Gastric Cancer Surgery

1. 5-YEAR SURVIVAL
OF GASTRIC
CANCER PATIENTS
AFTER COMPLETE
GASTRECTOMIES
SIGNIFICANTLY
DEPENDED ON PHASE
TRANSITION “EARLY-
INVASIVE CANCER”,
LYMPH NODE
METASTASES AND CELL
RATIO FACTORS
Oleg Kshivets
EP144
2012 WCC-1864

2. 5-YEAR SURVIVAL OF GASTRIC CANCER
PATIENTS AFTER COMPLETE
GASTRECTOMIES SIGNIFICANTLY
DEPENDED ON PHASE TRANSITION
“EARLY-INVASIVE CANCER”, LYMPH NODE
METASTASES AND CELL RATIO FACTORS
Oleg Kshivets
OBJECTIVE: 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 Gastrectomies
METHODS: In trial (1975-2011) the data of consecutive 612 GCP after
radical surgery (age=56.6±9.4 years; m=422, f=190; tumor
diameter=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, Monte
Carlo, bootstrap, neural network simulation were used to determine any
significant regularity.
Poster number Track Disclosure of Interest:
EP144 2012WCC-1864 Declared

3. 5-YEAR SURVIVAL OF GASTRIC CANCER
PATIENTS AFTER COMPLETE
GASTRECTOMIES SIGNIFICANTLY
DEPENDED ON PHASE TRANSITION
“EARLY-INVASIVE CANCER”, LYMPH NODE
METASTASES AND CELL RATIO FACTORS
Oleg Kshivets
RESULTS: Overall life span (LS) was 2015.5±2208.5 days and
cumulative 5-year survival (5YS) reached 50.9%, 10 years – 44.2%, 20
years – 32.6%. 222 GCP lived more than 5 years without GC. 271 GCP
died because of GC. Cox modeling displayed that 5YS significantly
depended on: phase transition (PT) early-invasive GC in terms of
synergetics, PT N0-N12, cell ratio factors (CRF) (ratio between cancer
cells – CC and blood cells subpopulations) (P=0.000-0.047). Neural
networks, genetic algorithm selection and bootstrap simulation revealed
relationships 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 5YS
was 100% by neural networks computing.
CONCLUSIONS: 5-year survival of gastric cancer patients after radical
gastrectomies 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