• Journal of Gastric Cancer
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• v.21 no.1
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.248-261
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• 2024

Backgrounds/Aims: This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model. Results: Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7). Conclusions: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.

• Korean Journal of Environment and Ecology
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• v.30 no.1
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• pp.92-97
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• 2016

The purpose of this study was to improve growth and survival rate of marine microalgae and macroalga zoospores using with eco-friendly capsulation materials. The capsulation materials were chosen an alginic acid which extracted from marine brown algae combining with starch and calcium chloride. The capsulated microalgae, Nannochloropsis salina and macroalga zoospores, Ulva australis were evaluated with growth and survival rate. When the mixed ratio of alginic acid was less than 50%, capsule formation was not performed. When the ratio of 50% alginic acid and 50% starch, the microalgae was shown the highest growth and survival rate increasing up to $8.74{\times}10^5cells\;mL^{-1}$ while 100% of alginic acid was the lowest rate up to $4.92{\times}10^5cells\;mL^{-1}$. The increasing starch ratio improved to their growth and survival rate, however decreasing alginic acid make physical capsule formation weaken. By applying on a surface of artificial reef, capsulated algal zoospores were germinated 99 individuals $cm^{-2}$. This attempt will be provided to basic core technology for marine afforestation in coastal area.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4363-4368
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• 2015

Background: The tumor-stroma ratio (TSR) represents the percentage of neoplastic cell components compared to the combined area of neoplastic cells and the surrounding tumor-induced stroma. A low TSR (predomination of stromal component) has been demonstrated to be an independent adverse prognostic factor in cancers of several organs. In cervical carcinoma patients, TSR has been evaluated in only one previous study with different histological types. The present study aimed to assess the prognostic value of TSR in early stage cervical cancer patients with adenocarcinoma histology only. Materials and Methods: Histological slides of patients with early stage (IB-IIA) cervical adenocarcinoma who underwent surgical treatment between January 2003 and December 2011 were reviewed. Patients who had received preoperative chemotherapy were excluded. TSR was categorized as low (<50%) and high (${\geq}50%$). Correlations between TSR and clinicopathological variables were evaluated. Prognostic values of TSR and other variables were estimated using Cox's regression. Results: Of 131 patients; 38 (29.0%) had low TSR and 93 (71.0%) had high TSR. The patients with low TSR had significantly higher proportions of deep cervical stromal invasion (outer third of wall, p=0.011; residual stroma less than 3 mm, p=0.008) and parametrial involvement (p=0.026). Compared to the patients with high TSR, those with low TSR tended to have lower 5-year disease-free survival rate (83.8% versus 88.9%) and overall survival rate (85.6% versus 90.3%), although the differences were not statistically significant. Low TSR was significantly associated with decreased overall survival in univariate analysis (HR 2.7; 95% CI 1.0-7.0; p=0.041), but not in multivariate analysis. TSR was not significantly associated with decreased disease-free survival. Conclusions: Low TSR is associated with decreased overall survival in patients with early stage cervical adenocarcinoma treated by surgery. However, it was not found to be an independent prognostic predictor in this study.

• Journal of Aquaculture
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• v.20 no.1
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• pp.31-40
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• 2007

To find out the effect of the spat planting time and environmental factors in the arkshell, Scapharca broughtonii (Schrenck), we investigated the growth, survival rate of arkshell and habitat characteristics in Gamak Bay, Yeoja Bay and Saryang Island. We planted artificial spats of arkshell in Gamak Bay and Yeoja Bay at November 2004, and also planted domestic and Chinese natural spats in Saryang Island at March 2005. We measured growth, survival rate of arkshell, physiochemical parameters of the water mass (water temperature, salinity, dissolved oxygen, nutrients and chlorophyll a) and characteristics of the sediment (oxygen penetration depth, oxygen microprofiles, ignition loss and chemical oxygen demand) by monthly. The cumulative survival ratio of arkshell in Gamak Bay was the highest at December, whereas the ratio of arkshell in Yeoja Bay was recorded as 0% at October. The monthly growth rates of arkshell length in Gamak Bay and Yeoja Bay were the highest in May and the growth rate of the Korean arkshell in Saryang Island was higher than Chinese ones significantly. The high mortality (> 65%) of the arkshell in Yeoja Bay during summer probably caused by high water temperature, inflow of low salinity water, and low dissolved oxygen concentration in sediment. The concentrations of nutrient and sediment COD were considered to play an important role in the monthly survival ratio of arkshell in Gamak Bay and Sarayng Island. We suggest that the growth and mortality of arkshell might be influenced to the planting time of spat and the habitat characteristics.

• Korean journal of applied entomology
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• v.50 no.4
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• pp.335-342
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• 2011

The effects of gamma irradiation on the survival, development, fecundity, and sex ratio of the multicolored Asian ladybird beetle (Harmonia axyridis) were investigated. A dose of more than 50 Gy dose of irradiation on eggs completely inhibited hatch, and 1st and 3rd instar larva irradiated with over 40 Gy almost died. Adverse effects of gamma irradiation over 70 Gy were also observed in the survival and development of pupae and adults. Although irradiated individuals usually survived, they had longer periods of larval and pupal development than untreated individuals. Slight female-biased sex ratios were observed in some treatments. However, sex ratio differences soon equilibrated. Generally, inherited harmful effects of gamma irradiation were observed in F1 and F2 generations. Comet tail indicating DNA damage was showed in survival individuals exposed to gamma irradiation.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.391-394
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• 2012

Aim: Depression is thought to be a predictor of poor survival among cancer patients. In our study, we aimed to investigate the association between depression and survival in patients with gastric cancer. Methods: The subjects were a total of 300 patients aged 20-75 years who had histological confirmed diagnosis of gastric cancer from January 2004 to May 2006. Three months after patients diagnosis, depression was scored using by the Depression Status Inventory (DSI) designed by Willian WK Zung. The follow-up period consisted of a total of 13,643 person-months. A Cox's regression analysis was used to assess the association between depression and survival. Results: The percentage of subjects with depression according to the DSI depression criteria was 31%. Tumor stage and treatment methods were significantly associated with depression of patients. Age (60 years or older), annual income, tumor stage, lymph nodes metastasis and treatment were significantly associated with increased hazard ratio (HR) for gastric cancer survival. The adjusted HR for mortality risk in gastric cancer patients with depression tended to be high (HR=3.34, 95% CI=1.23-5.49) and a significant trend was found (P<0.05). Conclusion: The data obtained in this prospective study in Chinese support the hypothesis that depression is associated with poor survival among gastric cancer patients. Further studies with a large sample and longer term follow-up period are needed.

• Journal of Gastric Cancer
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• v.13 no.4
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• pp.226-231
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• 2013

Purpose: The role of metastasectomy has been debatable and unclear in the treatment for patients with metastatic gastric cancer. Therefore, this study was designed to evaluate the role of metastasectomy on the overall survival of these patients. Materials and Methods: In 2,406 patients who underwent gastrectomy for gastric cancer between 1998 and 2010, 188 (7.8%) patients had their first surgery for metastatic gastric cancer. To minimize the bias of systemic chemotherapy, 99 patients who received postoperative chemotherapy (fewer than 2 cycles) were excluded. The primary gastrectomy or metastasectomy had not been enforced in the following cases. Patients with far advanced peritoneal dissemination, multiple liver and lung metastasis (more than 2), and a poor general condition (Eastern Cooperative Oncology Group>2) were excluded. Based on the metastasectomy, the patients were classified into two groups, gastrectomy with metastasectomy and gastrectomy only group. Results: There was no significant difference between both groups in clinicopathological characteristics except for the mean age (P=0.047). The univariate analysis for overall survival show statistical significances in metastasectomy (P=0.026), distal gastrectomy (P=0.047), and combined resection of another organ (P=0.047) group. With a multivariate analysis, metastasectomy was a significant factor in patient survival after surgery (odds ratio 1.679; P=0.034). Conclusions: Based on our results, we assume that a detailed strategy for surgery is needed to improve the overall survival of patients with metastatic gastric cancer. Therefore, we suggest that a metastasectomy can help prolong overall survival in some patients with metastatic gastric cancer.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.274-286
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• 2018

Purpose: The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer. Materials and Methods: A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (${\leq}18.5kg/m^2$, n=51), normal BMI group ($18.6-24.9kg/m^2$, n=308), and high BMI group (${\geq}25.0kg/m^2$, n=151). Results: There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186-154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644-16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383-212.940; P=0.027). Conclusions: Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.164-172
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• 2014

Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases. Materials and Methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed. Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors. Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.