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O. Kshivets
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-003 - Survival of Lung Cancer Patients was Depended on Tumor Characteristics, Blood Cell Circuit, Cell Ratio Factors, Hemostasis System (ID 3715)
14:30 - 14:30 | Author(s): O. Kshivets
- Abstract
Background:
This study aimed to determine homeostasis and tumor factors for 5-year survival (5YS) of non-small cell lung cancer (LC) patients (LCP) (T1-4N0-2M0) after complete en block (R0) lobectomies/pneumonectomies (LP).
Methods:
We analyzed data of 676 consecutive LCP (age=57.5±8.3 years; tumor size=4.4±2.4 cm) radically operated and monitored in 1985-2016 (m=585, f=91; lobectomies=431, pneumonectomies=245, mediastinal lymph node dissection=676; combined LP with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=188; only surgery-S=532, adjuvant chemoimmunoradiotherapy-AT=144: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T1=239, T2=249, T3=131, T4=57; N0=428, N1=130, N2=118, M0=676; G1=168, G2=202, G3=306; squamous=381, adenocarcinoma=249, large cell=46; early LC=134, invasive LC=542. Multivariate Cox modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence.
Results:
Overall life span (LS) was 2109.1±1692.4 days (median=1936 days) and cumulative 5-year survival (5YS) reached 69.7%, 10 years – 61.4%, 20 years – 42.9%. 419 LCP lived more than 5 years without cancer, 111 – 10 years, 14 – 20 years. 195 LCP died because of LC (LS=560±372.1 days). AT significantly improved 5YS (64.4% vs. 34.1%) (P=0.00002 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0-N12, histology, G, blood cell circuit, cell ratio factors (ratio between blood cells subpopulations and cancer cells-CC), prothrombin index, heparin tolerance, recalcification time, glucose, AT (P=0.000-0.041). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT N0-N12 (rank=1), PT early-invasive LC (rank=2), eosinophils/CC (3), prothrombin index (4), thrombocytes/CC (5), glucose (6), lymphocytes/CC (7), erythrocytes/CC (8), healthy cells/CC (9), segmented neutrophils/CC (10), stick neutrophils/CC (11), monocytes/CC (12), leucocytes/CC (13). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Conclusion:
5YS of LCP after radical procedures significantly depended on: tumor characteristics, blood cell circuit, cell ratio factors, hemostasis system and AT.
