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Kshivets O. Gastric Cancer Surgery

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Gastric Cancer Surgery

Publié dans : Santé & Médecine

Kshivets O. Gastric Cancer Surgery

  1. 1. 5-YEAR SURVIVALOF GASTRICCANCER PATIENTSAFTER COMPLETEGASTRECTOMIESSIGNIFICANTLYDEPENDED ON PHASETRANSITION “EARLY-INVASIVE CANCER”,LYMPH NODEMETASTASES AND CELLRATIO FACTORS Oleg Kshivets EP144 2012 WCC-1864
  2. 2. 5-YEAR SURVIVAL OF GASTRIC CANCERPATIENTS AFTER COMPLETEGASTRECTOMIES SIGNIFICANTLYDEPENDED ON PHASE TRANSITION“EARLY-INVASIVE CANCER”, LYMPH NODEMETASTASES AND CELL RATIO FACTORSOleg KshivetsOBJECTIVE: We examined prognostic factors of gastric cancer (GC)patients (GCP) (T1-4N0-2M0) after complete (R0) gastrectomies (GE). Cox Regression: Variables in the Equation Chi2=74.35; df=5; P=0.00000; B SE Wald df Sig. Exp(B) PT E-I Cancer -,340 ,169 4,047 1 ,044 ,712 PT N0-N12 -,272 ,046 35,091 1 ,000 ,762 Monocytes/CC ,384 ,193 3,947 1 ,047 1,468 Lymphocytes/CC -,098 ,046 4,527 1 ,033 ,906 Erythrocytes/CC ,013 ,021 ,385 1 ,535 1,013 Cumulative Proportion Surviving (Kaplan-Meier) Cumulative Proportion Surviving (Kaplan-Meier) Complete Censored Complete Censored P=0.000 by Log-Rank Test P=0.000 by Log-Rank Test 1.0 1.0 0.9 0.9 GCP with N1-2, n=309 GCP with N0, n=303 Cumulative Proportion Surviving Cumulative Proportion Surviving 0.8 0.8 0.7 0.7 0.6 0.6 0.5 0.5 Invasive GCP, n=515 0.4 Early GCP, n=97 0.4 0.3 0.3 0.2 0.2 0.1 0.1 0.0 0.0 0 5 10 15 20 25 30 35 40 0 5 10 15 20 25 30 35 40 Years after Gastrectomies Years after GastrectomiesMETHODS: In trial (1975-2011) the data of consecutive 612 GCP afterradical surgery (age=56.6±9.4 years; m=422, f=190; tumordiameter=5.7±3.0 cm; distal GE=364, proximal=132, total=116, D2-lymphadenectomy=381, D3-4=231; combined procedures=209; T1=168,T2=182, T3=127, T4=135; N0=303, N1=84, N2=225; G1=175, G2=104,G3=333) was reviewed. Cox regression, clustering, SEPATH, MonteCarlo, bootstrap, neural network simulation were used to determine anysignificant regularity. Poster number Track Disclosure of Interest: EP144 2012WCC-1864 Declared
  3. 3. 5-YEAR SURVIVAL OF GASTRIC CANCERPATIENTS AFTER COMPLETEGASTRECTOMIES SIGNIFICANTLYDEPENDED ON PHASE TRANSITION“EARLY-INVASIVE CANCER”, LYMPH NODEMETASTASES AND CELL RATIO FACTORSOleg KshivetsRESULTS: Overall life span (LS) was 2015.5±2208.5 days andcumulative 5-year survival (5YS) reached 50.9%, 10 years – 44.2%, 20years – 32.6%. 222 GCP lived more than 5 years without GC. 271 GCPdied because of GC. Cox modeling displayed that 5YS significantlydepended on: phase transition (PT) early-invasive GC in terms ofsynergetics, PT N0-N12, cell ratio factors (CRF) (ratio between cancercells – CC and blood cells subpopulations) (P=0.000-0.047). Neuralnetworks, genetic algorithm selection and bootstrap simulation revealedrelationships between 5YS and PT early-invasive GC (rank=1), PT N0-N12 (rank=2), healthy cells/CC, erythrocytes/CC, lymphocytes/CC,monocytes/CC, leucocytes/CC, stab neutrophils/CC, eosinophils/CC,segmented neutrophils/CC, thrombocytes/CC. Correct prediction of 5YSwas 100% by neural networks computing. CONCLUSIONS: 5-year survival of gastric cancer patients after radicalgastrectomies significantly depended on:1)Phase transition “early-invasive cancer”;2)Phase transition N0-N12;3)Cell Ratio Factors. Poster number Track Disclosure of Interest: EP144 2012WCC-1864 Declared

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