• 제목/요약/키워드: overall survival rate

검색결과 1,140건 처리시간 0.041초

외상환자 중증도 평가도구의 타당도 평가 - ICISS 사망확률과 전문가의 예방가능한 사망에 대한 판단간의 일치도 - (Validation of the International Classification of Diseases l0th Edition Based Injury Severity Score(ICISS) - Agreement of ICISS Survival Probability with Professional Judgment on Preventable Death -)

  • 김윤;안형식;이영성
    • 보건행정학회지
    • /
    • 제11권1호
    • /
    • pp.1-18
    • /
    • 2001
  • The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.

  • PDF

Cranioplasty Using Autologous Bone versus Porous Polyethylene versus Custom-Made Titanium Mesh : A Retrospective Review of 108 Patients

  • Kim, Jun-Ki;Lee, Sang-Bok;Yang, Seo-Yeon
    • Journal of Korean Neurosurgical Society
    • /
    • 제61권6호
    • /
    • pp.737-746
    • /
    • 2018
  • Objective : The purpose of this study was to compare the cosmetic outcome and complications after cranioplasty (CP) due to three different implant materials, and analyze the mean implant survival and cumulative survival rate based on these results. Methods : We reviewed 108 patients retrospectively who underwent CP between January 2014 and November 2016. Autologous bone (AB; 45 patients) and synthetic materials with porous polyethylene (PP; 32 patients) and custom-made 3-dimensional printed titanium mesh (CT; 31 patients) were used as implants. Results : Regardless of implanted materials, more than 89.8% of the CP patients were satisfied with the cosmetic outcome. No statistically significant difference was observed among the three groups. The overall postoperative complication rates of each group were 31.1% in the AB group, 15.6% in the PP group and 3.2% in the CT group. The CT group showed lower complication rates compared with AB and PP groups (${\chi}^2$-test : AB vs. PP, p=0.34; AB vs. CT, p=0.00; PP vs. CT, p=0.03). The AB and PP groups demonstrated a higher post-CP infection rate (11.1% and 6.3%) than the CT group (3.2%). However, no significant difference in the incidence of post-CP infection was observed among the three groups. The PP and CT groups demonstrated a higher mean implant survival time and cumulative survival rate than the AB group at the last follow-up (p<0.05). Conclusion : In comparison with AB and PP, cranioplasty with CT shows benefits in terms of lower post-CP complication, less intraoperative bleeding loss, shorter operation time and in-hospital stay. The PP and CT groups showed higher implant survival time and cumulative survival rate compared with the AB group.

Comparison of survival rates between patients treated with conventional radiotherapy and helical tomotherapy for head and neck cancer

  • Kong, Moonkyoo;Hong, Seong Eon;Choi, Jinhyun;Kim, Youngkyong
    • Radiation Oncology Journal
    • /
    • 제31권1호
    • /
    • pp.1-11
    • /
    • 2013
  • Purpose: Compared to conventional radiotherapy (RT), intensity-modulated radiotherapy (IMRT) significantly reduces the rate of treatment-induced late toxicities in head and neck cancer. However, a clear survival benefit of IMRT over conventional RT has not yet been shown. This study is among the first comparative study to compare the survival rates between conventional RT and helical tomotherapy in head and neck cancer. Materials and Methods: From January 2008 to November 2011, 37 patients received conventional RT and 30 patients received helical tomotherapy for management of head and neck cancer. We retrospectively compared the survival rates between patients treated with conventional RT and helical tomotherapy, and analyzed the prognostic factors for survival. Results: The 1- and 2-year locoregional recurrence-free survival rates were 61.2% and 58.1% for the conventional RT group, 89.3% and 80.3% for the helical tomotherapy group, respectively. The locoregional recurrence-free survival rates of the helical tomotherapy group were significantly higher than conventional RT group (p = 0.029). There were no significant differences in the overall and distant metastasis-free survival between the two groups. RT technique, tumor stage, and RT duration were significant prognostic factors for locoregional recurrence-free survival. Conclusion: This study showed the locoregional recurrence-free survival benefits of helical tomotherapy in the treatment of head and neck cancers.

Efficacy of High Dose Radiotherapy in Post-operative Treatment of Glioblastoma Multiform - A Single Institution Report

  • Pashaki, Abdolazim Sedighi;Hamed, Ehsan Akbari;Mohamadian, Kamal;Abassi, Mohammad;Safaei, Afsane Maddah;Torkaman, Tayebe
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권6호
    • /
    • pp.2793-2796
    • /
    • 2014
  • Background: Glioblastoma multiform (GBM) is a highly aggressive tumor with median survival of approximately 14 months. Management consists of maximal surgical resection followed by post-operative chemoradiation with concurrent then adjuvant temozolamide. The standard radiotherapy dose is 60Gy in 2-Gy fractions recommended by the radiation therapy oncology group (RTOG). With the vast majority of tumor recurrences occurring within the previous irradiation field and the poor outcome associated with standard therapy, regimens designed to deliver higher radiation doses to improve local control and enhance survival are needed. In this study, we report a single institutional experience in treatment of 68 consecutive patients with GBM, treated with resection, and given post-operative radiotherapy followed by concurrent and/or adjuvant chemotherapy. Results: Of the 80 patients who entered this study, 68 completed the treatment course; 45 (66.2%) males and 23 (33.8%) females with a mean age at diagnosis of $49.0{\pm}12.9$ (21-75) years. At a median follow up of 19 months, 39 (57.3%) patients had evidence of tumor progression and 36 (52.9%) had died. The median over all survival for all patients was 16 months and progression free survival for all patients was 6.02 months. All potential prognostic factors were analyzed to evaluate their effects on overall survival. Age ${\leq}50$ year, concurrent and adjuvant chemotherapy and extent of surgery had significant p values. We found lower progression rate among patients who received higher doses of radiotherapy (>60Gy). Higher radiation doses improved progression free survival (p=0.03). Despite increasing overall survival, this elevation was not significant. Conclusions: This study emphasize that higher radiation doses of (>60Gy) can improve local control and potentially survival, so we strongly advise prospective multi centric studies to evaluate the role of higher doses of radiotherapy on GBM patient outcome.

Elective neck dissection versus observation in early stage oral squamous cell carcinoma: recurrence and survival

  • Kim, Dong Wook;Lee, Ba-Da;Lim, Jung Hwan;Park, Jung-Hyun;Nam, Woong;Kim, Hyung Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제42권6호
    • /
    • pp.358-364
    • /
    • 2016
  • Objectives: To evaluate the results of elective neck dissection versus those of observation in the treatment of early stage oral squamous cell carcinoma and to identify factors related to recurrence and survival. Materials and Methods: This was a retrospective study of 52 patients who underwent elective neck dissection and 27 who did not receive neck dissection. Results: In survival analyses, elective neck dissection showed a benefit in overall recurrence (P=0.027), especially in stage I patients (P=0.024). With regard to survival, the benefit was statistically insignificant (P=0.990). In multivariable analysis, overall recurrence was independently related to poor histologic grade (odds ratio [OR]=9.65, P=0.006), and cancer-specific death was independently related to advanced age (OR=6.3, P=0.022), higher clinical T stage (OR=15.2, P=0.01), and poorly differentiated histologic grade (OR=6.6, P=0.025). Conclusion: Though there was lower recurrence in the elective neck dissection group, there were no statistically significant results on survival. The characteristics of the tumor itself, such as clinical T stage and poor histologic grade, may be more important in cancer-specific survival.

Lack of any Association between Season of Diagnosis and Survival of Gastric Cancer Cases in Kayseri, Turkey

  • Unal, Dilek;Oguz, Arzu;Acmaz, Banu;Goksu, Sema Sezgin;Arslan, Alaettin;Eroglu, Celalettin
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권4호
    • /
    • pp.1763-1766
    • /
    • 2014
  • Background: The influence of season of diagnosis on cancer survival has been an interesting issue for many years. Most studies have shown a possible association between seasonality and survival in some cancers. We aimed to investigate whether there is an association between season of diagnosis and survival in patients with gastric cancer. Materials and Methods: We reviewed retrospectively the files of 279 histologically proven gastric cancer patients. According to diagnosis date, the patients were grouped into 4 seasons of diagnosis groups, spring, summer, autumn, and winter. Results: There was no significant differences when the overall survival rates of the patients were compared according to the patients' season of diagnosis (p: 0.871). Median overall survival rates were 22.0 (14.5-29.5) months for the patients who were diagnosed in spring, 24.0 (12.4-35.6) for summer, 18.0 (9.96-26.0) for autumn and 21.0 (16.3-25.7) for winter. Median disease-free survival rates were 66.0 (44.1-68.1) months for the patients who were diagnosed in spring, 28.0 (17.0-39.0) for summer, 22.0 (0-46.4) for autumn and 23.0 (17.5-28.5) for winter. While the rate was best for the patients diagnosed in spring the differences were not statistically significant (p= 0.382). Conclusions: On the basis of the above results the season was not suggested as contributing to prognosis in gastric cancer cases in Kayseri, Turkey.

주 타액선 종양 315예의 임상적 고찰 (A Clinical Review on 315 Cases of Major Salivary Gland Tumor)

  • 채명석;백낙환;김상효
    • 대한두경부종양학회지
    • /
    • 제15권2호
    • /
    • pp.205-210
    • /
    • 1999
  • Objectives: Major salivary gland tumor mainly develops in the parotid gland and pleomorphic adenoma is a large percentage. The aim of this study is to get clinicopathologic characteristics of overall major salivary gland tumors and suggestions regarding surgical management through collective review of 315 cases. Materials and Methods: This is a clinicopathologic review of 315 cases of major salivary gland tumor who were treated surgically at Department of Surgery, Head and Neck Clinic, Pusan Paik Hospital, Inje University during the period of 18 years from 1980 to 1997. Analysis was performed regarding the incidence, classification, surgery and its complications, and survival rate of salivary gland cancer. Results : 1) Parotid gland was the most prevalent site of salivary gland tumor(78%) and submandibular gland(21%) was next in order. Benign tumors were 257cases(81%) and malignant tumors were 58 cases(19%). 2) Male to female sex ratio was 1:1.2, the most prevalent age group was 3rd decade and the second group was 4th decade. 3) Histopathologically, the most common benign salivary gland tumor was pleomorphic adenoma. Warthin's tumor was next common. Among the malignant tumors, mucoepidermoid carcinoma was most common, and the next were adenoid cystic carcinoma and acinic cell carcinoma. 4) In pleomorphic adenoma, superficial parotidectomy was performed in 129 cases, and extracapsular tumorectomy was performed in 3 cases. In non-pleomorphic benign tumor, tumorectomy was performed in 21 cases. In 40 cases of deep lobe tumor, total parotidectomy was performed in only 2 cases and deep parotidectomy was performed in 38 cases. 5) Surgical complications were facial nerve injury 19 cases, Frey syndrome 13 cases, and salivary fistula 3 cases. 6) Overall 5-year survival rate of salivary gland cancer was 63%. Conclusion: Postoperative recurrence rate is low in benign tumor, but high in cancer of salivary gland tumor. Surgical procedure should not be aggressive in benign tumor, especially in parotid tumor, but should be aggressive in malignant salivary gland tumors.

  • PDF

원발성 상악동 암의 방사선 치료 (Radiotherapy of Carcinoma of Maxillary Antrum)

  • 문창우;정태식;염하용
    • Radiation Oncology Journal
    • /
    • 제12권1호
    • /
    • pp.51-58
    • /
    • 1994
  • 1980년 6월부터 1986년 12월까지 고신의료원 치료방사선과에서 방사선 치료를 받았던 상악동 암환자 79예에서 생존율과 치료실패에 대해 후향적으로 비교 분석하였다. 43예에서는 방사선 단독 치료를 하였고, 36예에서는 수술과 방사선 치료를 병용 하였다. 전체 환자들의 5년 생존율은 32$ \% $ 였으며 방사선 단독 치료만을 받았던 환자들의 5년 생존율은 23$ \% $였으며 수술과 방사선 치료를 병용한 환자들의 5년 생존율은 42$ \% $였다. 전체 환자 79예중 54예 (68.3$ \% $ )였고 국소치료 실채 및 원격전이가 동시에 나타난 경우가 16예(29.6$ \% $ )였으며 원격전이 단독으로 인한 경우가 1예였다. 상기와 같은 치료결과에서 상악동 암의 국소치료율을 높이고 생존율을 증가시키기 위해서는 방사선 단독 치료보다는 수술과 방사선 치료의 병용 요법이 필요할 것으로 사료된다.

  • PDF

육상수조에서 돌기해삼, Stichopus japonicus의 성장 및 생존율 (Survival and Growth of Sea Cucumber(Stichopus japonicus in Indoor Tank)

  • 김철원;허준욱
    • 현장농수산연구지
    • /
    • 제20권1호
    • /
    • pp.97-105
    • /
    • 2018
  • 돌기해삼의 성장과 생존에 가장 효과적이며 경제성이 있는 사육밀도를 조사하였는데 체중 성장은 250, 350과 500 개체/m2 실험구에서 각각 31.9±18.3g, 26.8±14.6g과 21.5±16.4g으로 성장하였고, 실험 시작할 때 보다 250마리/m2 실험구는 약 5.1배, 350마리/m2 실험구는 약 4.3배 및 500마리/m2 실험구에서는 3.5배의 성장을 보여 수용밀도가 낮을수록 빠른 성장을 보였다. 생존율은 250마리/m2 실험구는 50.1%로 가장 높게 나타났으며 350마리/m2 실험구는 47.6% 그리고 500마리/m2 실험구에서는 44.2%로 낮게 나타났다. 실험기간동안 성장과 생존율은 사육밀도가 낮을수록 높아지는 것으로 나타났으며 일정시기와 일정크기에 따른 선별이 필요할 것으로 판단된다.

Can Induction Chemotherapy before Concurrent Chemoradiation Impact Circumferential Resection Margin Positivity and Survival in Low Rectal Cancers?

  • Bhatti, Abu Bakar Hafeez;Waheed, Anum;Hafeez, Aqsa;Akbar, Ali;Syed, Aamir Ali;Khattak, Shahid;Kazmi, Ather Saeed
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권7호
    • /
    • pp.2993-2998
    • /
    • 2015
  • Background: Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Materials and Methods: Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Results: Patients in the IC group presented with advanced stage (Stage 3=89.2% versus 75.4%) (P=0.02) but a high rate of total mesorectal excision (TME) (100% versus 93.4%) (P=0.01) and sphincter preservation surgery (54.9 % versus 22.9%) (P=0.001). Patients with low rectal cancer who received IC had a significantly low positive CRM rate (9.2% versus 34%) (P=0.002). Actuarial 5 year DFS in IC and no IC groups were 39% and 43% (P=0.9) and 5 year OS were 70% and 47% (P=0.003). Pathological tumor size [HR: 2.2, CI: 1.1-4.5, P=0.01] and nodal involvement [HR: 2, CI: 1.08-4, P=0.02] were independent predictors of relapse while pathological nodal involvement [HR: 2.6, CI: 1.3-4.9, P=0.003] and IC [HR: 0.7, CI: 0.5-0.9, P=0.02] were independent predictors of death. Conclusions: In low rectal cancer, induction chemotherapy before CRT may significantly decrease CRM positivity and improve 5 year overall survival.