• Title/Summary/Keyword: SURVIVAL RATIO

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Postoperative Serum CEA Level is a More Significant Prognostic Factor than Post/Preoperative Serum CEA Ratio in Non-small Cell Cancer Patients

  • Tomita, Masaki;Ayabe, Takanori;Chosa, Eiichi;Nakamura, Kunihide
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7809-7812
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    • 2015
  • Background: In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. In addition, in other cancers, the post/preoperative serum CEA ratio has been reported as a useful parameter. Materials and Methods: We enrolled 123 NSCLC patients with preoperative high CEA levels (${\geq}5ng/mL$) who underwent curative surgery between 2004 and 2011. Prognostic significance of postoperative serum CEA level and the CEA ratio was examined. Results: The 5-year survival of patients with persistently high serum CEA level after surgery was poor. On the other hand, patients with normal postoperative serum CEA levels had significant favorable prognosis. The patients with CEA ratio>1 had poor prognosis, however the number was only 7 (5.7%). The 5-year survival rates of patients with other subgroup based on the CEA ratio ($0.5{\geq}CEA$ ratio and $0.5{\leq}CEA$ $ratio{\leq}1$) was similar. Multivariate analysis revealed prognostic significance for the postoperative serum CEA level but not the CEA ratio. Conclusions: For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio.

Multiple Gamma Knife Radiosurgery for Multiple Metachronous Brain Metastases Associated with Lung Cancer : Survival Time

  • Kim, Hyung-Seok;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.334-338
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    • 2012
  • Objective : We compared the survival time between patients with multiple gamma knife radiosurgery (GKRS) and patients with a single GKRS plus whole brain radiation therapy (WBRT), in patients with multiple metachronous brain metastases from lung cancer. Methods : From May 2006 to July 2010, we analyzed 31 patients out of 112 patients who showed multiple metachronous brain metastases. 20 out of 31 patients underwent multiple GKRS (group A) and 11 patients underwent a single GKRS plus WBRT (group B). We compared the survival time between group A and B. Kaplan-Meier method and Cox proportional hazards were used to analyze relationship between survival and 1) the number of lesions in each patient, 2) the average volume of lesions in each patient, 3) the number of repeated GKRS, and 4) the interval of development of new lesions, respectively. Results : Median survival time was 18 months (range 6-50 months) in group A and 6 months (range 3-18 months) in group B. Only the average volume of individual lesion (over 10 cc) was negatively related with survival time according to Kaplan-Meier method. Cox-proportional hazard ratio of each variable was 1.1559 for the number of lesions, 1.0005 for the average volume of lesions, 0.0894 for the numbers of repeated GKRS, and 0.5970 for the interval of development of new lesions. Conclusion : This study showed extended survival time in group A compared with group B. Our result supports that multiple GKRS is of value in extending the survival time in patients with multiple metachronous brain metastases, and that the number of the lesions and the frequency of development of new lesions are not an obstacle in treating patients with GKRS.

Tumor Diameter for Prediction of Recurrence, Disease Free and Overall Survival in Endometrial Cancer Cases

  • Senol, Taylan;Polat, Mesut;Ozkaya, Enis;Karateke, Ates
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7463-7466
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    • 2015
  • Aims: To analyse the predictors of recurrence, disease free survival and overall survival in cases with endometrial cancer. Materials and Methods: A total of 152 women diagnosed with endometrial cancer were screened using a prospectively collected database including age, smoking history, menopausal status, body mass index, CA125, systemic disorders, tumor histology, tumor grade, lymphovascular space invasion, tumor diameter, cervical involvement, myometrial invasion, adnexal metastases, positive cytology, serosal involvement, other pelvic metastases, type of surgery, fertility sparing approach to assess their ability to predict recurrence, disease free survival and overall survival. Results: In ROC analyses tumor diameter was a significant predictor of recurrence (AUC:0.771, P<0.001). The optimal cut off value was 3.75 with 82% sensitivity and 63% specificity. In correlation analyses tumor grade (r=0.267, p=0.001), tumor diameter (r=0.297, p<0.001) and the serosal involvement (r=0.464, p<0.001) were found to significantly correlate with the recurrence. In Cox regression analyses when some different combinations of variables included in the model which are found to be significantly associated with the presence of recurrence, tumor diameter was found to be a significant confounder for disease free survival (OR=1.2(95 CI,1.016-1.394, P=0.031). On Cox regression for overall survival only serosal involvement was found to be a significant predictor (OR=20.8 (95 % CI 2.4-179.2, P=0.006). In univariate analysis of tumor diameter > 3.75 cm and the recurrence, there was 14 (21.9 %) cases with recurrence in group with high tumor diameter where as only 3 (3.4 %) cases group with smaller tumor size (Odds ratio:7.9 (95 %CI 2.2-28.9, p<0.001). Conclusions: Although most of the significantly correlated variables are part of the FIGO staging, tumor diameter was also found to be predictor for recurrence with higher values than generally accepted.

Profile and Survival of Tongue Cancer Patients in "Dharmais" Cancer Hospital, Jakarta

  • Sutandyo, Noorwati;Ramli, Ramadhan;Sari, Lenny;Soeis, Dewi Syafriyetti
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1971-1975
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    • 2014
  • Background: Tongue cancer is still a major health problem in most developing countries around the world. Statistics shown the number of tongue cancers, especially in early age, to be increasing, with poor survival. Objective: To analyze the characteristic profile of tongue cancer patients in Indonesia as well as the survival rate. Materials and Methods: A cross sectional study was conducted in Dharmais National Cancer Hospital by collecting general, clinical, and survival data of tongue cancer patients from medical records for January 2009 to April 2012. Results: Tongue cancer incidence increased year by year. The average age of tongue cancer patients was 47.5 years, and males predominated, accounting for 64.5% of cases. Most patients presented at an advanced stage (69.6%). The histopathology type was squamous cell carcinoma in the vast majoriy (96.8%). The therapies applied were surgery (45.6%), radiation (63.6%) and chemotherapy (57.6%). The survival rate after one year is 60.6% and after two years was 12.1%. In addition, median survival of tongue cancer patients was 20 months (95% confidence interval 9.07-30.9). The significant factor affecting survival was size of tumor with a hazard ratio of 3.18 (95% CI, 1.02-9.93; p 0.046) for largest versus smallest categories. Conclusions: In each year, the number of tongue cancer incidents in Indonesia is increasing. The age of tongue cancer patients in Indonesia is younger compared to other countries. Moreover, the survival rates are not high.

Associations of Most Prevalent Risk Factors with Lung Cancer and Their Impact on Survival Length

  • Khan, Mohammad Haroon;Hussain, Shahid;Bano, Raisa;Jamshed-ul-Hassan, Hafiz;Aadil ur Rehman, Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.65-70
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    • 2016
  • Lung cancer is one of the most common malignancies in the world. Its incidence and mortality rates are on the rise in Pakistan. However, epidemiological studies to identify common lung cancer determinants in the Pakistani population have been limited. In this study, data of 440 cases and 323 controls were collected from different hospitals in Peshawar and Islamabad, along with information about socio-demographic factors including age, sex and smoking. Univariate and multi-factorial analyses of socio-demographic factors in association with each other were also performed. Overall survival analysis highlighted that, out of 440 patients in the lung cancer dataset, 204 people were uncensored with a median survival time of 13 months (95% CI=12-18). There were 41 femaleand 399 male patients. Differences were observed between length of survival in the males and females (${\chi}12$ = 6.1; p-value = 0.01). Gender was observed to be significantly related to survival (p-value< 0.01), with better survival in females (hazard ratio=2). Cox regression was extended to adjust for the covariate age (z = 2.5; p-value = 0.02). Survival analysis was also performed on the basis of smoking groups (current smokers, former smokers and never smoked individuals) and smoking duration (smoking duration >10 years, <10 years and never smoked). Smoking duration was significantly associated with survival (p-value < 0.01), with better survival in never smokers in comparison to both smoking for greater or less than 10 years. Strong associations were observed for smoking group with duration greater than 10 years, OR=6.1(3.9-9.5) on univariate and multifactorial analysis OR=11.3(CI=6.8-19.3).

Survival in Head and Neck Cancers - Results of A Multi-Institution Study

  • Nandakumar, Ambakumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1745-1754
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    • 2016
  • Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.

Survival of the Ark Shell, Scapharca subcrenata and Physiological and Histological Changes at Decreasing Salinity

  • Shin, Yun-Kyung;Lee, Won-Chan;Jun, Rae-Hong;Kim, Sung-Yeon;Park, Jung-Jun
    • Fisheries and Aquatic Sciences
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    • v.12 no.3
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    • pp.209-218
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    • 2009
  • We examined physiological and histological responses related to the survival, oxygen consumption, excretion, and O/N ratio of the ark shell, Scapharca subcrenata, as a result of salinity changes. The 20-day $LS_{50}$ (median lethal salinity) at $15^{\circ}C$ was 13.87 practical salinity units (psu; confidence limits 10.30-18.74 psu), whereas the 14-day $LS_{50}$ at $25^{\circ}C$ was 12.59 psu (confidence limits 8.03-18.16 psu). In conditions of decreasing salinity, the osmolarity of individuals acclimated within 5 h above 26.4 psu but required more than 60 h below 13.2 psu. Oxygen consumption and ammonia excretion rates varied irregularly as salinity decreased. The O/N ratio was 19 and 27 at water temperatures of $15^{\circ}C$ and $25^{\circ}C$, respectively, but decreased to 1-10 as salinity declined. The effects of decreasing salinity were observed in the histological changes to each organ of S. subcrenata. As salinity decreased, cilia fell off, the epithelial layer underwent necrosis and vacuolation, the connective tissue layers of the mantle and visceral mass were destroyed, and hemocytes increased in the gills. The results of this study could prove important in investigating causes of mass mortality and managing shellfish aquaculture farms.

Effects of Stocking Density on the Blind-side Hypermelanosis of Cultured Olive Flounder Paralichthys olivaceus

  • Kang, Duk-Young;Kim, Hyo-Chan;Chang, Young-Jin
    • Fisheries and Aquatic Sciences
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    • v.14 no.2
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    • pp.123-129
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    • 2011
  • To determine whether rearing density affects the hypermelanosis on the blind side (ambicoloration) of olive flounders Paralichthys olivaceus, we reared fry with an unpigmented non-eyed (blind) side in duplicate at densities of 150 individuals/$m^2$ (commercial production density: control) and 450 individuals/$m^2$ (high density group) for 90 days in 1-t dark-green fiberglass reinforced plastics (FRP) tank. We recorded feed intake, feed conversion efficiency (FE), growth and survival, and measured the ratios of staining blind-side area (staining area) and ambicolored fish every 30 days. Daily feed intake (DFI), feed conversion efficiency (FE), growth rate, condition factors, and survival rate were calculated at the end of the experiment. Although the FE was higher in the high-density compared to the control, the two density groups showed similar feed intakes, growth, and survival. The ratio of staining area as well as the ratio of ambicolored fish significantly were significantly higher in the high-density group than in the control from days 30 to 60, but significantly increased and evened out by the end of the experiment (P<0.05). In conclusion, we determined that rearing density is not the main cause of the blind-side hypermelanosis, but found that increasing the rearing density can accelerate the ambicoloration in olive flounders.

Risk Factors for Deliberate Self-extubation (기관 내 삽관환자의 의도적 자가발관 위험요인)

  • Cho, Young Shin;Yeo, Jung Hee
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.573-580
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    • 2014
  • Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

The Prognosis of Patients with Stage IV Gastric Carcinoma without Distant Metastasis (원격전이를 동반하지 않은 4기 위암 환자의 예후)

  • Lee Jun Ho;Noh Sung Hoon;Choi Seung Ho;Min Jin Sik
    • Journal of Gastric Cancer
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    • v.1 no.2
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    • pp.100-105
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    • 2001
  • Purpose: In the UICC staging system, stage IV contains not only those patients with distant metastasis but also patients with far advanced T and N status but without distant metastasis. We investigated the prognostic factors of stage IV gastric carcinoma patients without distant metastasis after curative resection. Materials and Methods: 190 stage IV gastric carcinoma patients without distant metastasis were reviewed after curative resection. Results: Male sex, distal third location, Borrmann type III, IV and histologically undifferentiated type were common. 5 year survival rate of the 190 patients was $22.2\%$. Depth of invasion and lymph node metastasis did not influence survival. The lymph node ratio (positive lymph node / retrieved lymph node) and combined resection affected survival by univariate and multivariate analysis. Conclusion: Combined resection and positive lymph node ratio were the independent prognostic factors in the patients with stage IV gastric carcinoma who underwent curative resection.

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