• Title/Summary/Keyword: SURVIVAL STRATEGY

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Customer-Centric CRM Implementation Case Study (고객중심의 CRM 구축비교 사례연구)

  • Lee, Ho-Seoub
    • Management & Information Systems Review
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    • v.23
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    • pp.25-40
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    • 2007
  • In the highly competitive and divers world of financial market, customer is the single most important factor to company's survival. Especially, creating a relationship with valued customers is a key to success. CRM provides the mean to retain high value customers. It takes a prospect of what customers expect. Utilizing those knowledge can help the products and service meet the customers' needs, thereby maximizing customer satisfaction and company's profit. In this report, I am going to suggest a few ways to develop successful CRM in the life insurance industry. First, CRM should innovate the way of communication to keep pace with Web 2.0 era. In other words, the customer's needs should be caught by real-time communication than traditional off-line market research. Thus, the functionality and specification of products can be decided by customer's direct choice so that the customers are able to purchase the understanding and experience of the products. Second, CRM project should consider whether the initial strategy plan can promise the stable growth of customer at the first step. When planning strategy, the project needs to identify what customer wants and how to fulfill the needs with stable growth of the customer. In addition, the CRM should be developed by realizing that customer centric benefits ultimately guarantee the growth of the organization. Third, CRM systems should enhance the organization's ability to take the customer's insight in a 360 degree view and to capture the voice of the customer directly. In order to develop the best matched product package, more precise customer segmentation should be ahead of market segmentation strategy. Forth, the biggest reward from CRM will be a customer royalty program. Many successful banks are already planning and practicing customer royalty strategy. A comprehensive analysis of customers and their behavior allow organization to identify high value potential customers' needs and determine a strategy required to meet those needs. Even life insurance companies such as Prudential Korea are developing products designed for royal customers. Fifth, understanding and managing the experience of customer called Customer Experience Management also can increase customer satisfaction. Measuring only customers' experience and adapting it to marketing strategy make products position in the gap between the customers' expectation and experience not required by market. A key component of CEM is its application across all organizational functions. At last, the direction of change and development of CRM can be defined from the conceptualization of information technology represented by Ubiquitous and Web 2.0. Instead of just managing customer information, companies should take the initiative in personalized system with customer oriented strategy. Furthermore, with the regular communication between CRM stakeholders (Sales-Marketing-IT), customer's demand should be directly reflected to enterprise strategy in real time.

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Preoperative Chemotherapy in Advanced Stomach Cancer (Pros) (위암에서의 수술 전 선행항암화학요법(in the View of Pros))

  • Park, Sook Ryun
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.57-64
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    • 2008
  • In gastric cancer, the only potentially curative treatment is surgery that attempts to achieve curative (R0) resection. However, despite the use of curative resection, a recurrence develops in a high percentage of patients, especially in cases of serosa and/or lymph node involvement. As a strategy to improve the survival of the patients with resectable advanced gastric cancer, neoadjuvant chemotherapy has been evaluated in several phase II trials and a few phase III trials. The results of these trials have confirmed the feasibility and safety of this approach with no apparent increase in surgical complications. Recently, the findings of a large phase III randomized trial (MAGIC trial) have indicated that compared to the use of surgery alone, perioperative chemotherapy, using both a neoadjuvant and adjuvant strategy, decreased the number of T and N stage cancers and improved survival. The results of another recent phase III trial (FNLCC 94012/FFCD 9703) also showed that compared to the use of surgery alone, perioperative chemotherapy improved the R0 resection rate and survival. In both trials, the improved outcomes may be attributed to the use of neoadjuvant chemotherapy because of poor compliance with adjuvant chemotherapy. These results cannot be directly translated to clinical practice in Korea due to differences in surgical techniques and outcomes. However, the findings of a few small phase II and III trials performed in patients with locally advanced gastric cancer in Korea have also suggested that neoadjuvant chemotherapy would result in the improvement of the R0 resection rate and down-staging of the disease. More effective chemotherapy regimens are needed in future large randomized trials to determine the subset of patients that will benefit from neoadjuvant chemotherapy and to determine the extent of benefit.

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Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease

  • Lee, Won-Young;Yoo, Jae Suk;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.255-261
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    • 2014
  • Background: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. Methods: We identified 103 patients (23 females; mean age, $64.1{\pm}12.3$ years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). Results: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was $80.9%{\pm}4.3%$ and $71.7%{\pm}5.9%$, respectively. Reoperation-free survival at 5 and 10 years was $77.3%{\pm}4.8%$ and $70.2%{\pm}5.8%$. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). Conclusion: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.

Advantages of ypTNM Staging in Post-surgical Prognosis for Initially Unresectable or Stage IV Gastric Cancers

  • Jeong, Gyu-Seong;Lee, In-Seob;Park, Young-Soo;Kim, Beom-Su;Yoo, Moon-Won;Yook, Jeong-Hwan;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.20 no.3
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    • pp.233-244
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    • 2020
  • Purpose: For unresectable or initially metastatic gastric cancer, conversion surgery (CVS), after systemic chemotherapy, has received attention as a treatment strategy. This study evaluated the prognostic value of ypTNM stage and the oncologic outcomes in patients receiving CVS. Materials and Methods: A retrospective review of clinicopathologic findings and oncologic outcomes of 116 patients who underwent CVS with curative intent, after combination chemotherapy, between January 2000 and December 2015, has been reported here. Results: Twenty-six patients (22.4%) underwent combined resection of another organ and 12 patients received para-aortic lymphadenectomy (10.3%). Pathologic complete remission (CR) was confirmed in 11 cases (9.5%). The median overall survival (OS) and disease-free survival (DFS) times were 35.0 and 21.3 months, respectively. In multivariate analysis, ypTNM stage was the sole independent prognostic factor for DFS (P=0.042). Tumors invading an adjacent organ or involving distant lymph nodes showed better survival than those with peritoneal seeding or solid organ metastasis (P=0.084). Kaplan-Meier curves showed that the 3-year OS rate of patients with pathologic CR and those with CR of the primary tumor but residual node metastasis was 81.8% and 80.0%, respectively. OS was 65.8% for stage 1 patients, 49.8% for those at stage 2, and 36.3% for those at stage 3. Conclusions: The ypTNM staging is a significant prognostic factor in patients who underwent CVS for localized unresectable or stage IV gastric cancers. Patients with locally advanced but unresectable lesions or with tumors with distant nodal metastasis may be good candidates for CVS.

Treatment Results in Patients with Salivary Gland Malignancy (타액선 악성 종양 환자에 대한 치료성적)

  • Song Dal-Won;Ahn Jae-Hyun;Sohn Jin-Sik;Kim Tae-Jong;Ahn Byung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.46-51
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    • 2000
  • Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

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Comparison of Radical Cystectomy and Chemoradiotherapy in Patients with Locally Advanced Bladder Cancer

  • Ikeda, Masaomi;Matsumoto, Kazumasa;Nishi, Morihiro;Tabata, Ken-Ichi;Fujita, Tetsuo;Ishiyama, Hiromichi;Hayakawa, Kazushige;Iwamura, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6519-6524
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    • 2014
  • The aim of this study was to evaluate the clinical outcomes of radical cystectomy (RC) and concurrent chemoradiotherapy (CRT) with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with locally advanced bladder cancer (BC). From December 2000 to February 2012, 72 patients with locally advanced BC (T3-4a, N0 or N+, M0) received either RC or CRT. RC with bilateral pelvic lymph node dissection including the common iliac region as the standard procedure. Patients in the CRT group received one cycle of MVAC followed by radiotherapy with a half dose of MVAC and then two more cycles of MVAC. Standard fractionation at a daily dose of 1.8-2.0 Gy was used, with a median total dose of 50 Gy (range, 45-60 Gy). The 3-year progression-free survival (PFS) rates in the RC and CRT groups were 56.2% and 25.6%, respectively (p=-0.015) and the 3-year overall survival (OS) rates were 63.5% and 48.1% (p=0.272). Multivariate Cox proportional hazards regression analysis with application of a propensity score indicated that RC was a significant predictor of PFS (p=0.033) but not of OS (p=0.291). Among patients with locally advanced BC, PFS was significantly prolonged in the RC group compared with the CRT group. However, RC was not a significant predictor of OS. Although the sample size in this study was small, the results suggest that patient background and postoperative quality of life should be considered when choosing treatment strategy for locally advanced BC.

Pemetrexed Continuation Maintenance versus Conventional Platinum-Based Doublet Chemotherapy in EGFR-Negative Lung Adenocarcinoma: Retrospective Analysis

  • Paik, Seung Sook;Hwang, In Kyoung;Park, Myung Jae;Lee, Seung Hyeun
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.148-155
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    • 2018
  • Background: Although targeted therapy and immuno-oncology have shifted the treatment paradigm for lung cancer, platinum-based combination is still the standard of care for advanced non-small cell lung cancer (NSCLC). Pemetrexed continuation maintenance therapy has been approved and increasingly used for patients with nonsquamous NSCLC. However, the efficacy of this strategy has not been proven in patients without driving mutations. The objective of this study was to compare the clinical benefit of pemetrexed continuation maintenance to conventional platinum-based doublet in epidermal growth factor receptor (EGFR)-negative lung adenocarcinoma. Methods: A total of 114 patients with EGFR-negative lung adenocarcinoma who were treated with platinum doublet were retrospectively enrolled. We compared the survival rates between patients received pemetrexed maintenance after four-cycled pemetrexed/cisplatin and those received at least four-cycled platinum doublet without maintenance chemotherapy as a first-line treatment. Results: Forty-one patients received pemetrexed maintenance and 73 received conventional platinum doublet. Median progression-free survival (PFS), which was defined as the time from the day of response evaluation after four cycles of chemotherapy to disease progression or death, was significantly higher in the pemetrexed maintenance group compared to conventional group (5.8 months vs. 2.2 months, p<0.001). Median overall survival showed an increasing trend in the pemetrexed maintenance group (22.3 months vs. 16.1 months, p=0.098). Multivariate analyses showed that pemetrexed maintenance chemotherapy was associated with better PFS (hazard ratio, 0.73; 95% confidence interval, 0.15-0.87). Conclusion: Compared to conventional platinum-based chemotherapy, premetrexed continuation maintenance treatment is associated with better clinical outcome for the patients with EGFR wild-type lung adenocarcinoma.

Neuroprotective Effect of Rapamycin (Autophagy Enhancer) in Transgenic SOD1-G93A Mice of Amyotrophic Lateral Sclerosis (근위축성측삭경화증의 SOD1-G93A 유전자 이식 마우스 모델에서 라파마이신의 신경보호효과)

  • Ahn, Suk-Won;Jeon, Gye Sun;Park, Kwang-Yeol;Hong, Yoon-Ho;Lee, Kwang-Woo;Sung, Jung-Joon
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.53-58
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    • 2013
  • Background: The autophagy is the major route for lysosomal degradation of misfolded protein aggregates and oxidative cell components. We hypothesized that rapamycin (autophagy enhancer) would prolong the survival of motor neuron and suppress the disease progression in amyotrophic lateral sclerosis (ALS). Methods: A total of 24 transgenic mice harboring the human G93A mutated SOD1 gene were used. The clinical status involving rotarod test and survival, and biochemical study of ALS mice model were evaluated. Results: The onset of symptoms was significantly delayed in the rapamycin administration group compared with the control group. However, after the clinical symptom developed, the rapamycin exacerbated the disease progression and shortened the survival of ALS mice model, and apoptosis signals were up-regulated compared with control group. Conclusions: Even though further detailed studies on the relevancy between autophagy and ALS will be needed, our results revealed that the rapamycin administration was not effective for being novel promising therapeutic strategy in ALS transgenic mice and exacerbated the apoptosis.

Hypothermia Improves Outcomes of Cardiopulmonary Resuscitation After Cardiac Arrest In a Rat Model of Myocardial Infarction (심근경색에 의한 심정지 후 치료적 저체온증으로 호전된 쥐의 심폐소생술 모델)

  • Roh, Sang-Gyun;Kim, Jee-Hee;Moon, Tae-Young;Park, Jeong-Hyun
    • Proceedings of the KAIS Fall Conference
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    • 2011.12a
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    • pp.170-173
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    • 2011
  • Therapeutic hypothermia(TH) improves neurological outcomes and reduces mortality among survivors of out-of-hospital cardiac arrest. Animal and human studies have shown that TH results in improved salvage of the myocardium, reduced infarct size, reduced left ventricular remodeling and better long-term left ventricular function in settings of regional myocardial ischemia. This study is to investigate the effect of TH on post-resuscitation myocardial dysfunction and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction (MI). Thoracotomies were performed in 10 Male Sprague-Dawley rats weighing 450-550 g. MI was induced by ligation of the left anterior descending coronary artery (LAD). Ninety min after LAD ligation, ventricular fibrillation induction and subsequent cardiopulmonary resuscitation was performed before defibrillation attempts. Animals were randomized to two groups: a) Acute MI-Normothermia b) Acute MI-Hypothermia ($32^{\circ}C$ for 4 h). Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured echocardiographically together with duration of survival. Ejection fraction, cardiac output and myocardial performance index were $54.74{\pm}9.16$, $89.00{\pm}8.89$, $1.30{\pm}0.09$ respectively and significantly better in the TH group than those of the normothermic group at the first 4 h after resuscitation($32.20{\pm}1.85$,$41.60{\pm}8.62$,$1.77{\pm}0.19$)(p=0.00). The survival time of the hypothermic group ($31.8{\pm}14.8$ h) was greater than that of the normothermic group($12.3{\pm}6.5$ h, p<0.05). This study suggested that TH attenuated post resuscitation myocardial dysfunction in acute MI and would be a potential strategy in post resuscitation care.

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Trends and Outcomes of Non-compliance with Treatment for Gastric Cancer in Korea over the 16 years from 1999 to 2015

  • Eom, Bang Wool;Jung, Kyu-Won;Won, Young-Joo;Kim, Young-Woo
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.92-101
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    • 2019
  • Purpose: The aim of this study was to evaluate the trend of non-compliance with treatment (NCT) among gastric cancer patients in the Korean population. Materials and Methods: Using data from the Korea Central Cancer Registry from 1999 to 2015, patients who did not receive any treatment for gastric cancer within 4 months after diagnosis were defined as the NCT group. The annual incidence rate, distributions according to age group and stage, and 5-year relative survival of the patients exhibiting NCT were analyzed. Results: The number of NCT patients was 5,871 (30.6%) in 1999 and continuously decreased to 4,434 (15.3%) in 2015. Between 2006 and 2015, the proportions of NCT patients decreased from 72.9% to 55.0% among those 80 years old or older and from 9.2% to 5.4% among patients younger than 40 years. In patients with distant metastases, this proportion decreased from 35.5% to 32.7%, and this proportion also decreased from 17.6% to 8.2% among those with localized disease. The 5-year relative survival rates of NCT patients between 2011 and 2015 were significantly lower than those of the treated patients in each stage (60.2% vs. 99.7%, 13.8% vs. 67.1%, and 2.0% vs. 8.3% among those with localized, regional, and distant disease, respectively). Conclusions: The proportion of NCT gastric cancer patients has decreased during the last 16 years. However, considerable numbers of elderly patients are still NCT. There must be a strategy to decrease NCT and improve the nationwide survival rate of patients with gastric cancer.