• Title/Summary/Keyword: prognostic model

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Long Term Survivors with Metastatic Pancreatic Cancer Treated with Gemcitabine Alone or Plus Cisplatin: a Retrospective Analysis of an Anatolian Society of Medical Oncology Multicenter Study

  • Inal, Ali;Ciltas, Aydin;Yildiz, Ramazan;Berk, Veli;Kos, F. Tugba;Dane, Faysal;Unek, Ilkay Tugba;Colak, Dilsen;Ozdemir, Nuriye Yildirim;Buyukberber, Suleyman;Gumus, Mahmut;Ozkan, Metin;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1841-1844
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    • 2012
  • Background: The majority of patients with pancreatic cancer present with advanced disease. Systemic chemotherapy has limited impact on overall survival (OS) so that eligible patients should be selected carefully. The aim of this study was to analyze prognostic factors for survival in Turkish advanced pancreatic cancer patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and receiving gemcitabine (Gem) alone or gemcitabine plus cisplatin (GemCis). Methods: This retrospective evaluation was performed for patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and who received gemcitabine between December 2005 and August 2011. Twenty-seven potential prognostic variables were chosen for univariate and multivariate analyses to identify prognostic factors associated with survival. Results: Among the 27 variables in univariate analysis, three were identified to have prognostic significance: sex (p = 0.04), peritoneal dissemination (p =0.02) and serum creatinine level (p=0.05). Multivariate analysis by Cox proportional hazard model showed only peritoneal dissemination to be an independent prognostic factor for survival. Conclusion: In conclusion, peritoneal metastasis was identified as an important prognostic factor in metastatic pancreatic cancer patients who survived more than one year from the diagnosis of recurrent and/or metastatic disease and receiving Gem or GemCis. The findings should facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

  • Somboonporn, Charoonsak;Mangklabruks, Ampica;Thakkinstian, Ammarin;Vatanasapt, Patravoot;Nakaphun, Suwannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2805-2810
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    • 2016
  • Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

Prognostic Technique for Ball Bearing Damage (볼 베어링 손상 예측진단 방법)

  • Lee, Do Hwan;Kim, Yang Seok
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.37 no.11
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    • pp.1315-1321
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    • 2013
  • This study presents a prognostic technique for the damage state of a ball bearing. A stochastic bearing fatigue defect-propagation model is applied to estimate the damage progression rate. The damage state and the time to failure are computed by using RMS data from noisy acceleration signals. The parameters of the stochastic defect-propagation model are identified by conducting a series of run-to-failure tests for ball bearings. A regularized particle filter is applied to predict the damage progression rate and update the degradation state based on the acceleration RMS data. The future damage state is predicted based on the most recently measured data and the previously predicted damage state. The developed method was validated by comparing the prognostic results and the test data.

Maintenance-based prognostics of nuclear plant equipment for long-term operation

  • Welz, Zachary;Coble, Jamie;Upadhyaya, Belle;Hines, Wes
    • Nuclear Engineering and Technology
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    • v.49 no.5
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    • pp.914-919
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    • 2017
  • While industry understands the importance of keeping equipment operational and well maintained, the importance of tracking maintenance information in reliability models is often overlooked. Prognostic models can be used to predict the failure times of critical equipment, but more often than not, these models assume that all maintenance actions are the same or do not consider maintenance at all. This study investigates the influence of integrating maintenance information on prognostic model prediction accuracy. By incorporating maintenance information to develop maintenance-dependent prognostic models, prediction accuracy was improved by more than 40% compared with traditional maintenance-independent models. This study acts as a proof of concept, showing the importance of utilizing maintenance information in modern prognostics for industrial equipment.

Prognostic Value of Early Postoperative Intraperitoneal Chemotherapy in Resectable Advanced Gastric Cancer (절제 가능한 진행위암에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치)

  • Yu Wansik;Chung Ho Young;Sugarbaker Paul H.
    • Journal of Gastric Cancer
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    • v.1 no.4
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    • pp.197-201
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    • 2001
  • Purpose: There are variants of gastric cancer assoclated with predominantly peritoneal spread of with haematogenous metastases. Perioperative intraperitoneal chemotherapy as an adjuvant to surgery is considered as a rational therapeutic modality to prevent peritoneal spread. We evaluated the influence of early postoperative intraperitoneal chemotherapy on the prognosis of resectable advanced gastric cancer. Materials and Methods: From 1990 to 1995, 246 patients with biopsy proven advanced gastric cancer were enrolled in the study. Among them 123 patients received early postoperative intraperitoneal mitomycin C and 5-fluorouracil. The survival rate was calculated using by the Kaplan-Meier method and was compared using the log-rank test according to 13 clinico-pathologic factors. Multivariate analysis was performed with the Coxproportional hazards model. Results: Gastric resection plusearly postoperative intraperitoneal chemotherapy showed an improved survival rate as compared to surgery alone ($54.1\%\;versus\;40.3\%;$ P=0.0325). Depth of tumor invasion, degree of regional lymph vode metastasis, distant metastasis, tumor size, tumor location, extent of gastric resection, and curability of surgery significantly influenced survival. When a multivariate analysis was performed, depth of tumor invasion, lymph node metastasis, early postoperative intraperitoneal chemotherapy, curability of surgery, and extent of gastric resection emerged as the statistically significant and independent prognostic factors. Conlusion: Early postoperative intraperitoneal chemotherapy is one of the independent prognostic indicators of resectable advanced gastric cancer.

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Clinicopathological Features and Survival of Patients with Gastric Cancer with a Family History: a Large Analysis of 2,736 Patients with Gastric Cancer

  • Jeong, Oh;Jung, Mi Ran;Park, Young Kyu;Ryu, Seong Yeob
    • Journal of Gastric Cancer
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    • v.17 no.2
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    • pp.162-172
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    • 2017
  • Purpose: Previous studies indicated conflicting results regarding the prognosis of gastric cancer with a family history (FHX). This study aimed to determine the clinicopathological features and survival of patients with gastric cancer with a FHX. Materials and Methods: We reviewed 2,736 patients with gastric cancer who underwent surgery between 2003 and 2009. The prognostic value of a FHX was determined in the multivariate model after adjusting for variables in the Asian and internationally validated prognostic models. Results: Of the patients, 413 (15.1%) had a FHX of gastric cancer. The patients with a FHX were younger (58.1 vs. 60.4 years; P<0.001) than the patients without a FHX. There were no significant differences in the histopathological characteristics between the 2 groups. A FHX was associated with a better overall survival (OS) rate only in the stage I group (5-year survival rate, 95% vs. 92%; P=0.006). However, the disease-specific survival (DSS) rate was not significantly different between the 2 groups in all stages. The multivariate model adjusted for the variables in the Asian and internationally validated prognostic models revealed that FHX has no significant prognostic value for OS and DSS. Conclusions: The clinicopathological features and survival of the patients with gastric cancer with a FHX did not significantly differ from those of the patients without a FHX.

The Impact of Different Types of Complications on Long-Term Survival After Total Gastrectomy for Gastric Cancer

  • Mi Ran Jung;Sung Eun Kim;Oh Jeong
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.584-597
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    • 2023
  • Purpose: This study aimed to investigate the impact of different types of complications on long-term survival following total gastrectomy for gastric cancer. Materials and Methods: A total of 926 patients who underwent total gastrectomy between 2008 and 2016 were included. Patients were divided into the morbidity and no-morbidity groups, and long-term survival was compared between the 2 groups. The prognostic impact of postoperative morbidity was assessed using a multivariate Cox proportional hazard model, which accounted for other prognostic factors. In the multivariate model, the effects of each complication on survival were analyzed. Results: A total of 229 patients (24.7%) developed postoperative complications. Patients with postoperative morbidity showed significantly worse overall survival (OS) (5-year, 65.0% vs. 76.7%, P<0.001) and cancer-specific survival (CSS) (5-year, 74.2% vs. 83.1%, P=0.002) compared to those without morbidity. Multivariate analysis adjusting for other prognostic factors showed that postoperative morbidity remained an independent prognostic factor for OS (hazard ratio [HR], 1.442; 95% confidence interval [CI], 1.136-1.831) and CSS (HR, 1.463; 95% CI, 1.063-2.013). There was no significant difference in survival according to the severity of complications. The following complications showed a significant association with unfavorable long-term survival: ascites (HR, 1.868 for OS, HR, 2.052 for CSS), wound complications (HR, 2.653 for OS, HR, 2.847 for CSS), and pulmonary complications (HR, 2.031 for OS, HR, 1.915 for CSS). Conclusions: Postoperative morbidity adversely impacted survival following total gastrectomy for gastric cancer. Among the different types of complications, ascites, wound complications, and pulmonary complications exhibited significant associations with long-term survival.

Prognostic Model in Patients with Early-stage Squamous Cell Carcinoma of the Uterine Cervix: A Combination of Invasive Margin Pathological Characteristics and Lymphovascular Space Invasion

  • Khunamornpong, Surapan;Lekawanvijit, Suree;Settakorn, Jongkolnee;Sukpan, Kornkanok;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6935-6940
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    • 2013
  • Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamous cell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamous cell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. In addition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type of invasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also included in the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction of recurrence and decreased survival was selected. Results: The model with the best performance was composed of a combined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reaction and stromal desmoplasia (total score =10). Compared to those with score ${\leq}8$, the patients with score 9-10 had a significantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy (p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition, the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-free survival was significantly lower in the patients with score 9-10 than those with score ${\leq}8$ among the overall patients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy (p=0.047). Conclusions: In this study, a prognostic model based on a combination of pathological characteristics of invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survival in patients with early-stage cervical squamous cell carcinoma.

Prognostic Significance of 18F-fluorodeoxyglucose Positron Emission Tomography (PET)-based Parameters in Neoadjuvant Chemoradiation Treatment of Esophageal Carcinoma

  • Ma, Jin-Bo;Chen, Er-Cheng;Song, Yi-Peng;Liu, Peng;Jiang, Wei;Li, Ming-Huan;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2477-2481
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    • 2013
  • Aims and Background: The purpose of the research was to study the prognostic value of tumor 18F-FDG PET-based parameters in neoadjuvant chemoradiation for patients with squamous esophageal carcinoma. Methods: Sixty patients received chemoradiation therapy followed by esophagectomy and two 18FDG-PET examinations at pre- and post-radiation therapy. PET-based metabolic-response parameters were calculated based on histopathologic response. Linear regression correlation and Cox proportional hazards models were used to determine prognostic value of all PET-based parameters with reference to overall survival. Results: Sensitivity (88.2%) and specificity (86.5%) of a percentage decrease of SUVmax were better than other PET-based parameters for prediction of histopathologic response. Only percentage decrease of SUVmax and tumor length correlated with overall survival time (linear regression coefficient ${\beta}$: 0.704 and 0.684, P<0.05). The Cox proportional hazards model indicated higher hazard ratio (HR=0.897, P=0.002) with decrease of SUVmax compared with decrease of tumor size (HR=0.813, P=0.009). Conclusion: Decrease of SUVmax and tumor size are significant prognostic factors in chemoradiation of esophageal carcinoma.

Prognostic Role of Nucleophosmin in Colorectal Carcinomas

  • Yang, Yu-Feng;Zhang, Xi-Ying;Yang, Mei;He, Ze-Hua;Peng, Ning-Fu;Xie, Shu-Rui;Xie, Yan-Fang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2021-2026
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    • 2014
  • Aim: Recent research suggests that nucleophosmin (NPM) may be a prognostic marker in colorectal carcinomas (CRC). We here tested its use to predict the survival of CRC patients. Methods: We investigated NPM expression by immunohistochemistry in histologically normal to malignant colorectal tissues and evaluated its association with clinicopathological variables. Overall and disease-free survival after tumor removal were calculated by the Kaplan-Meier method, and differences in survival curves were analyzed by the log-rank test. The Cox proportional hazards model was used for multivariate analysis of prognostic factors. Results: NPM expression was found significantly upregulated in CRC compared to adjacent colorectal tissue, villous adenoma, tubular adenoma and normal colorectal mucosa (p<0.05 for all). NPM expression was statistically linked to cancer embolus, lymph node metastasis, differentiation grade, and recurrence of CRC. Overall and disease-free survival of NPM-negative CRC patients tended to be better than those for patients with NPM-positive lesions (log-rank statistic, p<0.05 for all). Multivariate analysis indicated NPM expression as an independent prognostic indicator for CRC patients (p<0.05 ). Conclusion: Our results suggest that NPM expression can predict the survival of CRC patients. Prognosis of CRC is determined by not only many known prognostic factors but also by NPM expression.