• Title/Summary/Keyword: log rank test

Search Result 243, Processing Time 0.021 seconds

Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.18 no.1
    • /
    • pp.7-13
    • /
    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Surgical Treatment of Pulmonary Metastases (전이성 폐암의 외과적 치료)

  • Kang, Jeong-Ho;Ro, Sun-Kyun;Chung, Won-Sang;Kim, Hyuck;Ban, Dong-Gyu;Kim, Young-Hak
    • Journal of Chest Surgery
    • /
    • v.40 no.2 s.271
    • /
    • pp.103-108
    • /
    • 2007
  • Background: Surgical resection is an important modality in the treatment of pulmonary metastases from various solid tumors. We analyzed 37 patients who underwent surgical treatments of pulmonary metastases in our hospital from 1996 to 2005. Material and Method: Age, sex, disease free interval, operative procedure, the number of pulmonary metastases, and lymphatic metastasis were investigated with admission and operative records, and pathologic reports. Actuarial survival and comparisons between each survival rate were calculated according to Kaplan-Meier method and log-rank test, respectively, Result: Complete resections were carried out in 34 of 37 patients. The primary tumor was carcinoma in 25 cases, sarcoma in 10, and others in 2. The number of pulmonary metastases was 1 in 25 cases and 2 or more in 12 cases. 3-year and 5-year survival rates after complete resection were 50.5% and 35.9%, respectively. 3-year and 5-year survival rates for carcinoma were 64.5% and 45.0%, respectively, and 3-year survival rate for sarcoma was 17.5%. Otherwise, none of the operative procedures, the number of pulmonary metastases, lymphatic metastasis, adjunctive therapy and the disease free interval in the case of carcinoma significantly affected the survival rates. Conclusion: Complete resection of pulmonary metastasis in well selected patients allows high long term survival rate with low mortality and morbidity. Long-term follow up and randomized prospective studies were necessary to determine the prognostic factors of pulmonary metastases after surgical resection.

Locally Advanced, Unresectable Pancreatic Cancer Treated by Stereotactic Radiation Therapy (국소적으로 진행된, 절제 불가능한 췌장암에서 정위 방사선 치료)

  • Choi Chul-Won;Kim Mi-Sook;Cho Chul-Koo;Yoo Seong-Yul;Yang Kwang-Mo;Yoo Hyung-Jun;Lee Dong-Han;Ji Young-Hoon;Han Chul-Ju;Kim Jin;Kim Young-Han
    • Radiation Oncology Journal
    • /
    • v.24 no.1
    • /
    • pp.11-20
    • /
    • 2006
  • Puroose: In order to find out whether stereotactic radiation therapy (RT) using CyberKnife (CK) could improve survival rate and lower acute toxicity compared to conventional RT. Materials and Methods: From April 2003 through April 2004, 19 patients with Eastern Cooperative Oncology Group (ECOG) performance status ${\leq}3$ and locally advanced pancreas cancer without distant metastasis, evaluated by CT or PET/CT, were included. We administered stereotactic RT consisting of either 33 Gy, 36 Gy or 39 Gy in 3 fractions to 6, 4 and 9 patients, respectively, in an effort to increase the radiation dose step by step, and analyzed the survival rate and gastrointestinal toxicities by the acute radiation morbidity criteria of Radiation Therapeutic Oncology Group (RTOG). Prognostic factors of age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9, planning target volume (PTV), and adjacent organ and vessel invasion on CT scan were evaluated by Log Rank test. Results: The median survival time was 11 months with 1-year survival rate of 36.8%. During follow-up period (range $3{\sim}20$ months, median 10 months), no significant gastrointestinal acute toxicity (RTOG grade 3) was observed. In univariate analysis, age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9 level, and adjacent organ and vessel invasion did not show any significant changes of survival rate, however, patients with PTV (80 cc showed more favorable survival rate than those with PTV>80 cc (p-value<0.05). In multivariate analysis, age younger than 65 years and PTV>80 cc showed better survival rate. Conclusion: In terms of survival, the efficacy of stereotactic radiation therapy using CK was found to be superior or similar to other recent studies achieved with conventional RT with intensive chemotherapy, high dose conformal RT, intraoperative RT (IORT), or intensity modulated RT (IMRT). Furthermore, severe toxicity was not observed. Short treatment time in relation to the short life expectancy gave patients more convenience and, finally, quality of life would be increased. Consequently, this could be regarded as an effective novel treatment modality for locally advanced, unresectable pancreas cancer. PTV would be a helpful prognostic factor for CK.

Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area (구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구)

  • Chae, Hyun-Seok;Wang, Yuan-Kun;Lee, Jung-Jin;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.57 no.4
    • /
    • pp.342-349
    • /
    • 2019
  • Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

Estrogenic Activity of Persistent Organic Pollutants and Parabens Based on the Stably Transfected Human Estrogen Receptor-α Transcriptional Activation Assay (OECD TG 455)

  • Kim, Tae-Sung;Kim, Chang-Yeong;Lee, Hae-Kyung;Kang, Il-Hyun;Kim, Mi-Gyeong;Jung, Ki-Kyung;Kwon, Yong-Kwan;Nam, Hye-Seon;Hong, Soon-Keun;Kim, Hyung-Sik;Yoon, Hae-Jung;Rhee, Gyu-Seek
    • Toxicological Research
    • /
    • v.27 no.3
    • /
    • pp.181-184
    • /
    • 2011
  • Screening of estrogenic activity on dichloro diphenyl trichloroethane (DDT), dichloro diphenyl dichloro ethylene (DDE), dieldrin, heptachlor, aldrin, chlordane, lindane, polybrominated diphenyl ethers (PBDE) and parabens was compared using Organization for Economic Cooperation and Development (OECD) test guideline 455 (TG455). The estrogenic activity of DDT was 58,000-fold ($PC_{50}$, $1.67{\times}10^{-6}$ M) less than $17{\beta}$-estradiol($E_2$) ($PC_{50}$, $2.88{\times}10^{-11}$ M) but DDE, dieldrin, heptachlor, aldrin, chlordane, lindane and PBDE did not show any estrogenic activity in this assay system. In the case of paraben compounds, the rank of relative transcriptional activation (logRTA) was butyl paraben -1.63752 ($PC_{50}$, $1.25{\times}10^{-7}$ M) > isobutyl paraben -2.34008 ($PC_{50}$, $6.3{\times}10^{-7}$ M) > ethyl paraben -2.64016 ($PC_{50}$, $1.26{\times}10^{-6}$ M) > isopropyl paraben -2.73993 ($PC_{50}$, $1.58{\times}10^{-6}$ M) > propyl paraben -2.84164 ($PC_{50}$, $2.0{\times}10^{-6}$ M). Our data suggest that OECD test guideline TG455 may be useful as a screening tool for potential endocrine disruptors.

A Treatment Outcomes and Prognostic Factors of Malignant Submandibular Gland Tumor (악하선 암의 치료성적과 예후인자)

  • Lim Chi-Young;Nam Kee-Hyun;Lee Jan-Dee;Chang Hang-Seok;Chung Woong-Youn;Cha In-Ho;Lee Chang-Geol;Choi Eun-Chan;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.21 no.2
    • /
    • pp.201-207
    • /
    • 2005
  • Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
    • /
    • v.19 no.4
    • /
    • pp.327-334
    • /
    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

  • PDF

Prognostic Factors Influencing the Result of Postoperative Radiotherapy in Endometrial Carcinoma (자궁내막암의 수술 후 방사선치료 결과에 영향을 미치는 예후인자)

  • Ki Yong-Kan;Kwon Byung-Hyun;Kim Won-Taek;Nam Ji-Ho;Yun Man-Su;Lee Hyung-Sik;Kim Dong-Won
    • Radiation Oncology Journal
    • /
    • v.24 no.2
    • /
    • pp.110-115
    • /
    • 2006
  • Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

Prognostic Value of p53 Overexpression in Patients with Pathologic Stage I Non-small Cell Lung Cancer (제 1기 비소세포폐암 환자에서 p53 과발현과 예후의 관계)

  • Um, Sang-Won;Kim, Hojoong;Kwon, O Jung;Han, Joungho;Shim, Young Mog
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.6
    • /
    • pp.487-494
    • /
    • 2008
  • Background: Chromosome 17p allele losses and mutations of p53 gene are the most common genetic abnormalities in lung cancer. The purposes of this study were to evaluate the factors associated with p53 protein overexpression and to evaluate its prognostic value in patients with pathologic stage I non-small cell lung cancer (NSCLC). Methods: This is a retrospective review for the patients who underwent surgical resection at Samsung Medical Center between Jan 2003 and Jun 2004. Immunohistochemical staining for p53 protein was performed on tumor tissues from patients with lung cancer. The p53 overexpression was evaluated in relation to age, sex, smoking history, histology and pathologic stage by univariate and multivariate analyses. The disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) were analyzed using the Kaplan-Meier methods and the differences in DFS, DSS and OS were assessed by using the log-rank tests. Results: A total of 125 patients were included in the analysis and a median frequency of p53 expression in tumor tissue was 10%. The p53 overexpression (${\geq}10%$) was more common in squamous cell carcinoma (66%) than in adenocarcinoma (38%, p=0.002). The p53 overexpression was more common in pathologic stage IB (59%) than in IA (38%, p=0.002). Patients with p53-overexpressing tumor (27 years) smoked more years compared with those without it (20 years, p=0.032). Smoking history ${\geq}25$ pack-years was more common in patients with p53 overexpression (58%) than in those without it (38%, p=0.024). In the multivariate analysis, only histology was significantly associated with p53 overexpression. However, there were no significant differences of DFS, DSS and OS in relation to p53 status. Conclusion: The p53 overexpression was associated with histology, pathologic stage and smoking history in patients with pathologic stage I NSCLC. However, the p53 overexpression was not associated with patient's survival.

Comparison of Efficacy and Toxicity of First Line Chemotherapy with or without Epirubicin for Patients with Advanced Stage Soft Tissue Sarcoma

  • Cao, Jie;Huang, Xin-En;Liu, Jin;Wu, Xue-Yan;Lu, Yan-Yan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.12
    • /
    • pp.7171-7177
    • /
    • 2013
  • Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.