Background: The patterns of gastric cancer recurrence vary across societies. We designed the current study in an attempt to evaluate and reveal the outbreak of the recurrence patterns of gastric cancer and also prediction of time to recurrence and its effected factors in Iran. Materials and Methods: This research was performed from March 2003 to February 2007. Demographic characteristics, clinical and pathological diagnosis and classification including pathologic stage, tumor grade, tumor site and tumor size in of patients with GC recurrent were collected from patients' data files. To evaluate of factors affected on the relapse of the GC patients, gender, age at diagnosis, treatment type and Hgb were included in the research. Data were analyzed using Kaplan-Meier and logistic regression models. Results: After treatment, 82 patients suffered recurrence, 42, 33 and 17 by the ends of first, second and third years. The mean ( SD) and median ( IQR) time to recurrence in patients with GC were 25.5 (20.6-30.1) and 21.5 (15.6-27.1) months, respectively. The results of multivariate analysis logistic regression showed that only pathologic stage, tumor grade and tumor site significantly affected the recurrence. Conclusions: We found that pathologic stage, tumor grade and tumor site significantly affect on the recurrence of GC which has a high positive prognostic value and might be functional for better follow-up and selecting the patients at risk. We also showed time to recurrence to be an important factor for follow-up of patients.
Introduction: The extent of lymphadenectomy in the surgical treatment of gastric cancer is a topic of controversy among surgeons. This study was conducted to analyze the American National Cancer Database (NCDB) and conclude the optimal extent of lymphadenectomy for gastric adenocarcinoma. Methods: The NCDB for gastric cancer was utilized. Patients who received at least a partial gastrectomy were included. Patients with metastatic disease, unknown TNM stages, R1/R2 resection, or treated with a palliative intent were excluded. Joinpoint regression was used to identify the extent of lymphadenectomy that reflects the optimal survival. Cox regression analysis and Bayesian information criterion were used to identify significant survival predictors. Kaplan-Meier was applied to study overall survival and stage migration. Results: 40,281 patients of 168,377 met the inclusion criteria. Joinpoint analysis showed that dissection of 29 nodes provides the optimal median survival for the overall population. Regression analysis reported the cutoff ${\geq}29$ to have a better fit in the prognostic model than that of ${\geq}15$. Dissection of ${\geq}29$ nodes in the higher stages provides a comparable overall survival to the immediately lower stage. Nonetheless, the retrieval of ${\geq}15$ nodes proved to be adequate for staging without a significant stage migration compared to ${\geq}29$ nodes. Conclusion: The extent of lymphadenectomy in gastric adenocarcinoma is a marker of improved resection which reflects in a longer overall survival. Our analysis concludes that the dissection of ${\geq}15$ nodes is adequate for staging. However, the dissection of 29 nodes might be needed to provide a significantly improved survival.
The purpose of this study was to utilize the K-MBI (Korean Modified Barthel Index) and subscales of K-MBI in predicting the length of hospital stay (LOS) and the discharge destinations for stroke patients. The study population consisted of 97 stroke patients (57 men and 40 women) admitted to the Seoul National University at the Bundang Hospital. All participants were assessed by K-MBI at admission and discharge after rehabilitation therapy and the information available was investigated at admission. The data were analyzed by using the Mann-Whitney U test, the stepwise multiple regression and the logistic regression. The median LOS was 30 days (mean, 32.8 days; range, 22 to 43 days). The K-MBI score at initiation of rehabilitation therapy (p<.001), the type of stroke and living habits before a stroke were the main explanatory indicators for LOS (p<.05). Within the parameters of K-MBI measured at initiation for rehabilitation, feeding and chair/bed transfer were the explanatory factors for LOS prediction (p<.01). Confidence in the prediction of LOS was 20%. Significant predictors of discharge destination in a logistic regression model were the discharge K-MBI score, sex and hemiplegic side. Dressing in items of discharge K-MBI was the significant predictor of discharge destination. The K-MBI score was the most important factor to predict LOS and discharge destination. Knowledge of these predictors can contribute to more appropriate treatment and discharge planning.
Journal of the Korea Institute of Building Construction
/
v.14
no.5
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pp.415-422
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2014
There is growing difference between a planned value and an actual cost for increasing as an risk of construction cost. A construction cost index is an alternative to redeem a problem, but it is still very difficult to reduce an actual differential as a price fluctuation. Furthermore an existing theory of a construction cost index is overly complex, and is unsuitable for using in working-level. This study suggests an optimum correction rate in respect of a total construction cost. It is analyzing the actual cost of 53 public buildings that the Public Procurement Service ordered. The objects are main processes that include architectural works, mechanical works, electrical works, telecommunication works, and service facilities. It is compared a total construction cost based on absolute error rate using the median from frequentist principle. For this, it is selected the suitable regression model and set a correction rate.
Kwon, Jaymin;Weisel, Clifford P.;Morandi, Maria T.;Stock, Thomas H.;Turpin, Barbara
Journal of Environmental Science International
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v.25
no.10
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pp.1349-1368
/
2016
Concentrations of fine particulate matter ($PM_{2.5}$) and several of its particle constituents measured outside homes in Houston, Texas, and Los Angeles, California, were characterized using multiple regression analysis with proximity to point and mobile sources and meteorological factors as the independent variables. $PM_{2.5}$ mass and the concentrations of organic carbon (OC), elemental carbon (EC), benzo-[a]-pyrene (BaP), perylene (Per), benzo-[g,h,i]-perylene (BghiP), and coronene (Cor) were examined. Negative associations of wind speed with concentrations demonstrated the effect of dilution by high wind speed. Atmospheric stability increase was associated with concentration increase. Petrochemical source proximity was included in the EC model in Houston. Area source proximity was not selected for any of the $PM_{2.5}$ constituents' regression models. When the median values of the meteorological factors were used and the proximity to sources varied, the air concentrations calculated using the models for the eleven $PM_{2.5}$ constituents outside the homes closest to influential highways were 1.5-15.8 fold higher than those outside homes furthest from the highway emission sources. When the median distance to the sources was used in the models, the concentrations of the $PM_{2.5}$ constituents varied 2 to 82 fold, as the meteorological conditions varied over the observed range. We found different relationships between the two urban areas, illustrating the unique nature of urban sources and suggesting that localized sources need to be evaluated carefully to understand their potential contributions to $PM_{2.5}$ mass and its particle constituents concentrations near residences, which influence baseline indoor air concentrations and personal exposures. The results of this study could assist in the appropriate design of monitoring networks for community-level sampling and help improve the accuracy of exposure models linking emission sources with estimated pollutant concentrations at the residential level.
Dan Shao;Qiang Gao;You Cheng;Dong-Yang Du;Si-Yun Wang;Shu-Xia Wang
Korean Journal of Radiology
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v.22
no.3
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pp.425-434
/
2021
Objective: To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. Materials and Methods: An analysis of FDG PET/CT findings in 37 primary tracheal malignant tumor patients with a median follow-up period of 43.2 months (range, 10.8-143.2 months) was performed. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18F-FDG PET/CT parameters, other clinic-pathological factors, and overall survival (OS). A risk prognosis model was established according to the independent prognostic factors identified on multivariate analysis. A survival curve determined by the Kaplan-Meier method was used to assess whether the prognosis prediction model could effectively stratify patients with different risks factors. Results: The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p < 0.001). Conclusion: This study shows that 18F-FDG PET/CT can predict the survival of patients with primary tracheal malignant tumors. Patients with an MTV > 5.19, a TLG > 16.94 on PET/CT scans, squamous cell carcinoma, and non-E1 were more likely to have a reduced OS.
The Journal of Asian Finance, Economics and Business
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v.6
no.3
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pp.91-101
/
2019
This paper finds some stylized facts about executive pay in South Korea. Using aggregate data of the listed companies since 2002, we find that 1) the director's remuneration has risen faster than the employee compensation, thus, the pay ratio of executive and employee has escalated from 3.0 to 4.5; 2) the executive compensation for large business group fluctuates more widely than that for small and medium enterprises does, hence the pay ratio for large firms changes widely too; 3) the median pay ratio has not grown monotonically but it rather rises to remain still around year 2011, which is accounted for mostly by small and medium enterprises. New information on executive compensation by compulsory disclosure starting from 2013 made further analysis of CEO compensation attainable. Based on the conventional regression analysis for 2013-2017, we find that 1) the elasticity of CEO pay with respect to firm value is about 0.18; 2) the volatility of stock return is negatively related to CEO pay; 3) contemporaneous stock return is positively associated with the pay; 4) there is insufficient evidence that large business groups pay their CEOs more than small and medium enterprises do. These results are robust under various model specifications.
Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.
Zeichner, Simon Blechman;Cavalcante, Ludimila;Suciu, Gabriel Pius;Ruiz, Ana Lourdes;Hirzel, Alicia;Krill-Jackson, Elisa
Asian Pacific Journal of Cancer Prevention
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v.15
no.8
/
pp.3435-3441
/
2014
Background: Axillary lymph node status at diagnosis remains the strongest predictor of long-term survival in breast cancer. Patients with more than ten axillary lymph nodes at diagnosis have a poor long-term survival. In this single institutional study, we set out to evaluate the prognosis of this high-risk group in the era of multimodality therapy. Materials and Methods: In this retrospective study, we looked at all breast cancer patients with greater than ten axillary lymph nodes diagnosed at Mount Sinai Medical Center (MSMC) from January 1st 1990 to December 31st 2007 (n=161). In the univariate analysis, descriptive frequencies, median survival, and 5- and 10-year survival rates were estimated for common prognostic factors. A multivariate prognostic analysis for time-to-event data, using the extended Cox regression model was carried out. Results: With a median and mean follow-up of 70 and 89.9 months, respectively, the overall median survival was estimated to be 99 months. The five-year disease-free survival (DFS) was 59.3% and the ten-year DFS was 37.9%, whereas the five- and ten-year overall survival (OS) was 66.6% and 43.9%, respectively. Multivariate analysis revealed a significant improvement in DFS among black patients compared to whites (p=0.05), improved DFS and OS among young patients (ages 21-45) compared to elderly patients (age greater than 70) (p=0.00176, p=0.0034, respectively), and improved DFS and OS among patients whose tumors were ER positive (p=0.049, p=0.0034). Conclusions: In this single institution study of patients with greater than 10 positive axillary nodes, black patients had a significantly improved DFS compared with white patients. Young age and ER tumor positivity was associated with improved outcomes. Using multivariate analysis, there were no other variables associated with statistically significant improvements in DFS or OS including date of diagnosis. Further work is needed to improve breast cancer survival in this subgroup of patients.
Background: Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease. Materials and Methods: In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model. Results: the mean age of patients was $46.10{\pm}10.81$ years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was $75%{\pm}0.43$. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= $11%{\pm}0.10$). Conclusions: Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.
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