kshivets o. gastric cancer surgery
DESCRIPTION
Gastric Cancer SurgeryTRANSCRIPT
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 KshivetsEP144
2012 WCC-1864
5-YEAR SURVIVAL OF GASTRIC CANCER PATIENTS AFTER COMPLETE GASTRECTOMIES SIGNIFICANTLY DEPENDED ON PHASE TRANSITION “EARLY-INVASIVE CANCER”, LYMPH NODE METASTASES AND CELL RATIO FACTORSOleg Kshivets
Poster number EP144
Track 2012WCC-1864
Disclosure of Interest: Declared
Cumulative Proportion Surviving (Kaplan-Meier)Complete Censored
P=0.000 by Log-Rank Test
Years after Gastrectomies
Cum
ulat
ive
Pro
port
ion
Sur
vivi
ng
0 5 10 15 20 25 30 35 400.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0GCP with N1-2, n=309 GCP with N0, n=303
Cumulative Proportion Surviving (Kaplan-Meier)Complete Censored
P=0.000 by Log-Rank Test
Years after Gastrectomies
Cum
ulat
ive
Pro
port
ion
Sur
vivi
ng
0 5 10 15 20 25 30 35 400.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Invasive GCP, n=515 Early GCP, n=97
Cox Regression: Variables in the EquationChi2=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
OBJECTIVE: We examined prognostic factors of gastric cancer (GC) patients (GCP) (T1-4N0-2M0) after complete (R0) gastrectomies (GE).
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 numberEP144
Track2012WCC-1864
Disclosure of Interest: Declared
5-YEAR SURVIVAL OF GASTRIC CANCER PATIENTS AFTER COMPLETE GASTRECTOMIES SIGNIFICANTLY DEPENDED ON PHASE TRANSITION “EARLY-INVASIVE CANCER”, LYMPH NODE METASTASES AND CELL RATIO FACTORSOleg KshivetsRESULTS: 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.