• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3575-3581
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• 2016

Background: Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. Materials and Methods: All data were retrieved from the National Cancer Patient Registry-Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include socio-demographic information, pathological features and treatment received. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of all variables was then made using the Log-rank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. Results: Total of 1,214 patients were included in the study. The overall 3- and 5-year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the socio-demographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. Conclusions: The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.239-249
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• 2017

Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10831-10836
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• 2015

This study was conducted to establish whether the preoperative platelet to lymphocyte ratio (PLR) is predictive of survival of women with ovarian clear cell carcinoma (OCCC). A PLR > 300 was deemed elevated. Progression-free survival (PFS) was estimated using the Kaplan-Meier method. Cox proportional hazard analysis was used to determine the independent effect of PLR. Thirty-six patients were reviewed. Elevated PLRs were more commonly noted in patients with an advanced vs an early stage of disease (88.9% vs 11.1%). Women with elevated PLR carried a higher rate of disease progression during primary therapy than that those in the normal PLR group (44.4 vs 22.2%). The median PFS for patients with elevated PLR was notably worse than that for patients with normal PLR (10 vs 34 months). Despite the impact of elevated PLR on PFS, it was found to be marginally significant when controlling for commonly applied prognostic markers. It, however, trended toward significance (HR=4.76; 95%CI, 0.95-23.8). In conclusion, an elevated PLR appears to be directly associated with adverse survival rather than being a surrogate for other indicators of a poor prognosis. PLR may be a useful biomarker for predicting survival of women with OCCC and merits further large-scale studies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1127-1130
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• 2013

Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.825-828
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• 2013

Objective: The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia. Methods: One hundred and twenty cervical cancer patients diagnosed between $1^{st}$ July 1995 and $30^{th}$ June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups. Results: The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)]. Conclusion: The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1101-1106
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• 2013

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.1
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• pp.15-20
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• 2011

Introduction: The characteristics of oral tongue squamous cell carcinomas (SCC) and the treatment results were reviewed to determine the appropriate treatment strategies. Materials and Methods: The medical records of 140 patients diagnosed and treated for oral tongue SCC at Yonsei University Health System from January 1995 to December 2004 were reviewed. For statistic analysis, the survival rate was determined using the Kaplan-Meier method with SPSS version 12.0, and the difference in survival rates was evaluated using a log-rank test. Results: The mean age of the patients with oral tongue SCC patients was 55 (19-85 years old). According to the T, N and pathologic stage, the patients were distributed from a higher to a lower incidence of cases, as follows: T2 (46.4%), T1 (37.9%), T4 (8.5%), and T3 (7.1%); N0 (65%), N1 (20.7%), N2 (13.6%), and N3 (0.7%); and stage I (31.4%), stage II(25.7%), stage IV (22.2%), and stage III (20.7%). Local and regional recurrence and distant metastasis was present in 13.6%, 5% and 4.2% of patients, respectively. The five-year survival rate was 72.2%, and the prognostic factors for oral tongue SCC included neck metastasis, pathologic stage of the disease, cell differentiation, treatment modality, neck dissection as part of the treatment plan, and neck node recurrence. Discussion: It is suggested that ipsilateral neck dissection or bilateral neck dissection should be selected as a treatment of tongue SCC patients with advanced stage.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.2
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• pp.83-88
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• 2009

The purpose of this epidemiologic study was to provide clinically useful information on the fundamentals for both the diagnosis and treatment planning of oral squamous cell carcinoma, which comprises $80{\sim}90%$ of all oral cancers. One hundred and forty two patients diagnosed with oral squamous cell carcinoma were selected from a total of 220 patients with oral malignancies. The patients' medical and follow-up records were reviewed and their survival was traced. The highest occurrence rate was observed in those aged between 60 and 69 years. The tongue was the most common primary site(31.7%) for oral squamous cell carcinoma. The survival rate was calculated using the Kaplan-Meier method. The overall five-year survival rate of oral squamous cell carcinoma patients was 66.90%. The 5-year survival rate according to stage was 85.82% for stage I, and 49.98% for stage IV. The five-year survival rate according to the originating site was 91.67% for the retromolar trigone, 75.30% for the tongue, and 62.41% for the maxillary gingiva. In terms of cell differentiation, the majority(58.5%) was the well-differentiated type, which had a 5-year survival rate of 70.62%.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.127-132
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• 1993

Total of 53 patients of unresectable and recurrent rectal cancer treated with neutron beam during the period from Oct.1987 to Apr.1992 were analyzed. Dose fractionation for the neutron only group was 1.5 Gy per fraction,3 fraction per week,21 Gy/41/2 wks for 42 patients out of 53 ($76{\%}$). Neutron only but modified fractionation schedule ($10{\%}$ more or less of total dose) was applied for 9 patients, and mixed beam (neutron boost) was for 4 patients, Complete tumor response was obtained in 40 patients ($76{\%}$, response rate). Local control rate was 28 out of 53 ($53{\%}$). Statistically significant better prognostic factors for local control were age below 49 years old (15/22, $68{\%}$) than above 50 years old (13/31, $42{\%}$), male (20/32, $63{\%}$) than female (8/21, $38{\%}$), tumor size less than 5 cm and non-metastatic (16/24, $67{\%}$) than size more than 5 cm or metastatic (12/29, $41{\%}$). Major complication had developed in 7 patients ($13{\%}$). Two year overall survival rate by Kaplan-Meier method was $30{\%}$, but it was rised to, $47{\%}$ when the turner was less than 5 cm non-metastatic.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.91-96
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• 1993

From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.