Kshivets O. Lung Cancer Surgery: Synergetics and Prediction

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SIGNIFICANT IMPACT OF PHASE TRANSITIONS AND CELL RATIO FACTORS FOR 5-YEAR SURVIVAL OF NON SMALLCELL LUNG CANCER PATIENTS AFTER SURGERY

Santé & Médecine

Abstract: N181 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Data : ,[object Object],[object Object],[object Object],[object Object]

Radical Procedures: ,[object Object],[object Object],[object Object]

Combined & E xtensive R adical P rocedures with R esection of P ericardium, A trium, A orta, V ena C ava S uperior, V ena A zygos, C arina, Trachea, D iaphragm, C hest W all , Ribs, etc.……………………. 130 Sistematic Mediastinal Lymph Node-N2 Dissection………….. 490

Staging: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Survival Rate of Lung Cancer Patients after Lobectomies and Pneumonectomies (R0) (n=490): ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Product-Limit (Kaplan-Maier) Analysis Results in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n= 490 ) :

Survival of Early LCP was Significantly Better Compared to Invasive LCP:

Survival of LCP with N0 was Significantly Better Compared to LCP with N1-2:

Results of Multivariate Proportional Hazard Cox Regression Modeling in Prediction of LCP Survival after Lobectomies and Pneumonectomies (n=490) : Global  2=131.51; Df=7; P=0.000

Results of Discriminant Function Analysis in Prediction of LCP survival after lobectomies and pneumonectomies (n=490) : Wilks' Lambda=0.785; approx. F (4,485)=33.159 P=0.000 Correct Classification Rate=72% Wilks' - Lambda Partial - Lambda F-remove - (1,485) P Toler. 1-Toler. - (R-Sqr.) Phase Transition “Early LC---Invasive LC” 0.800861 0.980512 9.63957 0.002 0.905212 0.094787 Eosinophils/Cancer Cells 0.797277 0.984920 7.42555 0.007 0.837585 0.162415 Lymphocytes/Cancer Cells 0.792552 0.990791 4.50772 0.034 0.822803 0.177197 Phase Transition “N0---N12” 0.879453 0.892889 58.18034 0.000 0.947110 0.052890

Results of Multifactor Clustering of Cell RatioFactors in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n=490): Correct Classification Rate=81%

Neural Networks in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n=490): ,[object Object],[object Object],[object Object],[object Object]

Results of Neural Networks Computing in Prediction of 5-Year Survival of LCP after Lobectomies and Pneumonectomies (n=490):

Results of Bootstrap simulation in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n=4 90 ) :

Results of Kohonen Self-Organizing Neural Networks Computing in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n=490):

Holling-Tenner Models of Alive Supersystem “Lung Cancer-Cytotoxic Cell Population ”

SEPATH Networks in Prediction of Lung Cancer Patients Survival after Lobectomies and Pneumonectomies (n=490):

Conclusions: ,[object Object],[object Object],[object Object],[object Object],[object Object]

Address: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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OBJECTIVE: 5-survival (5YS) and life span after radical surgery for non-small cell lung cancer (LC) pa¬tients (LCP) (T1-4N0-2M0) was analyzed. METHODS: We analyzed data of 771 consecutive LCP (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated and monitored in 1985-2022 (m=662, f=109; upper lobectomies=278, lower lobectomies=178, middle lobectomies=18, bilobectomies=42, pneumonectomies=255, mediastinal lymph node dissection=771; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=194; only surgery-S=620, adjuvant chemoimmunoradiotherapy-AT=151: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=322, T2=255, T3=133, T4=61; N0=518, N1=131, N2=122, M0=771; G1=195, G2=243, G3=333; squamous=418, adenocarcinoma=303, large cell=50; early LC=215, invasive LC=556; right LC=413, left LC=358; central=291; peripheral=480. Variables selected for study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Regression modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine significant dependence. RESULTS: Overall life span (LS) was 2240.9±1748.8 days and cumulative 5-year survival (5YS) reached 73%, 10 years – 64.2%, 20 years – 43%. 503 LCP lived more than 5 years (LS=3126.6±1536 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (77.7% vs.63.4%, P=0.00001 by log-rank test). AT significantly improved 5YS (64.4% vs. 34.8%) (P=0.00003 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.035). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), eosinophils/CC (4), erythrocytes/CC (5),healthy cells/CC (6), segmented neutrophils/CC (7), lymphocytes/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: PT early-invasive cancer; PT N0--N12; cell ratio factors; blood cell circuit; biochemical factors; hemostasis system; AT; LC characteristics; surgery type; anthropometric data.

Kshivets_ELCC2023.pdf

Oleg Kshivets

OBJECTIVE: 5-survival (5YS) and life span after radical surgery for non-small cell lung cancer (LC) pa¬tients (LCP) (T1-4N0-2M0) was analyzed. METHODS: We analyzed data of 771 consecutive LCP (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated and monitored in 1985-2022 (m=662, f=109; upper lobectomies=278, lower lobectomies=178, middle lobectomies=18, bilobectomies=42, pneumonectomies=255, mediastinal lymph node dissection=771; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=194; only surgery-S=620, adjuvant chemoimmunoradiotherapy-AT=151: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=322, T2=255, T3=133, T4=61; N0=518, N1=131, N2=122, M0=771; G1=195, G2=243, G3=333; squamous=418, adenocarcinoma=303, large cell=50; early LC=215, invasive LC=556; right LC=413, left LC=358; central=291; peripheral=480. Variables selected for study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Regression modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine significant dependence. RESULTS: Overall life span (LS) was 2240.9±1748.8 days and cumulative 5-year survival (5YS) reached 73%, 10 years – 64.2%, 20 years – 43%. 503 LCP lived more than 5 years (LS=3126.6±1536 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (77.7% vs.63.4%, P=0.00001 by log-rank test). AT significantly improved 5YS (64.4% vs. 34.8%) (P=0.00003 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.035). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), eosinophils/CC (4), erythrocytes/CC (5),healthy cells/CC (6), segmented neutrophils/CC (7), lymphocytes/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data.

Kshivets_ELCC2023.pdf

Oleg Kshivets

OBJECTIVE: 5-survival (5YS) and life span after radical surgery for non-small cell lung cancer (LC) pa¬tients (LCP) (T1-4N0-2M0) was analyzed. METHODS: We analyzed data of 771 consecutive LCP (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated and monitored in 1985-2022 (m=662, f=109; upper lobectomies=278, lower lobectomies=178, middle lobectomies=18, bilobectomies=42, pneumonectomies=255, mediastinal lymph node dissection=771; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=194; only surgery-S=620, adjuvant chemoimmunoradiotherapy-AT=151: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=322, T2=255, T3=133, T4=61; N0=518, N1=131, N2=122, M0=771; G1=195, G2=243, G3=333; squamous=418, adenocarcinoma=303, large cell=50; early LC=215, invasive LC=556; right LC=413, left LC=358; central=291; peripheral=480. Variables selected for study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Regression modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine significant dependence. RESULTS: Overall life span (LS) was 2240.9±1748.8 days and cumulative 5-year survival (5YS) reached 73%, 10 years – 64.2%, 20 years – 43%. 503 LCP lived more than 5 years (LS=3126.6±1536 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (77.7% vs.63.4%, P=0.00001 by log-rank test). AT significantly improved 5YS (64.4% vs. 34.8%) (P=0.00003 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.035). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), eosinophils/CC (4), erythrocytes/CC (5),healthy cells/CC (6), segmented neutrophils/CC (7), lymphocytes/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data.

Lung Cancer: Precise Prediction

Oleg Kshivets

OBJECTIVE: We examined factors significantly affecting lung cancer (LC) cell dynamics. METHODS: We analyzed data of 768 consecutive non-small cell LC patients (LCP) (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated and monitored in 1985-2022 (m=660, f=108; upper lobectomies=277, lower lobectomies=177, middle lobectomies=18, bilobectomies=42, pneumonectomies=254, mediastinal lymph node dissection=768; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=193; only surgery-S=618, adjuvant chemoimmunoradiotherapy-AT=150: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=320, T2=255, T3=133, T4=60; N0=516, N1=131, N2=121, M0=768; G1=194, G2=243, G3=331; squamous=417, adenocarcinoma=301, large cell=50; early LC=214, invasive LC=554; right LC=412, left LC=356; central=290; peripheral=478. Variables selected for study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Regression modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine significant dependence. RESULTS: Overall life span (LS) was 2244.9±1750.3 days and cumulative 5-year survival (5YS) reached 72.9%, 10 years – 64.3%, 20 years – 43.1%. 502 LCP lived more than 5 years (LS=3128.7±1536.8 days), 145 LCP – more than 10 years (LS=5068.5±1513.2 days).199 LCP died because of LC (LS=562.7±374.5 days). Regression modeling displayed LC cell dynamics significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, histology, T, G, LC growth, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), ESS, glucose, bilirubin (P=0.000-0.033). Neural networks simulation revealed relationships between LC cell dynamics and segmented neutrophils (rank=1), lymphocytes (2), PT N0—N12 (3), PT early-invasive LC (4), leucocytes (5), stick neutrophils (6), eosinophils (7), erythrocytes (8), monocytes (9), thrombocytes (10), Hb (11), ESS (12). Prediction was 92-95% by neural networks computing. CONCLUSIONS: Lung cancer cell dynamics significantly depended on blood cell circuit, biochemical factors, hemostasis system, cancer characteristics, anthropometric data.

Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...

Oleg Kshivets

OBJECTIVE: We examined cell ratio factors (CRF) significantly affecting gastric cancer (EC) patients GCP) survival. CRF - ratio between cancer cells (CC) and blood cells subpopulations. METHODS: We analyzed data of 799 consecutive GCP (T1-4N0-2M0) (age=57.1±9.4 years; tumor size=5.4±3.1 cm) radically operated (R0) and monitored in 1975-2022 (m=558, f=241; total gastrectomies=173, distal gastrectomies=461; proximal gastrectomies=165; combined gastrectomies=247 with resection of esophagus, pancreas, liver, duodenum, diaphragm, colon transversum, splenectomy, etc; only surgery-S=624, adjuvant chemoimmunotherapy-AT=175 (5-FU + thymalin/taktivin); T1=238, T2=220, T3=184, T4=157; N0=437, N1=109, N2=253, M0=799; G1=222, G2=164, G3=413. Variables selected for prognosis study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Survival curves were estimated by the Kaplan-Meier method. Differences in curves between groups of GCP were evaluated using a log-rank test. Multivariate Cox modeling, discriminant analysis, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence. RESULTS: Overall life span (LS) was 2128.9±2300.3 days and cumulative 5-year survival (5YS) reached 58.4%, 10 years – 51.9%, 20 years – 39%, 30 years – 27.2%. 318 GCP lived more than 5 years (LS=4304.5±2290.6 days), 169 GCP – more than 10 years (LS=5919.5±2020 days). 290 GCP died because of GC (LS=651±347.2 days). Cox modeling displayed that G CP survival significantly depended on CRF: healthy cells/CC, erythrocytes/CC, monocytes/CC, phase transition (PT) in terms of synergetics early—invasive cancer; PT N0--N12, age, G1-3, hemorrhage time, ESS, sex, AT, prothrombin index, residual nitrogen. Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early—invasive cancer (rank=1); PT N0--N12 (2); healthy cells/CC (3), erythrocytes/CC (4), thrombocytes/CC (5), monocytes/CC (6), segmented neutrophils/CC (7), leucocytes/CC (8), lymphocytes/CC (9), stick neutrophils/CC (10), eosinophils/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: GCP survival after radical procedures significantly depended on CRF.

• Gastric cancer prognosis and cell ratio factors

Oleg Kshivets

It was revealed that separation of LCP with early LC (n=215) from invasive LCP (n=555) significantly depended on: Hb, leucocytes (abs, total), thrombocytes (abs, tot), erythrocytes (abs, tot), segmented neutrophils (%, abs, total), stick neutrophils (%, abs, total), lymphocytes (%), monocytes (abs, tot), ESS, coagulation time, fibrinogen, cell ratio factors (CRF) (ratio between cancer cells- CC and blood cells subpopulations), tumor size, age, tumor growth, T1-4, G1-3, PT N0---N12 (P=0.046-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of PT early—invasive cancer and CRF: healthy cells/CC (rank=1), erythrocytes/CC (2), stick neutrophils/CC (3), thrombocytes/CC (4), eosinophils/CC (5), segmented neutrophils/CC (6), lymphocytes/CC (7), monocytes/CC (8), leucocytes/CC (9). Correct classification PT early—invasive cancer was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSION: Blood cell circuit significantly influenced the phase transition early—invasive lung cancer.

Kshivets elcc2022

Oleg Kshivets

10-Year survival of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) GC characteristics; 9) anthropometric data; 10) surgery type. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection of GC; 2) availability of experienced abdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunotherapy for GCP with unfavorable prognosis.

Kshivets gc 10_ys_wjarr-2021-0659

Oleg Kshivets

10-Year survival after radical procedures significantly depended on: 1) PT “early-invasive cancer”; 2) PT N0--N12; 3) Cell Ratio Factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) EC characteristics; 9) tumor localization; 10) anthropometric data; 11) surgery type. Optimal diagnosis and treatment strategies for EC are: 1) screening and early detection of EC; 2) availability of experienced thoracoabdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for ECP with unfavorable prognosis.

Kshivets eso10 y2021

Oleg Kshivets

CONCLUSIONS: 10-Year survival after radical procedures significantly depended on: 1) PT “early-invasive cancer”; 2) PT N0--N12; 3) Cell Ratio Factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) EC characteristics; 9) tumor localization; 10) anthropometric data; 11) surgery type. Optimal diagnosis and treatment strategies for EC are: 1) screening and early detection of EC; 2) availability of experienced thoracoabdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for ECP with unfavorable prognosis.

Kshivets ny2021aats

Oleg Kshivets

Gastric Cancer: 10-Year Survival Kshivets Oleg Surgery Department, Roshal Hospital, Moscow, Russia CONCLUSIONS: 10-Year survival of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) GC characteristics; 9) anthropometric data; 10) surgery type. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection of GC; 2) availability of experienced abdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunotherapy for GCP with unfavorable prognosis.

2021 esmo world_gi_poster_kshivets

Oleg Kshivets

Lymph Node Metastases of Lung Cancer and Blood Cell Circuit Kshivets Oleg Surgery Department, Roshal Hospital, Moscow, Russia OBJECTIVE: Significance of blood cell circuit in terms of detection of non-small cell lung cancer (LC) patients (LCP) with lymph node metastases was investigated. METHODS: We analyzed data of 757 consecutive LCP (age=57.6±8.2 years; tumor size=4.1±2.4 cm) radically operated (R0) and monitored in 1985-2020 (m=654, f=103; upper lobectomies=272, lower lobectomies=176, middle lobectomies=18, bilobectomies=42, pneumonectomies=249, mediastinal lymph node dissection=757; combined procedures with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=192; T1=317, T2=251, T3=132, T4=57; N0=509, N1=130, N2=118, M0=757; G1=194, G2=238, G3=325; squamous=415, adenocarcinoma=292, large cell=50. Variables selected for study were input levels of blood cell circuit, sex, age, TNMG. Differences between groups were evaluated using discriminant analysis, clustering, nonlinear estimation, structural equation modeling, Monte Carlo, bootstrap simulation and neural networks computing. RESULTS: It was revealed that separation of LCP with lymph node metastases (n=248) from LCP without metastases (n=509) significantly depended on: leucocytes (abs, total), segmented neutrophils (%, abs, total), lymphocytes (%), ESS, Rh, coagulation time, prothrombin index, fibrinogen, heparin tolerance, cell ratio factors (CRF) (ratio between cancer cells- CC and blood cells subpopulations), T, G, tumor size (P=0.047-0.000). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships of lymph node metastases and CRF: healthy cells/CC (rank=1), segmented neutrophils/CC (2), leucocytes/CC (3), erythrocytes/CC (4), lymphocytes/CC (5), thrombocytes/CC (6), eosinophils/CC (7), monocytes/CC (8), stick neutrophils/CC (9). Correct classification N0—N12 was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSION: Lymph node metastases significantly depended on blood cell circuit.

Kshivets iaslc singapore2020

Oleg Kshivets

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