• Title/Summary/Keyword: DFS

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Prognostic Analysis of Stage I Non-Small Cell Lung Cancer Abutting Adjacent Structures on Preoperative Computed Tomography

  • Soohwan Choi;Sun Kyun Ro;Seok Whan Moon
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.136-144
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    • 2024
  • Background: Early non-small cell lung cancer (NSCLC) that abuts adjacent structures requires careful evaluation due to its potential impact on postoperative outcomes and prognosis. We examined stage I NSCLC with invasion into adjacent structures, focusing on the prognostic implications after curative surgical resection. Methods: We retrospectively analyzed the records of 796 patients who underwent curative surgical resection for pathologic stage IA/IB NSCLC (i.e., visceral pleural invasion only) at a single center from 2008 to 2017. Patients were classified based on tumor abutment and then reclassified by the presence of visceral pleural invasion. Clinical characteristics, pathological features, and survival rates were compared. Results: The study included 181 patients with abutting NSCLC (22.7% of all participants) and 615 with non-abutting tumors (77.3%). Those with tumor abutment exhibited higher rates of non-adenocarcinoma (26.5% vs. 9.9%, p<0.01) and visceral/lymphatic/vascular invasion (30.4%/33.1%/12.7% vs. 8.5%/22.4%/5.7%, respectively; p<0.01) compared to those without abutment. Multivariable analysis identified lymphatic invasion and male sex as risk factors for overall survival (OS) and disease-free survival (DFS) in stage I NSCLC measuring 3 cm or smaller. Age, smoking history, vascular invasion, and recurrence emerged as risk factors for OS, whereas the presence of non-pure ground-glass opacity was a risk factor for DFS. Conclusion: NSCLC lesions 3 cm or smaller that abut adjacent structures present higher rates of various risk factors than non-abutting lesions, necessitating evaluation of tumor invasion into adjacent structures and lymph node metastasis. In isolation, however, the presence of tumor abutment without visceral pleural invasion does not constitute a risk factor.

The Association of Oral Impacts on Daily Performances for Children (C-OIDP), Oral Health Condition and Oral Health-Related Behaviors (어린이 일상생활구강영향지수(C-OIDP)와 구강관리 및 구강건강행태와의 관련성)

  • Jo, Hwa-Young;Jung, Yun-Sook;Park, Dong-Ok;Lee, Young-Eun;Choi, Youn-Hee;Song, Keun-Bae
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.242-248
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    • 2016
  • The purposes of this study were to investigate the factors affection the Oral Impacts on Daily Performances for Children (C-OIDP) in elementary and middle school students, and identify the association between oral health-related behaviors, oral health condition and C-OIDP. A cross-sectional study was conducted in three schools in Incheon, Asan, Korea. A total of 175 selected children were interviewed by a trained examiner using a questionnaire. Oral Health Related Quality of Life was assessed by the Korean version of C-OIDP. Socio-economic characteristics, oral health-related behaviors, oral health condition and C-OIDP were verified using the questionnaire. ANOVA analysis was performed to determine the oral health and C-OIDP, and multiple regression analysis was performed to determine the factors affecting the C-OIDP. The activities with the greatest effect were eating (28.0%), cleaning teeth (22.9%), and smiling (18.9%). In the logistic regression model, the high item score of C-OIDP was associated with experiencing dental caries and gum pain in the past month. The more the C-OIDP prevalence item, the more the fillng deciduous tooth surface (fs) (p=0.024), caries experienced deciduous tooth surface (dfs) (p=0.049), total caries tooth surface (ds+DS) (p=0.021), and total caries experienced tooth surface (dfs+DMFS) (p=0.047). It can be concluded that the factors affecting C-OIDP are fs, dfs, dfs+DMFS, and gingival pain. Based on these results, we can improve C-OIDP to advance preventive practice.

Radiotherapy Results in Stage IIB Uterine Cervix Cancer (자궁경부암 병기 IIB의 방사선치료결과)

  • Kil Whoon Jong;Chun Mison;Kang Seunghee;Oh Young Taek;Ryu Hee Sug;Ju Hee Jae;Lee Eun Ju
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.345-352
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    • 2001
  • Purpose : To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. Materials and methods : We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was $\geq4\;cm$ in 64 patients. Preteatment SCC level was measured in 75 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyper-fractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy $(4\;Gy\times7\;or\;5\;Gy\times6)$. No Patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). Results : The 5-year overall and disease free survival rates were $73.4\%\;and\;71.6\%$, respectively. Local recurrences occurred in $10\%$ of patients, and distant metastasis in $18.9\%$. There was a significant correlation between OS/DFS and tumor size $(<4cm;\;OS\;95.2\%,\;DFS\;91.4\%,\;\geq4cm;\;OS\;63.4\%,\;DFS\;63.4\%)$. Pretreatment SCC level was one of prognostic factors only in univariate analysis. Conclusion : With modified hyperfractionated radiotherapy, there was very low local recurrence rate $(6.6\%)$ and high 5-year overall and disease free survival rate $(75.4\%\;and\;70.5\%)$, which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.

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Pretreatment Prognostic Factors in Carcinoma of the Uterine Cervix (자궁경부암에 있어서의 치료전 예후인자)

  • Ha Sung Whan;Oh Do Hoon;Kim Mi Sook;Shin Kyung Hwan;Kim Jae Sung;Lee Moo Song;Yoo Keun Young
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.387-395
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    • 1993
  • To identify pretreatment prognostic factors in carcinoma of the uterine cervix, a retrospective analysis was undertaken of 510 patients treated with curative radiation therapy in Seoul National University Hospital during the 7 year period, from March 1979 through December 1986. According to FIGO classification,35 patients were stage I B,89 were stage IIA, 232 were stage IIB,8 were stage IIIA, 134 were IIIB, and 12 were stage IVA. Five year locoregional control (LRC) rates in stage I B, II A, II B, IIIA, IIIB, and IVA were $79\%,78\%,70\%,58\%,51\%\;and\;27\%,$ respectively. Five year disease free survival (DFS) rates were $76\%,67\%,60\$,57\%,40\%,\;and\;25\%,$ respectively. Overall survival (OS) rates at five years were $82\%,72\%,67\%,67\%,51\%,\;and\;33\%,$ respectively. In univariate analyses, stage, age, initial hemoglobin level, type of histology, tumor size, and several CT findings including pelvic lymph node (LN) status, paraaortic lymph node (PAN) status, extent of parametrial invasion, bladder invasion, and rectal invasion were significant factors in terms of LRC. All these factors and elevation of BUN or creatinine were associated with DFS. In terms of overall survival, stage, initial hemoglobin level, type of histology, tumor size, elevation of BUN or creatinine, and five CT findings associated with LRC were prognostically significant. In multivariate analysis excluding CT findings, stage IV disease, non-squamous histology, and tumor size $\ge$4 cm were associated with poor LRC and DFS. Stage IV disease and tumor size significantly affected OS. in multivariate analysis including CT findings, histology, tumor size, and pelvic LN status on CT were uniformly significant in terms of LRC, DFS, and 05, PAN status on CT affected overall survival only.

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$^{18}F$-FDG PET/CT in Patients with Initially Diagnosed Adenoid Cystic Carcinoma of the Head and Neck: Clinicoplathologic Correlation (처음 진단된 두경부 선양낭성암종에서 $^{18}F$-FDG PET/CT: 임상상 및 병리소견과의 상관성)

  • Lee, Ji-Young;Choi, Joon-Young;Ko, Young-Hyeh;Baek, Chung-Hwan;Son, Young-Ik;Cho, Suk-Kyong;Cheon, Mi-Ju;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.395-401
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    • 2009
  • Purpose: We evaluated $^{18}F$-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment $^{18}F$-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), $SUV_{max}$ of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the $SUV_{max}$ of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The $SUV_{max}$ were significantly higher in solid pattern group than in tubular/cribriform pattern group ($6.7{\pm}3.2$ vs. $4.2{\pm}0.9$, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The $SUV_{max}$ of ACC was significantly lower than that of size-matched SqCC ($5.1{\pm}2.4$ vs. $13.6{\pm}6.0$, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high $^{18}F$-FDG uptake ($SUV_{max}$ ${\geq}$6.0) had significantly shorter DFS than those with low $^{18}F$-FDG uptake ($SUV_{max}$ <6.0). Conclusion: $^{18}F$-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. $^{18}F$-FDG PET/CT may be useful for detecting unexpected metastasis. Since $^{18}F$-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC.

The Analyses of Treatment Results and Prognostic Factors in Supradiaphragmatic CS I-II Hodgkin's Disease (횡경막상부에 국한된 임상적 병기 1-2기 호지킨병에서 치료 결과와 예후 인자의 분석)

  • Park Won;Suh Chang Ok;Chung Eun Ji;Cho Jae Ho;Chung Hyun Cheol;Kim Joo Hang;Roh Jae Kyung;Hahn Jee Sook;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.147-157
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    • 1998
  • Purpose : The aim of this retrospective study is to assess the necessity of s1aging laparotomy in the management of supradiaphragmatic CS I-II Hodgkin's disease. Prognostic factors and the usefulness of prognostic factor groups were also analyzed. Materials and Methods : From 1985 to 1995, fifty one Patients who were diagnosed as supradiaphragmatic CS I-II Hodgkin's disease at Yonsei Cancer Center in Seoul, Korea were enrolled in this study Age range was 4 to 67 with median age of 30. The number of patients with each CS IA, II A, and IIB were 16, 25, and 10, respectively. Radiotherapy(RT) was delivered using 4 or 6 MV photon beam to a total dose of 19.5 to 55.6Gy (median dose : 45Gy) with a 1.5 to 1.BGy per fraction. Chemotherapy(CT) was given in 2-12 cycles(median : 6 cycles). Thirty one Patients were treated with RT alone, 4 patients with CT alone and 16 patients with combined chemoradiotherapy. RT volumes varied from involved fields(3), subtotal nodal fields(18) or mantle fields(26). Results : Five-year disease-free survival rate(DFS) was $78.0\%$ and overall survival rate(05) was $87.6\%$. Fifty Patients achieved a complete remission after initial treatment and 8 patients were relapsed. Salvage therapy was given to 7 patients, 1 with RT alone, 4 with CT alone, 2 with RT+CT. Only two patients were successfully salvaged. Feminine gender and large media-stinal adenopathy were significant adverse prognostic factors in the univariate analysis for DFS. The significant adverse prognostic factors of OS were B symptom and clinical stage. When patients were analyzed according to European Organization for Research and Treatment of Cancer(EORTC) prognostic factor groups, the DFS in Patients with very favorable, favorable and unfavorable group was 100, 100 and $55.8\%$(p<0.05), and the 05 in each patients' group was 100, 100 and $75.1\%$(p<0.05), respectively. In very favorable and favorable groups, the DFS and 05 were all $100\%$ by RT alone, but in unfavorable group, RT with CT had a lesser relapse rate than RT alone. The subtotal nodal irradiation had better OFS than mantle RT in patients treated with RT. Conclusion : In present study, the DFS and OS in patients who did not undergo s1aging laparotomy were similar with the results in the literatures of which patients were surgically staged. Therefore, we may suggest that staging laparotomy would not influence the outcome of treatments. In univariate analysis, gender, large mediastinal adenopathy. B symptoms and clinical stage were significant prognostic factors for the survival rate. We confirm the usefulness of EORTC prognostic factor groups which may be a good.

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Long-Term Results of 2-Dimensional Radiation Therapy in Patients with Nasopharyngeal Cancer (이차원방사선치료를 시행한 코인두암 환자의 장기 추적 결과 및 예후인자 분석)

  • Lee, Nam-Kwon;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Suk;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.193-204
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    • 2010
  • Purpose: To analyze the treatment outcomes, complications, prognostic factors after a long-term follow-up of patients with nasopharyngeal carcinoma treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Materials and Methods: Between December 1981 and December 2006, 190 eligible patients with non-metastatic nasopharyngeal carcinoma were treated at our department with a curative intent. Of these patients, 103 were treated with RT alone and 87 patients received CCRT. The median age was 49 years (range, 8~78 years). The distributions of clinical stage according to the AJCC 6th edition included I: 7 (3.6%), IIA: 8 (4.2%), IIB: 33 (17.4%), III: 82 (43.2%), IVA: 31 (16.3%), IVB: 29 (15.3%). The accumulated radiation doses to the primary tumor ranged from 66.6~87.0 Gy (median, 72 Gy). Treatment outcomes and prognostic factors were retrospectively analyzed. Acute and late toxicities were assessed using the RTOG criteria. Results: A total of 96.8% (184/190) of patients completed the planned treatment. With a mean follow-up of 73 months (range, 2~278 months; median, 52 months), 93 (48.9%) patients had relapses that were local 44 (23.2%), nodal 13 (6.8%), or distant 49 (25.8%). The 5- and 10-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 55.6% and 44.5%, 54.8% and 51.3%, in addition to 65.3% and 57.4%, respectively. Multivariate analyses revealed that CCRT, age, gender, and stage were significant prognostic factors for OS. The CCRT and gender were independent prognostic factors for both DFS and DSS. There was no grade 4 or 5 acute toxicity, but grade 3 mucositis and hematologic toxicity were present in 42 patients (22.1%) and 18 patients (9.5%), respectively. During follow-up, grade 3 hearing loss in 9 patients and trismus in 6 patients were reported. Conclusion: The results of our study were in accordance with findings of previous studies and we confirmed that CCRT, low stage, female gender, and young age were related to improvement in OS. However, there are limitations in the locoregional control that can be achieved by CCRT with 20 conventional radiation therapy. This observation has led to further studies on clarifying the efficacy of concurrent chemotherapy by intensity modulated radiation therapy.

I/O Efficient Cycle Region Recognizer for General Grid Graphs (일반 그리드 그래프를 위한 입출력 효율적인 영역 구분자)

  • Her Jun-Ho;Ramakrishna R.S.
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.11a
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    • pp.985-987
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    • 2005
  • 자료의 크기가 방대한 응용 프로그램에서는 메인 메모리와 저장 장치간의 자료 입출력(I/O)이 전체 계산의 주요 병목 요인으로 작용한다. 본 논문은 [2004 한국정보처리학회 추계논문집 제11권 제2호 1139-1142]에서 제안된 그리드(grid) 그래프를 위한 입출력 효율적인 depth-first search (DFS) 알고리즘을 지원하기 위한 입출력 효율적인 영역 구분자를 구하는 알고리즘을 제안 한다. 그 입출력 복잡도 (I/O-Complexity)는 O(Soft(N))이다. 여기서 N=|V|+|E|이고 $sort(N)=\Theta((N/B)log_{M/B}(N/B))$이다.

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A Proposal of Scenario Generation Process for Small Scale Engagement (소규모 교전을 위한 시나리오 생성 프로세스 제안)

  • Ahn, Euikoog;Ko, Minsuk;Cheon, Sang Uk;Park, Sang Chul
    • Korean Journal of Computational Design and Engineering
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    • v.18 no.2
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    • pp.104-112
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    • 2013
  • Computer-based modeling and simulation (M&S) techniques have become an essential component in the development of new weapons systems. M&S techniques provide a means to simulate military training, strategies, military doctrines, and weapons acquisition processes. This paper proposes a small scale engagement scenario generation method. This work also includes a process for scenario generation and visualization. The proposed scenario generation methodology employs the Timed-FSA (finite state automata) and DFS (depth first search) algorithms. The proposed scenario generation method is verified using a one-on-one combat engagement scenario between two submarines. In addition, we suggest a scenario generation process including whole scenario generation and scenario visualization.

Units' Path-finding Method Proposal for A* Algorithm in the Tilemap (타일맵에서 A* 알고리즘을 이용한 유닛들의 길찾기 방법 제안)

  • Lee Se-Il
    • Journal of the Korea Society of Computer and Information
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    • v.9 no.3
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    • pp.71-77
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    • 2004
  • While doing games, units have to find goal And according to algorism, there is great difference in time and distance. In this paper the researcher compared and described characteristics of each of the improved algorism and A* algorism by giving depth-first search, breadth-first search and distance value and then argued algorism. In addition. by actually calculating the presumed value in A* a1gorism, the researcher finds the most improved value. Finally, by means of comparison between A* algorism and other one, the researcher verified its excellence and did simple path-finding using A* algorism.

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