological type is an essential issue that may influence the treatment and follow-up planning of newly diagnosed cervical cancer cases. This study aimed to evaluate the prognostic impact of histological type on survival and mortality in patients with cervical squamous cell carcinoma (SCC), adenocarcinoma (ADC) and small cell neuroendocrine carcinoma (SNEC). Materials and Methods: All patients with cervical cancer diagnosed and treated at Chiang Mai University Hospital between January 1995 and October 2011 were eligible. We included all patients with SNEC and a random weighted sample of patients with SCC and ADC. We used competing-risks regression analysis to evaluate the association between histological type and cancer-specific survival and mortality. Results: Of all 2,108 patients, 1,632 (77.4%) had SCC, 346 (16.4%) had ADC and 130 (6.2%) had SNEC. Overall, five-year cancer-specific survival was 60.0%, 54.7%, and 48.4% in patients with SCC, ADC and SNEC, respectively. After adjusting for other clinical and pathological factors, patients with SNEC and ADC had higher risk of cancer-related death compared with SCC patients (hazard ratio [HR] 2.6; 95% CI, 1.9-3.5 and HR 1.3; 95% CI, 1.1-1.5, respectively). Patients with SNEC were younger and had higher risk of cancer-related death in both early and advanced stages compared with SCC patients (HR 4.9; 95% CI, 2.7-9.1 and HR 2.5; 95% CI, 1.7-3.5, respectively). Those with advanced-stage ADC had a greater risk of cancer-related death (HR 1.4; 95% CI, 1.2-1.7) compared with those with advanced-stage SCC, while no significant difference was observed in patients with early stage lesions. Conclusion: Histological type is an important prognostic factor among patients with cervical cancer in Thailand. Though patients with SNEC were younger and more often had a diagnosis of early stage compared with ADC and SCC, SNEC was associated with poorest survival. ADC was associated with poorer survival compared with SCC in advanced stages, while no difference was observed at early stages. Further tailored treatment-strategies and follow-up planning among patients with different histological types should be considered.

Nrf2 Overexpression Predicts Prognosis and 5-FU Resistance in Gastric Cancer

  • Hu, Xiu-Feng;Yao, Jun;Gao, She-Gan;Wang, Xin-Shuai;Peng, Xiu-Qing;Yang, Yan-Tong;Feng, Xiao-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5231-5235
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    • 2013
  • Objective: NF-E2-related factor 2 (Nrf2) is activated in several human malignancies. However, the role of Nrf2 in gastric cancer (GC) remains incompletely understood. In this study, we therefore analyzed associations of Nrf2 expression status with clinical features and chemotherapeutic resistance in GC. Materials and Methods: A total of 186 samples from GC patients who underwent gastrectomy were used for prognostic assessment. A further 142 samples from GC cases who received first-line combination chemotherapy were applied for investigation of chemoresistance. The Nrf2 expression was evaluated by immunohistochemistry in GC samples, and its relationship with clinicopathological parameters and chemotherapy sensitivity was analyzed. The effect of Nrf2 gene silencing on chemotherapy resistance was also examined by cell viability assay in vivo. Results: Of the 186 patients with GC, 104/186 (55.9%) showed high expression for Nrf2. The overexpression of Nrf2 was an independent predictor of overall survival [OS, hazard ratio (HR) 3.9; P=0.011] and disease-free survival (DFS, HR 4.3; P=0.002). The gene silencing of Nrf2 reduced resistance to cell death induced by 5-FU in GC cell lines. Conclusion: Our data show that Nrf2 is an independent prognostic factor in GC. Furthermore, Nrf2 confers resistance to chemotherapeutic drug 5-FU in GC cells. Taken together, Nrf2 is a potential prognostic marker and predictive for 5-FU resistance in GC.

A Study on the Dynamic Amplification Characteristics of the Domestic Seismic Observation Sites using Shear- and Coda-Wave (S파 및 Coda파를 이용한 국내 관측소지반의 동적 증폭특성에 관한 연구)

  • Kim, Jun-Kyoung
    • Tunnel and Underground Space
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    • v.19 no.5
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    • pp.432-439
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    • 2009
  • For more reliable estimation of seismic source, attenuation properties and dynamic ground property, site amplification function should be considered. Among various estimation methods, this study used the Nakamura's method (1989) for estimating site amplification characteristics. This method was originally applied to the surface waves of background noise and therefore there are some limitations in applying to general wave energy. However, recently this method has been extended and applied to the S wave energy successfully. This study applied the method to S wave and Coda wave energy, which is equivalent to the backscattered S wave energy. We used more than 60 observed ground motions from 5 earthquakes which were occurred recently, with magnitude range from 3.6 to 5.1. Each station showed characteristic site amplification property in low-, high- and resonance frequencies. Some of the stations showed as high as 4 times of site amplification in the range of specific frequencies, which may imply abnormal small scale geologic strata below the station or development of various trapped modes in the basin structure. Moreover, removal of site amplification can give us more reliable seismic source and attenuation parameters, addition to the seismic hazard estimation.

Studies on the Morphology of Smoke Particles for Each Type of Fire by Using Steady State Tube Furnace (등속공급 튜브연소로를 이용한 각 연소조건에서의 연기입자 형상 분석)

  • Goo, Jaehark
    • Fire Science and Engineering
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    • v.28 no.1
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    • pp.44-51
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    • 2014
  • Smoke from fire is a mixture of combustion gases and particles which include micro-droplets formed from condensed organic vapors and carbonaceous agglomerates. The inhalation of smoke particles causes adverse health effects, and it is prerequisite for the hazard and risk analysis of the smoke particles to know how they behaviour in the respiratory tract. The characteristics of the absorption and adsorption of toxic gases and the amount and location of the particle deposition within the respiratory tract that determine the adverse health effects are related to the morphology and the size distribution of smoke particles. In the present work, as a preliminary study for the adverse health effects of smoke particles, the morphologies of the smoke particles from combustible materials were investigated for each fire stage: smouldering, well-ventilated flaming, small under-ventilated flaming, fully-developed under-ventilated fire. The steady-state tube furnace method given in ISO/TS 19700 was used for the generation of smoke particles. The fire stages were controlled by changing furnace temperature and equivalent ratio. The morphologies were analyzed by using Transmission Electron Microscope (Bio-TEM) by collecting the particles on TEM grids put on each stage of a cascade impactor.

Characteristic of Auto Ignition Temperature due to the Mixture Ratio of Ethylene Glycol and Water (Ethylene Glycol과 물의 혼합비에 따른 자연발화온도 특성)

  • Kim, Jung-Hun;Choi, Jae-Wook
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.24-30
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    • 2016
  • Autoignition characteristic is an important factor of all combustible substances, and a critical determinant in assessing the effectiveness of fire hazard prevention. This study investigated the autoignition characteristic of mixtures of Ethylene Glycol and water using an ASTM D2155 type ignition temperature measuring apparatus. It was possible to get the minimum temperature as $434^{\circ}C$ from 100% Ethylene Glycol within range of $75{\sim}160{\mu}l$. A volume of $100{\sim}125{\mu}l$ of a mixed sample of Ethylene Glycol and water (80 : 20) was ignited at the same temperature ($434^{\circ}C$). Also it was possible to get the auto ignition temperature as $437^{\circ}C$ from a mixed sample of Ethylene Glycol and water (60 : 40) within range of $120{\sim}160{\mu}l$. The instantaneous ignition temperatures determined for $125{\mu}l$ of each of the three samples were $579^{\circ}C$, $595^{\circ}C$ and $611^{\circ}C$, respectively. Both auto ignition temperatures and instantaneous ignition temperatures were increased through the addition of water to the samples.

Geochemical Implication of Rare Earth Element Tetrad Effect from a Leucocratic Granite Gneiss in the Imweon Area, Gangwon Province, Korea (강원도 임원지역 우백질 화강편마암에 나타난 희토류원소 테트라드 효과의 지구화학적 의의)

  • Lee, Seung-Gu;Kim, Kun-Han;Song, Yong-Sun;Kim, Nam-Hoon;Park, Kye-Hun
    • The Journal of the Petrological Society of Korea
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    • v.16 no.1 s.47
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    • pp.27-37
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    • 2007
  • Here we discuss a geochemical characterisitc of rare earth element (REE) pattern of a Precambrain leucogranitic gneiss at Imweon, Gangwon Province, Korea. The outcrop includes biotite gneiss xenolith. The leucocratic granite gneiss contacting with biotite gneiss is pegmatitic. However, there is no evidence of contact metamorphism between biotite gneiss and leucocratic-pegmatitic granite gneiss. The leucocratic granite gneiss shows a specific phenomenon of M-type (convex curved) tetrad effect in chondrite-normalized REE patterns with large negative Eu anomaly. The degree of REE tetrad effect in the leucocratic-pegmatitic granitec gneiss is weak and shows partly W-type (concave curved) tetrad effect. The Eu anomaly of leucocratic granite gneiss has close relationship with the degree of tetrad effect as well as Ca/Sr ratio. Our results suggest that the REE tetrad effect from the leucocratic granite gneiss should be formed during differentiation process of granitic magma. We also confirmed that the weathering might affect Eu or Ce anomaly rather than the formation of REE tetrad effect in granitic rock.