• Title/Summary/Keyword: survival regression

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Prognostic Value of Serum Ferritin in Terminally Ill Cancer Patients (말기암환자에서 예후인자로서 혈청 Ferritin의 유용성)

  • Lee, Soo Hee;Choi, Youn Seon;Hwang, In Cheol;Yeom, Chang Hwan;Lee, June Yeong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.51-59
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    • 2015
  • Purpose: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. Methods: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. Results: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. Conclusion: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.

A 5-year retrospective clinical study of the Dentium implants

  • Lee, Jeong-Yol;Park, Hyo-Jin;Kim, Jong-Eun;Choi, Yong-Geun;Kim, Young-Soo;Huh, Jung-Bo;Shin, Sang-Wan
    • The Journal of Advanced Prosthodontics
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    • v.3 no.4
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    • pp.229-235
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    • 2011
  • PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

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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    • v.15 no.7
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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.

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

  • Fu, Si-Rui;Zhang, Ying-Qiang;Li, Yong;Hu, Bao-Shan;He, Xu;Huang, Jian-Wen;Zhan, Mei-Xiao;Lu, Li-Gong;Li, Jia-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3151-3156
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    • 2014
  • Background: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. Materials and Methods: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. Results: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. Conclusions: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.

Outcomes Based on Risk Assessment of Anastomotic Leakage after Rectal Cancer Surgery

  • Gong, Jian-Ping;Yang, Liu;Huang, Xin-En;Sun, Bei-Cheng;Zhou, Jian-Nong;Yu, Dong-Sheng;Zhou, Xin;Li, Dong-Zheng;Guan, Xin;Wang, Dong-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.707-712
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    • 2014
  • Purpose: Anastomotic leakage (AL) is associated with high morbidity and mortality, high reoperation rates, and increased hospital length of stay. Here we investigated the risk factors for AL after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Data for 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2003 to 2007 were prospectively collected. All patients experienced a total mesorectal excision (TME) operation. Clinical AL was defined as the presence of leakage signs and confirmed by diagnostic work-up according to ICD-9 codes 997.4, 567.22 (abdominopelvic abscess), and 569.81 (fistula of the intestine). Univariate and logistic regression analyses of 20 variables were undertaken to determine risk factors for AL. Survival was analysed using the Cox regression method. Results: AL was noted in 35 (7.6%) of 460 patients with rectal cancer. :Median age of the patients was 65 (50-74) and 161 (35%) were male. The diagnosis of AL was made between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate and multivariate analysis, age (p=0.004), gender (p=0.007), tumor site (p<0.001), preoperative body mass index (EMI) (p<0.001), the reduction of TSGF on 5th POD less than 10U/ml (p=0.044) and the pH value of pelvic dranage less than or equal to 6.978 on 3rd POD (p<0.001) were selected as 6 independent risk factors for AL. It was shown that significant differences in survival of the patients were AL-related (p<0.001), high ASA score related (p=0.036), high-level EMI related (p=0.007) and advanced TNM stage related

Initial Responses of Quercus serrata Seedlings and Forest Understory to Experimental Gap Treatments

  • Cho, Yong-Chan;Kim, Jun-Soo;Lee, Chang-Seok;Cho, Hyun-Je;Bae, Kwan-Ho
    • Journal of Ecology and Environment
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    • v.32 no.2
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    • pp.87-96
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    • 2009
  • Pinus thunbergii plantations in Pohang-si, Gyeongsangbuk-do, Korea, are of low ecological quality, with arrested succession and a high proportion of ruderal species. To improve the quality of the habitat, we created canopy gaps ($\sim42\;m^2$) and monitored changes in abiotic (light availability, canopy openness) and biotic (survival and growth of seedlings and understory communities) variables in 2007 and 2008 in plots that had received one of five types of treatment: cutting of canopy trees and removal of the understory (CU), cutting of canopy trees only (C), girdling of canopy trees and removal of the understory (GU), girdling of canopy trees (G) or control. Each treatment was applied to three replicate plots. Abiotic variables did not significantly differ among treatments. Survival rates of target species were slightly lower in the CU, G and control conditions. Based on logistic regression analysis, the only significant growth factor affecting survival was height growth. Positive effects of seedling height and leaf area growth on survival were also detected, but did not reach statistical significance. In treatment G, gradual improvement of overstory conditions and mitigation of competition by limitation of disturbance to the understory community were likely to have promoted seedling growth. There were no significant effects of gap treatments on changes in species abundance (cover and richness) and composition of understory between the study years. This result implies that the small gaps created in our study may be below the threshold size to affect understory growth. However, the results of this study are based on a short-term investigation of only two years. Long-term research is strongly recommended to clarify the effects of gap treatment on plant communities in afforested areas.

Retrospective Study on the Survival Rate of Preformed Metal Crowns in Permanent First Molars (제1대구치 기성금속관 생존율에 관한 후향적 연구)

  • Oh, Nayoung;Nam, Soonhyeun;Lee, Jaesik;Kim, Hyunjung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.140-147
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    • 2020
  • This study analyzed the longevity of preformed metal crowns (PMCs) in first permanent molars and evaluated factors influencing their survival during a long-term follow-up period. In all, 115 first permanent molars treated with PMCs between June 2008 and June 2018 were retrospectively analyzed. The overall combined success rate for the study group was 84.3%. The 5-year survival rate was 82.8%. Multivariate Cox regression analyses identified distal cavities and mandibular PMC placement as risk factors for restoration failure. Careful placement of PMCs at the final try-in stage augments the longevity of the crown.

Decreased Expression of LKB1 Correlates with Poor Prognosis in Hepatocellular Carcinoma Patients Undergoing Hepatectomy

  • Huang, Yue-Han;Chen, Zhen-Kun;Huang, Ka-Te;Li, Peng;He, Bin;Guo, Xu;Zhong, Jun-Qiao;Zhang, Qi-Yu;Shi, Hong-Qi;Song, Qi-Tong;Yu, Zheng-Ping;Shan, Yun-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1985-1988
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    • 2013
  • Aim: To study any correlation of LKB1 expression with prognosis in hepatocellular carcinoma (HCC) cases. Methods: A total of 70 HCC patients and 20 primary intrahepatic stone patients in the first affiliated hospital of Wenzhou Medical College were enrolled in this study. LKB1 expression was detected by immunohistochemistry. Patients were followed-up and prognostic factors were evaluated. Result: LKB1 expression was decreased in the HCC samples. Loss of LKB1 expression in HCC was significantly related to histologic grade (P=0.010), vascular invasion (P=0.025) and TMN stage (P=0.011). Patients showing negative LKB1 expression had a significantly shorter disease-free and overall survival than those with positive expression (P = 0.001, P=0.000, respectively). Multivariate Cox regression analysis indicated that LKB1 expression level was an independent factor of survival (P = 0.033). Conclusion: HCC patients with decreased expression LKB1 have a poor prognosis. The loss of LKB1 expression is correlated with a lower survival rate.

Prognostic Factors Influencing Survival and Success Rates of Autotransplanted Maxillary Canine (자가이식한 상악 견치의 생존율과 성공률에 영향을 주는 예후 인자 연구)

  • Kim, Dong-Hyun;Hyun, Hong-Keun;Kim, Young-Jae;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.3
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    • pp.317-326
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    • 2017
  • The aim of this study was to investigate the survival and success rates of autotransplanted maxillary canine at the artificially formed recipient socket and evaluate the factors that influence survival and success rates. A total of 28 children who had 37 impacted canines were reviewed over the mean observation time of 25.1 months. Tooth mobility, pathologic root resorption, vertical bone loss, periapical lesion and anklyosis of donor tooth were investigated clinically and radiographically. The survival rate was 100%. The success rate was 64.9%, because 13 teeth were evaluated as unsuccessful. Significant parameter in determining the success rate of autotransplantation was enlarged follicle size of donor tooth according to Cox proportional hazard regression model. The results provide information necessary for clinician to make a better treatment decision about autotransplantation at the artificially formed recipient socket.

Prognostic Value of Esophageal Resectionline Involvement in a Total Gastrectomy for Gastric Cancer (위전절제술 시 식도측 절제연 암 침윤의 예후적 가치)

  • Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.1 no.3
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    • pp.168-173
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    • 2001
  • Purpose: A positive esophageal margin is encountered in a total gastrectomy not infrequently. The aim of this retrospective review was to evaluate whether a positive esophageal margin predisposes a patient to loco-regional recurrence and whether it has an independent impact on long-term survival. Materials and Methods: A retrospective review of 224 total gastrectomies for adenocarcinomas was undertaken. The Chisquare test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and independent prognostic significance was evaluated using the Cox regression method. Results: The prevalence of esophageal margin involvement was $3.6\%$ (8/224). Univariate analysis showed that advanced stage (stage III/IV), tumor size ($\geq$5 cm), tumor site (whole or upper one-third of the stomach), macroscopic type (Borrmann type 4), esophageal invasion, esophageal margin involvement, lymphatic invasion, and venous invasion affected survival. Multivariate analysis demonstrated that TNM stage, venous invasion, and esophageal margin involvement were the only significant factors influencing the prognosis. All patients with a positive esophageal margin died with metastasis before local recurrence became a problem. A macroscopic proximal distance of more than 6 cm of esophagus was needed to be free of tumors, excluding one exceptional case which involved 15 cm of esophagus. Conclusion: All of the patients with a positive proximal resection margin after a total gastrectomy had advanced disease with a poor prognosis, but they were not predisposed to anastomotic recurrence. Early detection and extended, but reasonable, surgical resection of curable lesions are mandatory to improve the prognosis.

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