• 제목/요약/키워드: Survival duration

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Comorbidity Relationship to Outcome of Radical Cystectomy in Chinese: a Single Institution Study with the ACE-27 Comorbidity Index

  • Xuan, Zhu;Zhong, Zhao-Hui;Zhang, Xuan-Zhi;Zhang, Lei;Zhao, Xiao-Kun;Lv, Chen;Xu, Ran;Ren, Wei-Gang;Li, Song-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.827-831
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    • 2012
  • To determine the relationship between comorbidity and outcome after radical cystectomy in Chinese patients by using the Adult Comorbidity Evaluation (ACE)-27 index. Two-hundred-and-forty-six patients treated with radical cystectomy at the Second Xiangya Hospital of Central South University, Hunan Province, China between 2000 and 2010 were retrospectively analyzed. Medical records were reviewed for age, gender, delayed time of radical cystectomy, urinary diversion type, pelvic lymphadenectomy status, TNM stage, and pathological grade. Comorbidity information was assessed by the ACE-27 index. The outcome measurement was overall survival. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the association between comorbidity and outcome. The study population consisted of 215 (87.40%) males and 31 (12.60%) females with a mean age of $62{\pm}11$ years. Median duration of follow-up was $47{\pm}31$ months. A total of 151 (61.38%) patents died during follow-up. Of those, 118 (47.97%) had at least one comorbidity. According to the ACE-27 scores, 128 (52.03%) patients had no comorbidity, 79 (32.11%) had mild, 33 (13.41%) had moderate, and 6 (2.45%) had severe comorbidities. Multivariate analysis indicated that moderate (p=0.002) and severe (p<0.001) comorbidity was significantly associated with decreased overall survival. In addition, age ${\geq}70$ years (p=0.002), delayed time of radical cystectomy >12 weeks (p=0.044), pelvic lymphadenectomy status (p=0.014), and TNM stage >T3 (p<0.001) were determined to be independent risk factors of overall survival. Increasing severity of comorbidity statistically correlated with decreased overall survival after radical cystectomy.

High-dose chemotherapy and autologous peripheral blood stem cell transplantation in the treatment of children and adolescents with Ewing sarcoma family of tumors

  • Seo, Juhee;Kim, Dong Ho;Lim, Jung Sub;Koh, Jae-Soo;Yoo, Ji Young;Kong, Chang-Bae;Song, Won Seok;Cho, Wan Hyeong;Jeon, Dae-Geun;Lee, Soo-Yong;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.56 no.9
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    • pp.401-406
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    • 2013
  • Purpose: We performed a pilot study to determine the benefit of high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT/autoPBSCT) for patients with Ewing sarcoma family of tumors. Methods: We retrospectively analyzed the data of patients who received HDCT/autoPBSCT at Korea Cancer Center Hospital. Patients with relapsed, metastatic, or centrally located tumors were eligible for the study. Results: A total of 9 patients (3 male, 6 female), with a median age at HDCT/autoPBSCT of 13.4 years (range, 7.1 to 28.2 years), were included in this study. Patients underwent conventional chemotherapy and local control either by surgery or radiation therapy, and had achieved complete response (CR, n=7), partial response (n=1), or stable disease (n=1) prior to HDCT/autoPBSCT. There was no transplant-related mortality. However, the median duration of overall survival and event-free survival after HDCT/autoPBSCT were 13.3 months (range, 5.3 to 44.5 months) and 6.2 months (range, 2.1 to 44.5 months), respectively. At present, 4 patients are alive and 5 patients who experienced adverse events (2 metastasis, 2 local recur, and 1 progressive disease) survived for a median time of 2.8 months (range, 0.1 to 10.7 months). The 2-year survival after HDCT/autoPBSCT was $44.4%{\pm}16.6%$ and disease status at the time of HDCT/autoPBSCT tended to influence survival ($57.1%{\pm}18.7%$ of cases with CR vs. 0% of cases with non-CR, P=0.07). Conclusion: Disease status at HDCT/autoPBSCT tended to influence survival. Further studies are necessary to define the role of HDCT/autoPBSCT and to identify subgroup of patients who might benefit from this investigational treatment.

Result of Radiation Therapy for Stage I, II Non-Hodgkin's Lymphoma (I, II기 악성 림프종 환자의 방사선 치료 성적)

  • Lee, Kyu-Chan;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.159-166
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    • 1993
  • A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients (43/69, $62.3{\%}$) were Stage I and 26 patients (26/69, $37.7{\%}$) were Stage II, and B symptom was found in $10.1{\%}$ (7/69). Nodal lymphoma was $21.7{\%}$ (15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was $78.3{\%}$ (54/69): $64.8{\%}$ (35/54) for head and neck, $25.9{\%}$ (14/54) for gastrointestinal tract. Histologically, low grade consists of $8.7{\%}$ (6/69), intermediate grade $84.2{\%}$ (56/69), high grade $10.1{\%}$ (7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, $52.2{\%}$). Eighteen patients ($26.1{\%}$) were treated with radiation therapy alone,20 patients ($29.0{\%}$) with radiation therapy combined with chemotherapy, 15 patients ($21.7{\%}$) with radiation therapy combined with surgery and chemotherapy, Median survival duration was 28 months, and the range of survival time was from 1 month to 134 months. Overall five-year survival rate for Stage I and II disease was $54.2{\%}$, with $64.5{\%}$ for Stage I and $37.1{\%}$ for Stage II. For nodal lymphoma,5-year survival rate was $45.9{\%}$, and $56.5{\%}$ for extranodal lymphoma; $60.6{\%}$ for head and neck, $52.9{\%}$ for GI tract primary disease. Local control rate for all patients was $88.4{\%}$ (61/69), with $80{\%}$ (12/15) for nodal lymphoma and $90.7{\%}$ (49/54) for extranodal lymphoma. The total failure rate was $34.8{\%}$ (24/69). Five of 24 ($20.8{\%}$) patients who were failed developed local failure only, $12.5{\%}$ (3/24) local failure with distant failure, and distant failure only were found in $66.7{\%}$ (16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.

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Effects of Starvation on Growth, Surival and Feeding Incidence of Tiger Puffer(Takifugu rubripes) Larvae (자주복 Takifugu rubripes 자어의 성장 생존 및 섭이율에 미치는 기아의 영향)

  • 한경남
    • Journal of Aquaculture
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    • v.11 no.4
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    • pp.521-528
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    • 1998
  • The influence of starvation on survival, growth and feeding incidence of larval tiger puffer Takifugu rubripes was investigated for 16 days after let them hatched at the temperature of 16.5~18.5${\circ}C$. The effect by delayed initial feeding on larvace was also studied. Almost all larvae began to be fed from the stage of yolk absorption about 5 days after hatching, in which rearing trials revealed that their survival and growth were influenced by food availability. Survival of unfed larvae, which stated to decrease drastically since the oil globule was exhausted about 9 days after hatching, dropped to 50% and 0% respectively on the 11.5th and 16th day. the difference of growth between fed and unfed larvae came into sight on about 5th day after hatching when the initial feeding was started, and had reduced in proportion to the length of starvation period. The condition factors for the unfed larvae were lower than thost of the fed. Of the larvae which had starved less than 5 days, more than 80% could consume food upon feeding. No fish had the ability in having food after 10 days. It appeared that the turning point of recover for the starving larvae came on 7th or 8th day. Their taking-food ability seemed to be affected by the change in swimming activity which depended on the duration of starvation. For the seed production of tiger puffer, therefore, feeding should be initiated as soon as possible, so as to enhance the production and survival of healthy seeds.

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Clinicopathological Features of Primary Solitary Spinal Cord Tumors in Pediatric Patients : A 32-Year Single Institution Experience

  • Choi, Ho Yong;Kim, Kyung Hyun;Cho, Byung-Kyu;Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Park, Sung-Hye;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.592-607
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    • 2021
  • Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

External Beam Radiotherapy Alone in Advanced Esophageal Cancer (진행된 식도암의 방사선 단독치료 성적)

  • Ahn Sung Ja;Chung Woong Ki;Nah Byung Sik;Nam Taek Keun
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.11-16
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    • 2000
  • Purpose :We peformed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. Methods and Materials : One hundred and six Patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (94$\%$) and ranged from 1 month to 92 months (median; 6 months). Results :The median age was 62 years old and male to female ratio was 104 2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was peformed in 83$\%$. Mean tumor dose delivered with curative aim was 58.6 Gy (55$\~$70.8 Gy) and median duration of the radiation therapy was 53 days. The median survival of all patients was 6 months and )-year and 2-year overall survival rate was 27$\%$ and 12$\%$, respectively, Improvement of dysphagia was obtained in most patients except for 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32$\%$ (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30$\%$ respectively, while those of the nonresponder was 4 months and 0$\%$ respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 months and 16$\%$ while those of the patients who could not tolerate regular diet was 3 months and 0$\%$, respectively (p=0.004). The survival difference between the patients with S cm or less tumor length and those with more than 5 cm tumor length was marginally statistically significant (u=0,06). However, the survival difference according to the periesophageal invasion or mediastinal tyrnphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9$\%$). Conclusion :The survival outcome for advanced esophageal cancer patients treated by external beam radiotherapy alone was very poor. In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.

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Relationship Between Tumor Angiogenesis, Stage and Prognosis in Non-Small Cell Lung Cancer (비소세포 폐암에서 종양 혈관신생과 병기 및 예후와의 관련성)

  • Lee, Won-Yeon;Kim, Chong-Ju;Shin, Pyo-Jin;Cho, Mee-Yon;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.557-567
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    • 2001
  • Background : Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. Method : Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post operative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet endothelial cell adhesion molecule, PECAM). Results : Microvessel counts(MVCs) in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage I and II or N0 stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). Conclusion : In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status(limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.

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The Effect of External Radiation Therapy in Management of Malignant Obstructive Jaundice due to Porta Hepatis Metastasis from Stomach Cancer (위암의 간문맥 전이로 발생한 악성 폐쇄성 황달에 대한 외부 방사선치료 효과)

  • Yang, Kwang-Mo;Kim, Joon-Hee;Kim, Chul-Soo;Suh, Hyun-Suk;Kim, Re-Hwe
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.339-348
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    • 1995
  • Purpose : Since 1983, authors have conducted a study to evaluate the effect of external radiation therapy and to determine affected factors in management of the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. Materials and Methods : Thirty two patients with malignant obstructive jaundice due to porta hepatis metastasis from gastric cancer were presented. We have analysed 23 patients who were treated with external radiation therapy of more than 3000cGy. The radiation dose, disease extent at developement of jaundice, total bilirubin levels before radiation therapy, differentiation of histology, combind treatment, intent of primary surgery, initial stage of gastric cancer were analyzed to determine affected factors in radiation therapy. External radiation therapy was delivered with a daily dose of 180-300cGy, 5 times a week fractionation using 4 MeV linear accelerator. The radiation field included the porta hepatis with tumor mass by the abdominal ultrasonography or CT scan. In twenty three patients received more than 3000cGy, total irradiation dose was ranged from 3000cGy to 5480cGy, median 3770cGy. Among 23 patients, 13 patients were delivered more than equivalant dose of TDF 65(4140cGy/23fx). Results : Among 23 patients, complete, partial and no response were observed in 13, 5, 5 patients, respectively. The median survival for all patients was 5 momths. The significant prolongation of median survival was observed in complete responders(11 months) as compared to partial and no responders(5 months, 5 months respectively) Out of 13 patients with complete response, 6 patients lived more than a year Among 13 patients receiving more than 4140cGy equivalent dose, complete, partial and no response were observed in 10, 2 and 1 patients, respectively. The median survival for all these patients was 9.5 months. The median survival for complete responders(10/13) was 11.5 months. Among 10 patients receiving less than 4140cGy equivalent dose, complete, partial and no response were observed in 3, 3, 4 patients, respetively. The median survival for all these patients was 4.3 months Therefore, the radiation dose affected the results of treatment. For the complete response with prolongation of survival duration, at least 4140cGy equivalant dose should be delivered to porta hepatis. In evaluation of the disease extent, 7 patients of 13 complete responders showed localized disease in porta hepatis or peripancreatic area, but all patients with partial and no response showed wide extensive disease or persistant disease of primary gastric cancer. Therefore. the patients with the localized disease were the higher probability of complete response and long term survival. This study suggested that the radiation dose and the disease extent at developement of jaundice affected in radiation therapy for malignant obstructive jaundice. There were no serious complications related to external radiation therapy. Conclusion : External radiation therapy only could achieve the palliative effect in the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. This study suggested that the prolongation of survival duration could be achived in complete responders and radiation dose, extent of disease affected the results of treatment of malignant obstructive jaundice.

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Evaluation of Two Promising Hybrids Viz., HSP1 (A3x935 E) and HSP2 (A3x916 B) in the Silkworm, Bombyx mori L.

  • Begum, A.Naseema;Rekha, M.;Ahsan, M.M.;Rao, P.Sudhakara
    • International Journal of Industrial Entomology and Biomaterials
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    • v.1 no.2
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    • pp.103-109
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    • 2000
  • To evolve silkworm hybrids with higher survival and better cocoon characters, evaluation of semen hybrids in the laboratory (short-listed out of 143 hybrids) resulted in the identification of two promising hybrids, A3${\tines}$935 E (HSP1) and A3${\tines}$916 B (HSP2). The hybrids were evaluated at three different Regional Sericultural Research Stations of Central Silk Board during 1997-1998 and also tested with the farmers along with two control hybrids, KAxNB4D2 and PMxNB4D2. Evaluation of the hybrids indicated that these hybrids can be reared in all the seasons, especially during summer season. These hybrids show shorter larval duration (22 days 17 hrs against 23 days in control KAxNB4D2 and better cocoon characters as compared to the crossed breeds PM ${\tines}$NB4D2).

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Studies on the Chemical Composition and Antitumor Activity of the Acid Polysaccharide from Alga Sargassum fusiforme

  • Qianqun, Gu;Yuchun, Fang;Changyun, Wang;Bafang, Li;Wenjun, Mao
    • Natural Product Sciences
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    • v.4 no.2
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    • pp.88-90
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    • 1998
  • An acid polysaccharide (SFP), was extracted from alga Sargassum fusiforme in hot water, was purified by ion exchange chromatography on DEAE-cellulose. The PC, chemical analysis, electrophoresis and IR of SFP indicated that it was a kind of alginate with a mol. wt. of 13,000 and a molar ratio of mannuronic acid to guluronic acid 2.75. Pharmacological tests showed that SFP could prolong the survival duration of mice suffering from ascitic Sarcoma 180 with a rate of life prolongation of 63.44%.

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