• 제목/요약/키워드: Failure Prognostic

검색결과 266건 처리시간 0.023초

Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study

  • Kim, Youngkyong;Kim, Joo-Young;Kim, Ja Young;Lee, Nam Kwon;Kim, Jin Hee;Kim, Yong Bae;Kim, Young Seok;Kim, Juree;Kim, Yeon-Sil;Yang, Dae Sik;Kim, Yeon-Joo
    • Radiation Oncology Journal
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    • 제33권3호
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    • pp.198-206
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    • 2015
  • Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.

Prognostic impact of chromogranin A in patients with acute heart failure

  • Kim, Hong Nyun;Yang, Dong Heon;Park, Bo Eun;Park, Yoon Jung;Kim, Hyeon Jeong;Jang, Se Yong;Bae, Myung Hwan;Lee, Jang Hoon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
    • Journal of Yeungnam Medical Science
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    • 제38권4호
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    • pp.337-343
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    • 2021
  • Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Long Term Outcomes and Prognostic Factors of N0 Stage Nasopharyngeal Carcinoma: a Single Institutional Experience with 610 Patients

  • Sun, Jian-Da;Chen, Chuang-Zhen;Chen, Jian-Zhou;Li, Dong-Sheng;Chen, Zhi-Jian;Zhou, Ming-Zhen;Li, De-Rui
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2101-2107
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    • 2012
  • Treatment responses of $N_0$ stage nasopharyngeal carcinoma were firstly analyzed comprehensively to evaluate long term outcomes of patients and identify prognostic factors. A total of 610 patients with $N_0$ NPC, undergoing definitive radiotherapy to their primary lesion and prophylactic radiation to upper neck, were reviewed retrospectively. Concomitant chemotherapy was administrated to 65 out of the 610. Survival rates of the patients were calculated using the Kaplan-Meier method and compared by log-rank test. Prognostic factors were identified by the Cox regression model. The study revealed the 5-year and 10-year overall, disease-free, disease-specific, local failure-free, regional failure-free, locoregional failure-free and distant metastasis-free survival rates to be 78.7% and 66.8%, 68.8% and 55.8%, 79.9% and 70.4%, 81.2% and 72.5%, 95.8% and 91.8%, 78.3% and 68.5%, 88.5% and 85.5%, respectively. There were 192 patients experiencing failure (31.5%) after radiotherapy or chemoradiotherapy. Of these, local recurrence, regional relapse and distant metastases as the first event of failure occurred in 100 (100/610, 16.4%), 15(15/610, 2.5%) and 52 (52/610, 8.5%), respectively. Multivariate analysis showed that T stage was the only independent prognostic factor for patients with $N_0$ NPC (P=0.000). Late T stage (P=0.000), male (P=0.039) and anemia (P=0.007) were independently unfavorable factors predicting disease-free survival. After treatment, satisfactory outcome wasgenerally achieved in patients with $N_0$ NPC. Local recurrence represented the predominant mode of treatment failure, while T stage was the only independent prognostic factor for overall survival. Late T stage, male gender, and anemia independently predicted lower possibility of the disease-free survival.

볼 베어링 손상 예측진단 방법 (Prognostic Technique for Ball Bearing Damage)

  • 이도환;김양석
    • 대한기계학회논문집A
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    • 제37권11호
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    • pp.1315-1321
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    • 2013
  • 볼 베어링의 손상 상태를 예측하기 위한 방법을 본 논문에서 제시하였다. 손상 진전율을 추정하기 위해 확률적 베어링 피로 결함 진전 모델을 적용하고 잡음이 포함된 가속도 신호의 RMS 데이터를 이용하여 손상 상태와 고장 시간을 계산하였다. 확률적 결함 진전 모델의 파라미터는 볼 베어링에 대한 일련의 Run-to-Failure 시험을 수행하여 결정하였다. 가속도 RMS값으로부터 손상 진전율과 손상 상태를 추정하기 위해 규칙화된 파티클 필터 추정 방법을 적용하였다. 미래 시점에서의 손상 상태는 최근 측정된 데이터와 직전에 추정된 상태값을 이용하여 예측하였다. 예측된 손상 상태와 시험 데이터와 비교하여 개발된 방법의 적절성을 확인하였다.

INCORPORATING PRIOR BELIEF IN THE GENERAL PATH MODEL: A COMPARISON OF INFORMATION SOURCES

  • Coble, Jamie;Hines, J. W esley
    • Nuclear Engineering and Technology
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    • 제46권6호
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    • pp.773-782
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    • 2014
  • The general path model (GPM) is one approach for performing degradation-based, or Type III, prognostics. The GPM fits a parametric function to the collected observations of a prognostic parameter and extrapolates the fit to a failure threshold. This approach has been successfully applied to a variety of systems when a sufficient number of prognostic parameter observations are available. However, the parametric fit can suffer significantly when few data are available or the data are very noisy. In these instances, it is beneficial to include additional information to influence the fit to conform to a prior belief about the evolution of system degradation. Bayesian statistical approaches have been proposed to include prior information in the form of distributions of expected model parameters. This requires a number of run-to-failure cases with tracked prognostic parameters; these data may not be readily available for many systems. Reliability information and stressor-based (Type I and Type II, respectively) prognostic estimates can provide the necessary prior belief for the GPM. This article presents the Bayesian updating framework to include prior information in the GPM and compares the efficacy of including different information sources on two data sets.

Clinicopathological Characteristics of Triple Negative Breast Cancer at a Tertiary Care Hospital in India

  • Dogra, Atika;Doval, Dinesh Chandra;Sardana, Manjula;Chedi, Subhash Kumar;Mehta, Anurag
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10577-10583
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    • 2015
  • Background: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with a poor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling and most authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotype despite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study was aimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCs and categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between two subtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC cases during January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study were differentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers $34{\beta}E12$, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects were collated from clinical records. The comparison of clinicopathological features between two subgroups was done using statistical analyses. The pattern of treatment failure along with its association with prognostic factors was assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBL subtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant association was seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% were with BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was 30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively. Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Disease stage at presentation is an important prognostic factor influencing the treatment failure and survival among TNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinical course than that of NBL as shown by shorter DFS and OS, despite having no statistically significant difference between prognostic parameters. New therapeutic alternatives should be explored for patients with this subtype of breast cancer.

Prognostic Role of Right VentricularPulmonary Artery Coupling Assessed by TAPSE/PASP Ratio in Patients With Acute Heart Failure

  • Youngnam Bok;Ji-Yeon Kim;Jae-Hyeong Park
    • Journal of Cardiovascular Imaging
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    • 제31권4호
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    • pp.200-206
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    • 2023
  • BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E' ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.

인공신경망을 이용한 머신러닝 기반의 연료펌프 고장예지 연구 (Study of Fuel Pump Failure Prognostic Based on Machine Learning Using Artificial Neural Network)

  • 최홍;김태경;허경린;최성대;허장욱
    • 한국기계가공학회지
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    • 제18권9호
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    • pp.52-57
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    • 2019
  • The key technology of the fourth industrial revolution is artificial intelligence and machine learning. In this study, FMEA was performed on fuel pumps used as key items in most systems to identify major failure components, and artificial neural networks were built using big data. The main failure mode of the fuel pump identified by the test was coil damage due to overheating. Based on the artificial neural network built, machine learning was conducted to predict the failure and the mean error rate was 4.9% when the number of hidden nodes in the artificial neural network was three and the temperature increased to $140^{\circ}C$ rapidly.

Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue

  • Sharma, Kanika;Ahlawat, Parveen;Gairola, Munish;Tandon, Sarthak;Sachdeva, Nishtha;Sharief, Muhammed Ismail
    • Radiation Oncology Journal
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    • 제37권2호
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    • pp.73-81
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    • 2019
  • Purpose: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. Materials and Methods: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. Results: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. Conclusion: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.

근치적 절제후 병기 II,IIIA 비소세포암에서 수술후 방사선 치료의 역할 [연세암센터 20년 경험] (Postoperative Radiation Therapy in Resected Stage stage II and IIIA Non-Small Cell Lung Cancer (Yonsei Cancer Center 20-Year Experience))

  • 이창걸
    • Journal of Chest Surgery
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    • 제26권9호
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    • pp.686-695
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    • 1993
  • A total of eighty one patients with resected stage II and IIIA non-small cell lung cancer treated with postoperative adjuvant radiation therapy between Jan. 1971 and Dec. 1990 were retrospectively analysed to evaluate whether postoperative radiation therapy improves survival. Patterns of failure and prognostic factors were also analysed. The 5 year overall and disease free survival rate were 40.5%, 43.4% and median survival 30 months. The 5 year actuarial survival rates by stage II and IIIA were 53.9% and 36.2%. Loco-regional failure rate was 14.7% and distant metastasis rate was 33.3% and both 4%. Statistically significant prognostic factor affecting survival was presence of mediastinal lymph node metastasis[N2]. This retrospective study suggests that postoperative radiation therapy in resected stage II and IIIA non-small cell lung cancer can reduce loco-regional recurrence and may improve survival rate as compared with other studies which were treated by surgery alone.

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