• 대한핵의학회지
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• 제35권4호
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• pp.251-257
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• 2001

목적: 신 이식 이틀째 촬영한 Tc-99m DTPA 스캔 소견에서 나타난 이식신의 기능 저하가 이식신의 장기 생존에 영향을 미치는 지 알아보았다. 대상 및 방법: 생체 신 이식 총 64예에서 신장 스캔 소견에 따른 이식신 누적 생존율의 차이를 Kaplan-Meier법으로 분석하고, Cox proportional hazard model을 이용하여 이식신 장기 생존율 예측능을 알아보았다. Chi-square test로 두 군 간에 급성 거부반응의 빈도 차이를 보았다. 결과: 신장 스캔 비정상군의 이식신 장기 생존율이 정상군에 비하여 낮았으나 그 차이가 통계적으로 유의하지 않았다. 이식 직후 신장 스캔 소견 상 나타나는 이식신 기능저하도 이식신 장기 생존의 예후 인자가 아니었다. 단, 신장 스캔 비정상군에서 급성 거부 반응 빈도가 정상군에 비하여 유의하게 높았다. 결론: 생체 신이식 예에서 이식 직후 신장 스캔에서 이식신의 기능 저하 소견은 이식신의 장기 생존에 직접적 영향은 없으나 급성 거부 반응을 증가시켜 간접적 영향이 있을 것으로 판단된다.

• Journal of the Korean Statistical Society
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• 제36권2호
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• pp.321-333
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• 2007

In the proportional hazard model with the beta process prior, the posterior computation with the discrete approximation is considered. The time period of interest is partitioned by small intervals. On each partitioning interval, the likelihood is approximated by that of a binomial experiment and the beta process prior is by a beta distribution. Consequently, the posterior is approximated by that of many independent binomial model with beta priors. The analysis of the leukemia remission data is given as an example. It is illustrated that the length of the partitioning interval affects the posterior and one needs to be careful in choosing it.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5625-5633
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• 2015

Background: ${\beta}$-catenin plays a crucial role in the progression of breast cancer (BC) and a prognostic role of in BC patients has been widely reported. However, controversy still remains. Materials and Methods: Identical search strategies were used to search relevant literature in electronic databases updated to July 1, 2014. Individual hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled HRs with 95%CIs were used to evaluate the strength of association between positive ${\beta}$-catenin expression in different subcellular locations and survival results of BC patients. Subgroup and meta-regression analyses were performed to explore heterogeneity. Funnel plots of Begg's and Egger's linear regression test were used to investigate publication bias. Heterogeneity and sensitivity were also assessed. All the work was completed using STATA. Results: A total of 2,204 patients from 12 evaluative studies were finally included. Pooled HRs and 95%CIs suggested that ${\beta}$-catenin expression in cytoplasm/nucleus had an unfavorable impact on both overall survival (OS) (HR: 1.93, 95%CI: 1.40-2.65) and disease free survival (DFS)/ recurrent free survival (RFS) (HR: 1.60, 95%CI: 1.20-2.13) in BC patients. However, here was no significant association between ${\beta}$-catenin expression in the membranes with OS (HR: 0.65, 95%CI: 0.42-1.02) or DFS/RFS (HR: 0.66, 95%CI: 0.38-1.13). Publication bias was absent in all of the four outcomes. Sensitivity analysis revealed that the results of this meta-analysis were robust. Conclusions: Positive ${\beta}$-catenin expression in cytoplasm/nucleus rather than in membrane is a significant prognostic factor in patients with BC who have been surgically treated.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8861-8869
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• 2014

Background: The prognostic value of Bcl-2 protein expression in non-small cell lung cancer (NSCLC) is under debate. We therefore systematically reviewed the evidence for Bcl-2 protein effects on NSCLC survival to elucidate this issue. Materials and Methods: An electronic search in Pubmed and Embase complemented by manual searches in article references were conducted to identify eligible studies to evaluate the association between Bcl-2 protein expression and overall survival (OS) as well as disease free survival (DFS) of NSCLC patients. Combined hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were pooled using the random-effects model. Results: A total of 50 trials (including 52 cohorts) encompassing 7,765 patients were pooled in the meta-analysis regarding Bcl-2 expression and OS of NSCLC patients. High expression of Bcl-2 protein had a favorable impact (HR=0.76, 95%CI=0.67-0.86). In the group of Bcl-2 expression and DFS, 11 studies including 2,634 patients were included. The synthesized result indicated high expression of Bcl-2 protein might predict good DFS (HR=0.85, 95%CI=0.75-0.95). Conclusions: Our present meta-analysis demonstrated favorable prognostic values of Bcl-2 expression in patients with NSCLC. Further prospective trails are welcomed to validate the utility of assessing Bcl-2 in NSCLC patient management.

• Journal of Gastric Cancer
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• 제14권3호
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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.

• Radiation Oncology Journal
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• 제29권4호
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• pp.252-259
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• 2011

Purpose: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. Materials and Methods: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. Results: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; P = 0.038), lymph node dissection extent (HR, 0.201; P = 0.002). and maintenance oral chemotherapy (HR, 2.964; P = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). Conclusion: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.

• 한국조사연구학회지:조사연구
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• 제11권3호
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• pp.81-101
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• 2010

본 연구의 목적은 청소년의 최초 폭력 발생시점을 살펴보고, 최초 폭력 발생시점에 대하여 개인, 가족 및 학교체계변수들의 영향을 검증하는 것이다. 이를 위해 한국청소년패널조사에서 최초 폭력 발생시점을 회고적으로 응답한 자료에 비연속시간 생존분석(discrete-time survival analysis)을 적용하였다. 연구결과에 의하면, 최초의 폭력행동은 초등학교 시기에 발생할 확률은 매우 낮았으나, 중학교 1학년 시기부터 급증하여 고등학교 1학년이 되기까지 계속해서 증가하는 것으로 나타났다. 폭력행동의 최초 발생시점에 대한 개인체계요인 중에서는 성별, 자아존중감, 공격성이, 가족체계요인 중에서는 결손가정 여부와 부모의 학대요인이, 학교체계요인 중에서는 비행친구 수가 유의하게 나타났다. 본 연구의 결과를 바탕으로 최초 폭력 발생시점에 영향을 줄 수 있는 변수들에 초점을 맞추어 청소년의 폭력 발생을 예방하기 위한 적절한 대비책을 찾는 데 도움을 줄 것이다.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.251-257
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• 2023

Backgrounds/Aims: This is a retrospective analysis of whether the 8th edition American Joint Committee on Cancer (AJCC) was a significant improvement over the 7th AJCC distal extrahepatic cholangiocarcinoma classification. Methods: In total, 111 patients who underwent curative resection of mid-distal bile duct cancer from 2002 to 2019 were included. Cases were re-classified into 7th and 8th AJCC as well as clinicopathological univariate and multivariate, and Kaplan-Meier survival curve and log rank were calculated using R software. Results: In patient characteristics, pancreaticoduodenectomy/pylorus preserving pancreaticoduodenectomy had better survival than segmental resection. Only lymphovascular invasion was found to be significant (hazard ratio 2.01, p = 0.039) among all clinicopathological variables. The 8th edition AJCC Kaplan Meier survival curve showed an inability to properly segregate stage I and IIA, while there was a large difference in survival probability between IIA and IIB. Conclusions: The 8th distal AJCC classification did resolve the anatomical issue with the T stage, as T1 and T3 showed improvement over the 7th AJCC, and the N stage division of the N1 and N2 category was found to be justified, with poorer survival in N2 than N1. Meanwhile, in TMN staging, the 8th AJCC was able differentiate between early stage (I and IIA) and late stage (IIB and III) to better explain the patient prognosis.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.393-407
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• 2019

Purpose: To identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC). Materials and methods: Patients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts. Results: We found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590-0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570-0.890; P=0.003). Conclusions: Postoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3331-3335
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• 2013

Background: The incidence of prostate cancer, one of the most common cancers in elderly men, is increasing annually in Thailand. Matrix metalloproteinase 11 (MMP-11) is a member of the extracellular matrix metalloproteases which has been associated with human tumor progression and clinical outcome. Aim: To quantify MMP-11 expression in prostatic adenocarcinoma tissues and to determine whether its overexpression correlates with survival outcome, and to assess its potential as a new prognostic marker. Materials and Methods: Expression of MMP-11 was analyzed using immunohistochemistry in 103 Thai patients with prostatic adenocarcinoma. Overall survival was analyzed using Kaplan-Meier methods and Cox regression models. Results: Immunoreactivity of MMP-11 was seen in the stroma of prostatic adenocarcinoma tissue samples, high expression being significantly correlated with poor differentiation in Gleason grading, pathologic tumor stage 4 (pT4), and positive-bone metastasis (p<0.05), but not age and prostatic-specific antigen (PSA) level. Patients with high levels of MMP-11 expression demonstrated significantly shorter survival (p<0.001) when compared to those with low levels. Multivariate analysis showed that MMP-11 expression and pT stage were related with survival in prostatic adenocarcinoma [hazard ratio (HR)=0.448, 95% confidence interval (95%CI)=0.212-0.946, HR=0.333, 95%CI=0.15-0.74, respectively]. Conclusions: Expression of MMP-11 is significantly associated with survival in prostatic adenocarcinoma. High levels may potentially be used for prediction of a poor prognosis.