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Clinical Prognostic Factors of Terminal Cancer Patients with Palliative Procedures for Malignant Gastrointestinal Obstruction (완화적 시술을 받은 악성 위장관 폐색 말기 암환자의 임상적 예후인자)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.200-208
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    • 2005
  • Purpose: Palliative procedures or surgical interventions not only manage various symptoms of malignant gastrointestinal obstruction, but also improve the quality of life. We investigated the clinical characteristics and prognostic factors of terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction. Methods: We retrospectively reviewed the medical records of 48 terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction at Sam Anyang hospital from May in 2002 to May in 2005. We excluded patients with palliative tumor resection. We analyzed prognostic factors in symtom-free survival and overall survival using Kaplan-Meier method, univariate and multivariate analysis. Results: There were 25 males (52%) and 23 females (48%), and median age of 48 patients was 65 years. The most common cause of malignant gastrointestinal obstruction was colorectal (26 patients, 55%), followed by stomach (10, 21%). Twenty patients (42%) received previous treatment (chemotherapy, surgery, and radiotherapy) and 28 (58%) never received any. Eighteen of 20 had received chemotherapy. The most common symptom was pain (15 patients, 31%). Twenty three patients (48%) had Eastern Cooperative Oncology Group(ECOG) performance status of 1 or 2 score and 25 patients (52%) 3 or 4 score. The most common palliative procedure was colostomy and there was no mortality concerning the palliative procedures. By univariate and multivariate analysis, performance status was the only independent prognostic factor in overall survival and symptom-free survival. Overall survival was 150 days and symptom-free survival was 90 days. Conclusion:. We confirmed that perftatdormance status is significant independent prognostic factor in terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction.

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Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

  • Sipetic-Grujicic, Sandra Branko;Murtezani, Zafir Hajdar;Neskovic-Konstatinovic, Zora Borivoje;Marinkovic, Jelena Milutin;Kovcin, Vladimir Nikola;Andric, Zoran Gojko;Kostic, Sanja Vladeta;Ratkov, Isidora Stojan;Maksimovic, Jadranka Milutin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3233-3238
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    • 2014
  • Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was $64.3{\pm}10.5$ years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ${\leq}2cm$, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

Efficacy of Dose Dense Doxorubicin and Cyclophosphamide Followed by Paclitaxel versus Conventional Dose Doxorubicin, Cyclophosphamide Followed by Paclitaxel or Docetaxel in Patients with Node-Positive Breast Cancer

  • Yazilitas, Dogan;Sendur, Mehmet Ali Nahit;Karaca, Halit;Ozdemir, Nuriye;Aksoy, Sercan;Berk, Veli;Yazici, Ozan;Ozturk, Banu;Ozkan, Metin;Zengin, Nurullah;Altundag, Kadri
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1471-1477
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    • 2015
  • Background: Adding taxanes to adjuvant antracycline and cyclophosphamide (AC) in combination may provide significant improvement in node-positive and high risk node-negative breast cancer (BC) patients. However, the optimal dose and the role of dose-dense (DD) chemotherapy have yet to be determined. The aim of this study was to compare the efficacy of a DD paclitaxel (P)-AC combination with conventional weekly P-AC or docetaxel D-AC combinations in patients with node-positive breast cancer. Materials and Methods: Newly diagnosed 280 node-positive BC patients diagnosed from 1998 to 2013 in three clinics were retrospectively analyzed. Demographic and medical data were collected from the medical charts. Patients were categorized to 3 groups according to treatment arms: arm A, ddAC-P; arm B, weekly P and AC combination; and arm C; T and AC combination. Adjuvant trastuzumab was added for HER2-positive patients. Kaplan-Meier survival analysis was carried out for disease free survival (DFS) and overall survival (OS). The log-rank test was used to examine the statistical significance of the differences observed between the groups. Two-sided P values <0.05 were considered statistically significant. Results: Of the total of 280 patients, 101 were in arm A, 114 in arm B and 65 in arm C.The median ages were 49, 50 and 46, respectively (p=0.11). Median follow-up was 39 (3-193) months. Stage, lymphovascular and perineural invasion, receptor patern, and menopausal status were similar in the 3 treatment arms, but HER2 positivity was significantly lower in arm A, compared to arms B and C (25.7%, 53.1%, 41.5% in arms A, B and C, respectively; p<0.001). Also grade 3 tumors were significantly less frequent in treatment arm A compared to arm B and C (27.3%, 56.8% and 49.2%, respectively, p=0.01). Afterunivariate and multivariate analysis were performed, 3-year DFS rates were 89%, 81%, and 75%, respectively (p=0.12) and three year OS rates were 96.6%, 89%, and 75% (p=0.62). Conclusions: In this study, no significant difference was found between adjuvant dose dense and conventional taxane treatment regimens.

Genetic Variants of NBS1 Predict Clinical Outcome of Platinum-based Chemotherapy in Advanced Non-small Cell Lung Cancer in Chinese

  • Xu, Jia-Li;Hu, Ling-Min;Huang, Ming-De;Zhao, Wan;Yin, Yong-Mei;Hu, Zhi-Bin;Ma, Hong-Xia;Shen, Hong-Bing;Shu, Yong-Qian
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.851-856
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    • 2012
  • Objective: NBS1 plays a key role in the repair of DNA double-strand break (DSB). We conducted this study to investigate the effect of two critical polymorphisms (rs1805794 and rs13312840) in NBS1 on treatment response and prognosis of advanced non-small cell lung cancer (NSCLC) patients with platinum-based chemotherapy. Methods: Using TaqMan methods, we genotyped the two polymorphisms in 147 NSCLC patients. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated as a measure of difference in the response rate of platinum-based chemotherapy using logistic regression analysis. The Kaplan-Meier and log-rank tests were used to assess the differences in progression-free survival (PFS) and overall survival (OS). Cox proportional hazards model was applied to assess the hazard ratios (HRs) for PFS and OS. Results: Neither of the two polymorphisms was significantly associated with treatment response of platinum-based chemotherapy. However, patients carrying the rs1805794 CC variant genotype had a significantly improved PFS compared to those with GG genotype (16.0 vs. 8.0 months, P = 0.040). Multivariable cox regression analysis further showed that rs1805974 was a significantly favorable prognostic factor for PFS [CC/CG vs. GG: Adjusted HR = 0.62, 95% CI: 0.39-0.99; CC vs. CG/GG: Adjusted HR = 0.56, 95% CI: 0.32-0.97). Similarly, rs13312840 with a small sample size also showed a significant association with PFS (CC vs. CT/TT: Adjusted HR = 25.62, 95% CI: 1.53-428.39). Conclusions: Our findings suggest that NBS1 polymorphisms may be genetic biomarkers for NSCLC prognosis especially PFS with platinum-based chemotherapy in the Chinese population.

Variance Components and Genetic Parameters for Milk Production and Lactation Pattern in an Ethiopian Multibreed Dairy Cattle Population

  • Gebreyohannes, Gebregziabher;Koonawootrittriron, Skorn;Elzo, Mauricio A.;Suwanasopee, Thanathip
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.9
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    • pp.1237-1246
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    • 2013
  • The objective of this study was to estimate variance components and genetic parameters for lactation milk yield (LY), lactation length (LL), average milk yield per day (YD), initial milk yield (IY), peak milk yield (PY), days to peak (DP) and parameters (ln(a) and c) of the modified incomplete gamma function (MIG) in an Ethiopian multibreed dairy cattle population. The dataset was composed of 5,507 lactation records collected from 1,639 cows in three locations (Bako, Debre Zeit and Holetta) in Ethiopia from 1977 to 2010. Parameters for MIG were obtained from regression analysis of monthly test-day milk data on days in milk. The cows were purebred (Bos indicus) Boran (B) and Horro (H) and their crosses with different fractions of Friesian (F), Jersey (J) and Simmental (S). There were 23 breed groups (B, H, and their crossbreds with F, J, and S) in the population. Fixed and mixed models were used to analyse the data. The fixed model considered herd-year-season, parity and breed group as fixed effects, and residual as random. The single and two-traits mixed animal repeatability models, considered the fixed effects of herd-year-season and parity subclasses, breed as a function of cow H, F, J, and S breed fractions and general heterosis as a function of heterozygosity, and the random additive animal, permanent environment, and residual effects. For the analysis of LY, LL was added as a fixed covariate to all models. Variance components and genetic parameters were estimated using average information restricted maximum likelihood procedures. The results indicated that all traits were affected (p<0.001) by the considered fixed effects. High grade $B{\times}F$ cows (3/16B 13/16F) had the highest least squares means (LSM) for LY ($2,490{\pm}178.9kg$), IY ($10.5{\pm}0.8kg$), PY ($12.7{\pm}0.9kg$), YD ($7.6{\pm}0.55kg$) and LL ($361.4{\pm}31.2d$), while B cows had the lowest LSM values for these traits. The LSM of LY, IY, YD, and PY tended to increase from the first to the fifth parity. Single-trait analyses yielded low heritability ($0.03{\pm}0.03$ and $0.08{\pm}0.02$) and repeatability ($0.14{\pm}0.01$ to $0.24{\pm}0.02$) estimates for LL, DP and parameter c. Medium heritability ($0.21{\pm}0.03$ to $0.33{\pm}0.04$) and repeatability ($0.27{\pm}0.02$ to $0.53{\pm}0.01$) estimates were obtained for LY, IY, PY, YD and ln(a). Genetic correlations between LY, IY, PY, YD, ln(a), and LL ranged from 0.59 to 0.99. Spearman's rank correlations between sire estimated breeding values for LY, LL, IY, PY, YD, ln(a) and c were positive (0.67 to 0.99, p<0.001). These results suggested that selection for IY, PY, YD, or LY would genetically improve lactation milk yield in this Ethiopian dairy cattle population.

Social Determinants of Health and 5-year Survival of Colorectal Cancer

  • Heidarnia, Mohammad Ali;Monfared, Esmat Davoudi;Akbari, Mohammad Esmail;Yavari, Parvin;Amanpour, Farzaneh;Mohseni, Maryam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5111-5116
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    • 2013
  • Background: Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. Materials and Methods: This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. Results: Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean${\pm}$standard deviation of $63{\pm}11.8$ years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). Conclusions: Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.

Clinical Analysis of Atypical and Malignant Meningiomas : A study of 52 Cases (비정형성 및 악성 뇌수막종의 임상분석 : 52례 연구)

  • Park, Hong-Jun;Gwak, Ho-Shin;Hwang, Sung-Kyun;Kim, Jeong Eun;Lee, Sang Hyung;Jung, Hee-Won;Kim, Dong Gyu;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1103-1107
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    • 2001
  • Objective : Atypical and malignant meningiomas(AM, MM) are known to be rare and show aggressive behavior. Limited data are available concerning the clinical features, effectiveness of surgical removal and role of radiation therapy with AM, MM. The authors report our experience of AM, MM, with respect to clinical features. Methods : Twenty-four cases of AM and 28 cases of MM, who were operated between 1988 and 1999 were retro-spectively studied review of medical records and radiological findings. These were compared with control group of 24 cases of menigiomas manifestating usual clinical course, which are selected arbitrarily among operative cases between Apr. 1999 and Dec. 1999. Mean follow-up periods were 26(1-91) months for AM and 23(1-62) for MM. Authors analyzed the prognostic factors for survival, and statistical analysis were accomplished by Kaplan-Meier method and log-rank test. Results : Differences of clinical features between control groups and these atypical and malignant meningioma group were not significant. However, the location of MM was frequent in non-basal area(p<0.01). In AM, there were 4 patients of recurrence, and 3 patients of mortality. Among mortality cases, only one patient died of tumor progression, the other patients died of other causes. The survival at 2 year and 5 year in this group were 88% and 74% respectively, and in MM, 11 patients died due to tumor progression and 2 had spinal metastasis. The survival at 2 year and 5 year were 72% and 20%, respectively. For extent of resection, total removal(Simpson grade 1 or 2) was less often achieved in MM compared with AM(50% vs. 83%). Extent of resection of tumor and postoperative radiation therapy did not affect survival in both AM, MM. Conclusions : Clinical behavior of AM showed more benign than that of MM. Prognostic factor for survival is not related extent of resection of tumor and postoperative radiation therapy. However, further investigation with long-term follow-up and additional cases is mandatory.

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The Correlation between Activity Ability and Participation in Children with Cerebral Palsy (뇌성마비 아동의 활동 능력과 참여 사이의 상관관계)

  • Kim, Ji-Young;Kim, Hun-Ju;An, Sun-Jung;Kam, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.211-219
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    • 2012
  • This study was performed to search for correlation between activity limitation level and participation restriction of children with cerebral palsy by investigating the activity limitation level through the use of the GMFCS E&R and the MACS and by figuring out participation restriction level through questionnaire survey. This study was performed, from May 1, 2010 to August 31, 2010, on 152 children with cerebral palsy ranging from 4 to 12 years, who are receiving rehabilitation therapy in the hospitals and community clinics in Busan and Gyeongnam province. The levels of activity limitation were assessed by using GMFCS E&R and MACS, and a questionnaire survey was conducted for participation restriction of the participating children. Spearman rank correlation was used for correlation analysis with the statistical software, SPSS 12.0. Majority of the children scored level 5 in both GMFCS E&R and MACS which is high frequency of activity limitation levels. Children in these levels also showed severe or complete participation restriction for mobility, education, and social relations. The analysis showed a significantly positive correlation between activity limitation level and participation restriction. Therefore this study may be useful in assessing the functional movement component of participation in children with cerebral palsy and developing the intervention plan for participation.

Marine Environmental Assessment based on the Benthic Macroinfaunal Compositions in the Coastal Area of Inchon, Korea (인천연안역 저서동물의 종조성을 이용한 환경평가)

  • LEE Jae-Hac;KOH Byoung-Seol;PARK Heung-Sik
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.30 no.5
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    • pp.771-781
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    • 1997
  • In order to select an effective and appropriate evaluation method for the marine environmental protection and management, it is necessary to evaluate the present status of environmental conditions and to monitor and regulate the harzadous waste continuously. Among the evaluation methods that use benthic fauna, some graphical methods and biological index methods such as species abundance-biomass (SAB), Rank-frequency diagram (RFD), Abundance-Biomass comparison (ABC), log-normal distribution (LND), and Benthic Pollution Index (BPI) modified by Infaunal Trophic Index were used for the assessments of marine environment in the Inchon coastal area. Even though the graphic methods are convenient for easy glimpse of general trend of environmental condition but because they require sufficient ecological data, those methods do not fit for analysis or comparison of regional and detailed environmental condition. On the other hand, when BPI was applied, it was able to compare the spatial benthic conditions. Through considering the functional aspects of benthic fauna which can not be obtained in the cluster analysis, BPI was made it possible to measure or trace down the source of pollution. In the case of the environmental assessment result analyzed in Inchon coastal area, the north eastern part of Yongjongdo was more influenced by the pollution than the outer area of Inchon. The research indicates that especially Inchon harbor has been greatly affected.

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A Study on Technology Priorities for Green Highway (녹색도로 구현을 위한 기술 우선순위 결정에 관한 연구)

  • Lee, Yu-Hwa;Cho, Won-Bum;Kim, Se-Hwan
    • International Journal of Highway Engineering
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    • v.14 no.3
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    • pp.151-162
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    • 2012
  • It is not surprising to hear news about irresistible natural disasters all over the world due to climate change. Korean Government has focused on developing a variety of green technologies to reduce green house gasses, in particular, carbon dioxide. This study suggested 18 technology divisions for achieving green highway technology development in six different sub-sectors considering life-cycle of roadway and surveyed 29 highway and/or transportation professionals of three institutes using AHP(Analytical Hierarchy Process) analysis to construct "Green Highway"and realize carbon emission reductions and energy use efficiency in a road sector in Korea. Expert Choice Software was used to rank 18 technology divisions weighted by two-level choices. Transport Operating Infrastructure Improvement, Roadway Policy Implementation, Green Transportation(such as Pedestrian and Bicycle) were highly ranked by respondents according to results of the AHP modeling. Among the 18 divisions, technology policy for supporting R&D investments from development to commercialization was ranked as the most significant one to be focused. Green Transportation Facility Design/Construction/Operation and Eco-Friendly Roadway Plan were followed as expected since professionals have thought that the planning/design step of the life-cycle is a starting point to reduce carbon dioxide from roads more and more. Additionally, comparing the results with the Government investment trend 2006-2011 for the roads, it can be interpreted that the Government should invest to the R&D area more widely than before to promote element and core technology development for Green Highway Construction. Above all, small and mid-sized businesses have to be invested as well as encouraged to undertake green highwayrelated objects to accomplish the divisions which ranked high.