• 제목/요약/키워드: survival regression

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Does the Retrieval of at Least 15 Lymph Nodes Confer an Improved Survival in Patients with Advanced Gastric Cancer?

  • Kim, Yong Il
    • Journal of Gastric Cancer
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    • 제14권2호
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    • pp.111-116
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    • 2014
  • Purpose: The standard surgical procedure recommended to treat gastric cancer in advanced cases is dissection of D2 lymph nodes (LNs). However, the optimum number of LNs that should be retrieved in advanced gastric cancer (AGC) remains debatable. Therefore, this study aimed to investigate the optimum number of retrieved LNs and determine the clinical implications of retrieved LN numbers on the treatment of AGC. Materials and Methods: Of 575 AGC patients reviewed, 369 who underwent open curative gastrectomy with D2 or more extensive LN dissection at our institution were analyzed according to their clinicopathologic characteristics and number of LNs retrieved. Results: Multivariate regression analysis revealed that tumor size (P=0.006), depth of invasion (P=0.000), LN metastasis (P=0.000), and stage (P=0.000) were independent variables with predictive value. The 5-year survival rates were differed significantly according to the numbers of LNs retrieved ([1] 15~25 vs. >25 and [2] 15~39 vs. ${\geq}40$) in patients with differentiated carcinoma. Conclusions: Tumor size, depth of invasion, LN metastasis, and stage were independent predictive factors for survival. The number of retrieved LNs was significantly associated with a long-term survival benefit in patients with differentiated carcinoma. Therefore, our data suggest that the retrieval of a minimum of 15 LNs may not be sufficient to warrant a recommendation for further curative surgery and that extensive LN dissection should be considered in advanced carcinoma of the differentiated type.

넙치양식장 환경에 따른 생산성에 관한 연구 (An Environmental Effect on Productivity of Flounder Culture Farms)

  • 어윤양
    • 수산경영론집
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    • 제42권3호
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    • pp.79-93
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    • 2011
  • Water temperature of Oliver flounder farm affects Oliver flounder growth and mortality rate. In laboratory experimental tanks, optimal water temperature was $22.5^{\circ}C$($21{\sim}24^{\circ}C$) and cultivatable water temperature was $12{\sim}28^{\circ}C$. The purpose of this study is to identify applicable and useful water temperature of Oliver flounder farm in case of actual farming. The data applied in the analysis was collected from Jeju island. In the study, various analytical methods including productivity analysis, regression analysis, statistical analysis were conducted for 13 Oliver flounder culture farms. The result of analysis can be summarized as follows : First, growth rate on the Oliver flounder culture farms was related to mean of water temperature, variation of water temperature and low water temperature. Second, survival rate on the Oliver flounder culture farms was related to mean of water temperature. In case of including Oliver flounder stocking density, defined as the surface area of Oliver flounder per $m^2$ of water surface area, survival rate strongly related to mean of water temperature, variation of water temperature, cultivating capability and stocking density. Third, production weight per $m^2$ of water surface area was strongly related to mean of water temperature, low water temperature and cultivating capability. Growth rate and survival rate was analyzed into mediate variable character.

Retrospective Study of Adjuvant Chemotherapy Effects on Survival Rate after Three-Field Lymph Node Dissection for Stage IIA Esophageal Cancer

  • Chen, Hua-Xia;Wang, Zhou
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5169-5173
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    • 2015
  • To determine the efficacy of postoperative adjuvant chemotherapy with paclitaxel plus cisplatin (Taxol + DDP, TP therapy) for stage IIA esophageal squamous cell carcinoma (ESCC) and to investigate the expression of RUNX3 in lymph node metastasis-negative esophageal cancer and its relationship with medical prognosis, a retrospective summary of clinical treatment of 143 cases of stage IIA esophageal squamous cell carcinoma patients was made. The patients were divided into two groups, a surgery alone control group (52 patients) and a chemotherapy group that received postoperative TP therapy (91 patients). The disease-free and 5 year survival rates were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as RUNX3 positive and negative, with post-operative specimens assessed by immunohistochemistry. Although the disease-free and 5 year survival rates in control and chemotherapy groups did not significantly differ and there was no significance in RUNX3 negative cases, postoperative adjuvant chemotherapy in the chemotherapy group was shown to improve disease-free and 5 year survival rate compared to the control group in RUNX3 positive cases. On Cox regression multivariate analysis, postoperative adjuvant chemotherapy (P<0.01) was an independent prognostic factor for RUNX3 positive cases, suggesting that postoperative TP may be effective as adjuvant chemotherapy for stage IIA esophageal cancer patients with RUNX3 positive lesions.

Prognostic Significance of Preoperative Blood Transfusion in Stomach Cancer

  • Kim, Seok-Hwan;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • 제10권4호
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    • pp.196-205
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    • 2010
  • Purpose: We did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery. Materials and Methods: Data for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups. Results: Sixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates. Conclusions: We found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

경쟁적 위험하에서의 신뢰성 분석 (Reliability Analysis under the Competing Risks)

  • 백재욱
    • 한국신뢰성학회지:신뢰성응용연구
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    • 제16권1호
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    • pp.56-63
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    • 2016
  • Purpose: The purpose of this study is to point out that the Kaplan-Meier method is not valid to calculate the survival probability or failure probability (risk) in the presence of competing risks and to introduce more valid method of cumulative incidence function. Methods: Survival analysis methods have been widely used in biostatistics division. However the same methods have not been utilized in reliability division. Especially competing risks cases, where several causes of failure occur and the occurrence of one event precludes the occurrence of the other events, are scattered in reliability field. But they are not noticed in the realm of reliability expertism or they are analysed in the wrong way. Specifically Kaplan-Meier method which assumes that the censoring times and failure times are independent is used to calculate the probability of failure in the presence of competing risks, thereby overestimating the real probability of failure. Hence, cumulative incidence function is introduced and sample competing risks data are analysed using cumulative incidence function and some graphs. Finally comparison of cumulative incidence functions and regression type analysis are mentioned briefly. Results: Cumulative incidence function is used to calculate the survival probability or failure probability (risk) in the presence of competing risks and some useful graphs depicting the failure trend over the lifetime are introduced. Conclusion: This paper shows that Kaplan-Meier method is not appropriate for the evaluation of survival or failure over the course of lifetime. In stead, cumulative incidence function is shown to be useful. Some graphs using the cumulative incidence functions are also shown to be informative.

Impact of Treatment Type on Overall Survival in Elderly Brazilian Women with Breast Cancer

  • Bello, Marcelo Adeodato;de Menezes, Raquel Ferreira;de Sousa Silva, Brunna;da Silva, Rafael de Carvalho;Cavalcanti, Rousiane Silva;da Costa Moraes, Thayane de Fatima;Tonellotto, Fabiana;de Aguiar, Suzana Sales;Martucci, Renata Brum;Bergmann, Anke;Thuler, Luiz Claudio Santos
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4769-4774
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    • 2016
  • Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.

원발성 간암의 방사선치료및 온열요법의 병용치료 효과 (Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma)

  • 강기문;최일봉;계철승;최병옥;정수미;김인아;한성태;선희식;정규원;신경섭
    • Radiation Oncology Journal
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    • 제12권2호
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    • pp.191-199
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    • 1994
  • Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty

  • Troy Li;Akiro H. Duey;Christopher A. White;Amit Pujari;Akshar V. Patel;Bashar Zaidat;Christine S. Williams;Alexis Williams;Carl M. Cirino;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.231-237
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    • 2023
  • Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

Methylenetetrahydrofolate Reductase Gene Polymorphisms as Predictive and Prognostic Biomarkers in Ovarian Cancer Risk

  • Gao, Song;Liu, Ning;Ma, Yang;Ying, Liu
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.569-573
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    • 2012
  • Early diagnosis and better prognosis of ovarian cancer is still a challenge. Besides environmental risk factors, genetic factors have established a role in pathogenesis of ovarian cancer. Methods: A case-control and a prospective study design conducted in 224 ovarian cancer patients and 432 controls in Chinese population. MTHFR C677T genotyping was done by PCR-RFLP. Results: Patients with ovarian cancer is associated with a higher less number of delivery and less frequent oral contraceptive use. When potential confounding factors adjusted logistic regression analysis between cases and controls were performed, significant association was obtained for 677T/T genotype and ovarian cancer (OR=3.13, 95% CI=1.59-5.72). Cox regression survival analysis showed individuals carrying T/T genotype had significantly increased HR for death in ovarian cancer patients (HR=2.86, 95% CI=1.27-7.93). In conclusion, we observed that the MTHFR C677T polymorphism is associated with the susceptibility and survival of ovarian cancer in Chinese population.