P-0098 - Precise Prediction of 5-Year Survival of Gastric Cancer Patients After Gastrectomies

Abstract

Background: We examined factors in terms of precise prediction of 5-year survival (5YS) of gastric cancer (GC) patients (GCP) (T1-4N0-2M0) after complete (R0) gastrectomies (GE).Methods: We analyzed data of 618 consecutive GCP (age = 56.6 ± 9.5 years; tumor size = 5.7 ± 3.0 cm) radically operated and monitored in 1975-2012 (m = 424, f = 194; distal GE = 367, proximal GE = 133, total GE = 118, combined GE with resection of pancreas, liver, diaphragm, colon, splenectomy, etc = 212; only surgery-S = 510, adjuvant chemoimmunotherapy-AT = 108: 5FU + thymalin/taktivin; early GC = 97, invasive GC = 521; T1 = 168, T2 = 186, T3 = 128, T4 = 135; N0 = 307, N1 = 86, N2 = 225, M0 = 618; G1 = 176, G2 = 107, G3 = 335. 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 2052.2 ± 2288.8 days and cumulative 5YS reached 51.2%, 10 years – 44.6%, 20 years – 33.4%. 225 GCP lived more than 5 years without cancer. 272 GCP died because of GC. Cox modeling displayed (Chi2 = 288.54, df = 18, P = 0.000) that 5YS of GCP significantly depended on: phase transition (PT) early GC—invasive GC, PT N0—N12 in terms of synergetics, T, tumor growth, age, weight, procedure type, blood cells, prothrombin index, ESS, blood chlorides, residual nitrogen, bilirubin, hemorrhage time (P = 0.000-0.025). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive GC (rank = 1), PT N0—N12 (rank = 2), G, gender, hemorrhage time, T, blood cells, prothrombin index, blood chlorides, residual nitrogen, protein, tumor size, weight, cell ratio factors (CRF) (ratio between cancer cells and blood cells subpopulations), ESS, adjuvant Chemoimmunotherapy, Hb, bilirubin, age, glucose. Correct prediction of 5YS was 100% by neural networks computing.Conclusion: 5YS of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0—N12; 3) CRF; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) anthropometric data; 8) adjuvant chemoimmunotherapy. Background: We examined factors in terms of precise prediction of 5-year survival (5YS) of gastric cancer (GC) patients (GCP) (T1-4N0-2M0) after complete (R0) gastrectomies (GE). Methods: We analyzed data of 618 consecutive GCP (age = 56.6 ± 9.5 years; tumor size = 5.7 ± 3.0 cm) radically operated and monitored in 1975-2012 (m = 424, f = 194; distal GE = 367, proximal GE = 133, total GE = 118, combined GE with resection of pancreas, liver, diaphragm, colon, splenectomy, etc = 212; only surgery-S = 510, adjuvant chemoimmunotherapy-AT = 108: 5FU + thymalin/taktivin; early GC = 97, invasive GC = 521; T1 = 168, T2 = 186, T3 = 128, T4 = 135; N0 = 307, N1 = 86, N2 = 225, M0 = 618; G1 = 176, G2 = 107, G3 = 335. 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 2052.2 ± 2288.8 days and cumulative 5YS reached 51.2%, 10 years – 44.6%, 20 years – 33.4%. 225 GCP lived more than 5 years without cancer. 272 GCP died because of GC. Cox modeling displayed (Chi2 = 288.54, df = 18, P = 0.000) that 5YS of GCP significantly depended on: phase transition (PT) early GC—invasive GC, PT N0—N12 in terms of synergetics, T, tumor growth, age, weight, procedure type, blood cells, prothrombin index, ESS, blood chlorides, residual nitrogen, bilirubin, hemorrhage time (P = 0.000-0.025). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive GC (rank = 1), PT N0—N12 (rank = 2), G, gender, hemorrhage time, T, blood cells, prothrombin index, blood chlorides, residual nitrogen, protein, tumor size, weight, cell ratio factors (CRF) (ratio between cancer cells and blood cells subpopulations), ESS, adjuvant Chemoimmunotherapy, Hb, bilirubin, age, glucose. Correct prediction of 5YS was 100% by neural networks computing. Conclusion: 5YS of GCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0—N12; 3) CRF; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) anthropometric data; 8) adjuvant chemoimmunotherapy.