SlideShare a Scribd company logo

Kshivets barcelona2019

Gastric Cancer: System Approach

1 of 1
Download to read offline
21WCGIC
Poster
presented at:
Gastric Cancer: System Approach
Kshivets Oleg Surgery Department, Roshal Hospital, Roshal, Moscow, Russia
OBJECTIVE: Search of optimal diagnosis and treatment strategies for gastric cancer
(GC) patients (GCP) (T1-4N0-2M0) realized.
METHODS: We analyzed data of 788 consecutive GCP (age=57±9.4 years; tumor
size=5.4±3.1 cm) radically operated (R0) and monitored in 1975-2019 (m=550, f=238; distal
gastrectomies=460, proximal gastrectomies=163, total gastrectomies=165, combined
gastrectomies with resection of pancreas, liver, diaphragm, colon transversum, esophagus,
duodenum, splenectomy, small intestine, kidney, adrenal gland=241; D2-
lymphadenectomy=513, D3-4=275; T1=235, T2=219, T3=179, T4=155; N0=432, N1=108,
N2=248; G1=222, G2=161, G3=405; early GC=162, invasive=626; only surgery=620,
adjuvant chemoimmunotherapy-AT=168 (5-FU + thymalin/taktivin). 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 2136.6±2311.4 days and cumulative 5-year
survival (5YS) reached 58.4%, 10 years – 52.3%, 20 years – 40.3%. 314 GCP lived more
than 5 years (LS=4323.2±2297.4 days), 171 GCP – more than 10 years
(LS=5855.4±2083.6 days). 286 GCP died because of GC (LS=650.7±345.1 days). AT
significantly improved 5YS (69% vs. 56.4%) (P=0.0176 by log-rank test). Cox modeling
displayed that 5YS of GCP significantly depended on: phase transition (PT) early—invasive
GC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC
and blood cells subpopulations), G, AT, procedure type, blood cell circuit, prothrombin
index, hemorrhage time, residual nitrogen, ESS, gender (P=0.000-0.046). 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 (3);
erythrocytes/CC (4), thrombocytes/CC (5), glucose (6), prothrombin index (7);
monocytes/CC (8), lymphocytes/CC (9), eosinophils/CC (10), stick neutrophils/CC (11),
segmented neutrophils/CC (12), leucocytes/CC (13). Correct prediction of 5YS was 100%
by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: Survival outcomes 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) procedure type;
10) anthropometric data. Optimal diagnosis and treatment strategies for GC are: 1)
screening and early detection; 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.
P-143
Cox Proportional Hazards Results, n=788
Parameter
Estimate
Standard
Error
Chi-
square
P value
95%
Lower CL
95%
Upper CL
Hazard
Ratio
ESS -0.012758 0.005051 6.38089 0.011536 -0.02266 -0.002859 0.987323
Hemorrhage Time 0.001282 0.000382 11.27865 0.000784 0.00053 0.002031 1.001283
Residual Nitrogen 0.046850 0.009246 25.67652 0.000000 0.02873 0.064972 1.047965
Prothrombin Index 0.020024 0.005074 15.57157 0.000079 0.01008 0.029969 1.020225
Phase Transition N0—N12 0.843907 0.129833 42.24932 0.000000 0.58944 1.098374 2.325434
Gender 0.329383 0.125060 6.93693 0.008443 0.08427 0.574495 1.390110
Operation Type 0.149964 0.075202 3.97667 0.046135 0.00257 0.297358 1.161793
Adjuvant Chemoimmunotherapy -0.619714 0.183454 11.41118 0.000730 -0.97928 -0.260152 0.538098
Phase Transition Early GC—Invasive GC 0.747383 0.298512 6.26851 0.012290 0.16231 1.332455 2.111467
Segmented Neutrophils (tot) 0.844260 0.355982 5.62466 0.017710 0.14655 1.541971 2.326255
Lymphocytes (tot) 0.799475 0.355328 5.06234 0.024451 0.10305 1.495904 2.224372
Segmented Neutrophils/Cancer Cells -0.079159 0.031775 6.20620 0.012730 -0.14144 -0.016881 0.923893
Eosinophils (tot) 0.878755 0.358639 6.00373 0.014276 0.17584 1.581675 2.407901
Stick Neutrophils (tot) 0.761365 0.357698 4.53056 0.033295 0.06029 1.462441 2.141197
Leucocytes (tot) -0.827333 0.355348 5.42068 0.019900 -1.52380 -0.130864 0.437214
Monocytes (tot) 0.930051 0.368213 6.37993 0.011542 0.20837 1.651734 2.534638
G1-3 0.136446 0.067229 4.11909 0.042402 0.00468 0.268213 1.146193
Bootstrap Simulation Rank Kendall’Tau-A P<
Healthy Cells/Cancer Cells 1 0.240 0.000
Tumor Size 2 -0.234 0.000
Leucocytes/Cancer Cells 3 0.228 0.000
PT N0---N12 4 -0.227 0.000
Erythrocytes/Cancer Cells 5 -0.217 0.000
Residual Nitrogen 6 -0.217 0.000
Lymphocytes/Cancer Cells 7 0.216 0.000
T1-4 8 -0.214 0.000
Segmented Neutrophils/Cancer Cells 9 0.211 0.000
Thrombocytes/Cancer Cells 10 0.206 0.000
Hemorrhage Time 11 -0.199 0.000
PT Early---Invasive Cancer 12 -0.192 0.000
Monocytes/Cancer Cells 13 0.147 0.000
Tumor Growth 14 -0.133 0.000
G1-3 15 -0.117 0.001
Localization 16 -0.116 0.000
Chlorides 17 0.105 0.001
Histology 18 -0.084 0.01
Operation Type 19 -0.083 0.01
Combined Operation 20 0.064 0.05
Prothrombin Index 21 -0.055 0.05
Glucose 22 0.054 0.05
Neural Networks: Baseline Error=0.000
Area under ROC Curve=1.000
Correct Classification Rate=100%, n=600
Rank Sensitivity
Phase Transition Early-Invasive Cancer
Phase Transition N0-N12
Healthy Cells/Cancer Cells
Erythrocytes/Cancer Cells
Thrombocytes/Cancer Cells
Glucose
Prothrombin Index
Monocytes/Cancer Cells
Lymphocytes/Cancer Cells
Eosinophils/Cancer Cells
Stick Neutrophils/Cancer Cells
Segmented Neutrophils/Cancer Cells
Leucocytes/Cancer Cells
1
2
3
4
5
6
7
8
9
10
11
12
13
27747
18185
16386
10503
6864
4610
4542
4431
3744
3539
2974
2803
2430
Survival Function
5-Year Survival=58.4%; 10-Year Survival=52.3%;
20-Year Survival=40.3%; n=788; T1-4N0-2M0
Complete Censored
-5 0 5 10 15 20 25 30 35 40
Years after Gastrectomies
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
CumulativeProportionSurviving
Cumulative Proportion Surviving (Kaplan-Meier)
5-Year Survival of Early Gastric Cancer Patients=97.2%;
5-Year Survival of Invasive Gastric Cancer Patients=47%; P=0.000 by Log-Rank Test
Complete Censored
0 5 10 15 20 25 30 35 40
Years after Gastrectomies
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
CumulativeProportionSurviving
Invasive GCP=626
Early GCP=162
Cumulative Proportion Surviving (Kaplan-Meier)
5-Year Survival of GCP with N0=76.5;
5-Year Survival of GCP with N1-2=34.9%, P=0.000 by Log-Rank Test
Complete Censored
0 5 10 15 20 25 30 35 40
Years after Gastrectomies
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
CumulativeProportionSurviving
GCP with N1-2=356
GCP with N0=432
Cumulative Proportion Surviving (Kaplan-Meier)
5-Year Survival of GCP after Adjuvant Treatment=69%;
5-Year Survival of GCP after Surgery=56.4%, P=0.0176 by Log-Rank Test
Complete Censored
0 5 10 15 20 25 30 35 40
Years after Gastrectomies
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
CumulativeProportionSurviving
Only Surgery, n=620
Adjuvant Chemoimmunotherapy, n=168
143--P
Oleg Kshivets DOI: 10.3252/pso.eu.21wcgic.2019
Clinical Gastric Cancer

Recommended

Kshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer SurgeryKshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer SurgeryOleg Kshivets
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryOleg Kshivets
 
Kshivets ASCVTS Moscow2018
Kshivets ASCVTS Moscow2018Kshivets ASCVTS Moscow2018
Kshivets ASCVTS Moscow2018Oleg Kshivets
 
Kshivets iaslc denver2021
Kshivets iaslc denver2021Kshivets iaslc denver2021
Kshivets iaslc denver2021Oleg Kshivets
 
Kshivets barcelona2017
Kshivets barcelona2017Kshivets barcelona2017
Kshivets barcelona2017Oleg Kshivets
 
PRECISE EARLY DETECTION OF LUNG CANCER AND IMMUNE CIRCUIT
PRECISE EARLY DETECTION OF LUNG  CANCER AND IMMUNE CIRCUITPRECISE EARLY DETECTION OF LUNG  CANCER AND IMMUNE CIRCUIT
PRECISE EARLY DETECTION OF LUNG CANCER AND IMMUNE CIRCUITOleg Kshivets
 

More Related Content

What's hot

Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017Oleg Kshivets
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryOleg Kshivets
 
2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivetsOleg Kshivets
 
Kshivets eacts milan2018
Kshivets eacts milan2018Kshivets eacts milan2018
Kshivets eacts milan2018Oleg Kshivets
 
Kshivets iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015Oleg Kshivets
 
Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016Oleg Kshivets
 
Kshivets wscts2018 ljubljana
Kshivets wscts2018 ljubljanaKshivets wscts2018 ljubljana
Kshivets wscts2018 ljubljanaOleg Kshivets
 
Kshivets barcelona2016
Kshivets barcelona2016Kshivets barcelona2016
Kshivets barcelona2016Oleg Kshivets
 
Kshivets O. Esophageal and Cardioesophageal Cancer Surgery
Kshivets O. Esophageal and Cardioesophageal Cancer SurgeryKshivets O. Esophageal and Cardioesophageal Cancer Surgery
Kshivets O. Esophageal and Cardioesophageal Cancer SurgeryOleg Kshivets
 
Kshivets Hong Kong Sydney2020
Kshivets Hong Kong Sydney2020Kshivets Hong Kong Sydney2020
Kshivets Hong Kong Sydney2020Oleg Kshivets
 
Kshivets O. Esophageal Cancer Surgery
Kshivets O. Esophageal Cancer SurgeryKshivets O. Esophageal Cancer Surgery
Kshivets O. Esophageal Cancer SurgeryOleg Kshivets
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryOleg Kshivets
 
Kshivets O. Lung Cancer: Early Detection and Diagnosis
Kshivets O. Lung Cancer: Early Detection and Diagnosis Kshivets O. Lung Cancer: Early Detection and Diagnosis
Kshivets O. Lung Cancer: Early Detection and Diagnosis Oleg Kshivets
 
Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival           Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival Oleg Kshivets
 
Kshivets O. Lung Cancer Surgery: Prognosis
Kshivets O. Lung Cancer Surgery: PrognosisKshivets O. Lung Cancer Surgery: Prognosis
Kshivets O. Lung Cancer Surgery: PrognosisOleg Kshivets
 
Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Oleg Kshivets
 
Kshivets chicago2016
Kshivets chicago2016Kshivets chicago2016
Kshivets chicago2016Oleg Kshivets
 
Kshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer SurgeryKshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer SurgeryOleg Kshivets
 
Kshivets O. Esophagogastric Cancer Surgery
Kshivets O. Esophagogastric Cancer SurgeryKshivets O. Esophagogastric Cancer Surgery
Kshivets O. Esophagogastric Cancer SurgeryOleg Kshivets
 
Kshivets wscts2019 sofia
Kshivets wscts2019 sofiaKshivets wscts2019 sofia
Kshivets wscts2019 sofiaOleg Kshivets
 

What's hot (20)

Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
 
2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets
 
Kshivets eacts milan2018
Kshivets eacts milan2018Kshivets eacts milan2018
Kshivets eacts milan2018
 
Kshivets iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015
 
Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016
 
Kshivets wscts2018 ljubljana
Kshivets wscts2018 ljubljanaKshivets wscts2018 ljubljana
Kshivets wscts2018 ljubljana
 
Kshivets barcelona2016
Kshivets barcelona2016Kshivets barcelona2016
Kshivets barcelona2016
 
Kshivets O. Esophageal and Cardioesophageal Cancer Surgery
Kshivets O. Esophageal and Cardioesophageal Cancer SurgeryKshivets O. Esophageal and Cardioesophageal Cancer Surgery
Kshivets O. Esophageal and Cardioesophageal Cancer Surgery
 
Kshivets Hong Kong Sydney2020
Kshivets Hong Kong Sydney2020Kshivets Hong Kong Sydney2020
Kshivets Hong Kong Sydney2020
 
Kshivets O. Esophageal Cancer Surgery
Kshivets O. Esophageal Cancer SurgeryKshivets O. Esophageal Cancer Surgery
Kshivets O. Esophageal Cancer Surgery
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
 
Kshivets O. Lung Cancer: Early Detection and Diagnosis
Kshivets O. Lung Cancer: Early Detection and Diagnosis Kshivets O. Lung Cancer: Early Detection and Diagnosis
Kshivets O. Lung Cancer: Early Detection and Diagnosis
 
Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival           Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival
 
Kshivets O. Lung Cancer Surgery: Prognosis
Kshivets O. Lung Cancer Surgery: PrognosisKshivets O. Lung Cancer Surgery: Prognosis
Kshivets O. Lung Cancer Surgery: Prognosis
 
Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020
 
Kshivets chicago2016
Kshivets chicago2016Kshivets chicago2016
Kshivets chicago2016
 
Kshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer SurgeryKshivets O. Cardioesophageal Cancer Surgery
Kshivets O. Cardioesophageal Cancer Surgery
 
Kshivets O. Esophagogastric Cancer Surgery
Kshivets O. Esophagogastric Cancer SurgeryKshivets O. Esophagogastric Cancer Surgery
Kshivets O. Esophagogastric Cancer Surgery
 
Kshivets wscts2019 sofia
Kshivets wscts2019 sofiaKshivets wscts2019 sofia
Kshivets wscts2019 sofia
 

Similar to Kshivets barcelona2019

Kshivets barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020Oleg Kshivets
 
Kshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdfKshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdfOleg Kshivets
 
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...Oleg Kshivets
 
Kshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfKshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfOleg Kshivets
 
Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction      Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction Oleg Kshivets
 
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...Oleg Kshivets
 
Kshivets astana wscts2017
Kshivets astana wscts2017Kshivets astana wscts2017
Kshivets astana wscts2017Oleg Kshivets
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfOleg Kshivets
 
Kshivets O. Local Advanced Lung Cancer Surgery
Kshivets O. Local Advanced Lung Cancer Surgery Kshivets O. Local Advanced Lung Cancer Surgery
Kshivets O. Local Advanced Lung Cancer Surgery Oleg Kshivets
 
ovarian cancer - angiogenesis
ovarian cancer - angiogenesisovarian cancer - angiogenesis
ovarian cancer - angiogenesisMohamed Abdulla
 
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumours
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumoursMCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumours
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumoursEuropean School of Oncology
 
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...ssuserc0817d
 
Neuroendocrine tumors in 2015
Neuroendocrine tumors in 2015Neuroendocrine tumors in 2015
Neuroendocrine tumors in 2015Mohamed Abdulla
 
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...Mauricio Lema
 
Gallbladder CA.pptx
Gallbladder CA.pptxGallbladder CA.pptx
Gallbladder CA.pptxTiwariKripa
 
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...European School of Oncology
 

Similar to Kshivets barcelona2019 (20)

Kshivets barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020
 
Kshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdfKshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdf
 
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...
Survival of Lung Cancer Patients after Lobectomies was Significantly Superior...
 
Kshivets ny2021aats
Kshivets ny2021aatsKshivets ny2021aats
Kshivets ny2021aats
 
Kshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfKshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdf
 
Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction      Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction
 
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...
Combined Esophagogastrectomies: Survival Outcomes in Patients with Local Adva...
 
Kshivets elcc2022
Kshivets elcc2022Kshivets elcc2022
Kshivets elcc2022
 
Kshivets astana wscts2017
Kshivets astana wscts2017Kshivets astana wscts2017
Kshivets astana wscts2017
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
 
Kshivets O. Local Advanced Lung Cancer Surgery
Kshivets O. Local Advanced Lung Cancer Surgery Kshivets O. Local Advanced Lung Cancer Surgery
Kshivets O. Local Advanced Lung Cancer Surgery
 
Kshivets wscts2015
Kshivets wscts2015Kshivets wscts2015
Kshivets wscts2015
 
ovarian cancer - angiogenesis
ovarian cancer - angiogenesisovarian cancer - angiogenesis
ovarian cancer - angiogenesis
 
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumours
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumoursMCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumours
MCO 2011 - Slide 30 - K. Öberg - Spotlight session - Neuroendocrine tumours
 
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...
2019-ESMO-Summit-Africa-Current-Standard-Care-Practice-Changing-Studies-Soft-...
 
Kshivets esmo2021
Kshivets esmo2021Kshivets esmo2021
Kshivets esmo2021
 
Neuroendocrine tumors in 2015
Neuroendocrine tumors in 2015Neuroendocrine tumors in 2015
Neuroendocrine tumors in 2015
 
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...
4-yr OS after 2nd-line Nivolumab, pooled analysis (based on Scott Antonia pre...
 
Gallbladder CA.pptx
Gallbladder CA.pptxGallbladder CA.pptx
Gallbladder CA.pptx
 
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...
NY Prostate Cancer Conference - K. Touijer - Session 4: Predicting clinical a...
 

More from Oleg Kshivets

Kshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdfKshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdfOleg Kshivets
 
Kshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdfKshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdfOleg Kshivets
 
Kshivets gc 10_ys_wjarr-2021-0659
Kshivets gc 10_ys_wjarr-2021-0659Kshivets gc 10_ys_wjarr-2021-0659
Kshivets gc 10_ys_wjarr-2021-0659Oleg Kshivets
 
Kshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarrKshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarrOleg Kshivets
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021Oleg Kshivets
 
Kshivets ASCO Chicago2020
Kshivets ASCO Chicago2020Kshivets ASCO Chicago2020
Kshivets ASCO Chicago2020Oleg Kshivets
 
Kshivets aats new_york2019
Kshivets aats new_york2019Kshivets aats new_york2019
Kshivets aats new_york2019Oleg Kshivets
 
Kshivets aats new_york2018
Kshivets aats new_york2018Kshivets aats new_york2018
Kshivets aats new_york2018Oleg Kshivets
 
Kshivets iaslc toronto2018
Kshivets iaslc toronto2018Kshivets iaslc toronto2018
Kshivets iaslc toronto2018Oleg Kshivets
 

More from Oleg Kshivets (10)

Kshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdfKshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdf
 
Kshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdfKshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdf
 
Kshivets gc 10_ys_wjarr-2021-0659
Kshivets gc 10_ys_wjarr-2021-0659Kshivets gc 10_ys_wjarr-2021-0659
Kshivets gc 10_ys_wjarr-2021-0659
 
Kshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarrKshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarr
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021
 
Kshivets ASCO Chicago2020
Kshivets ASCO Chicago2020Kshivets ASCO Chicago2020
Kshivets ASCO Chicago2020
 
Kshivets aats new_york2019
Kshivets aats new_york2019Kshivets aats new_york2019
Kshivets aats new_york2019
 
Kshivets IASLC 2019
Kshivets IASLC 2019Kshivets IASLC 2019
Kshivets IASLC 2019
 
Kshivets aats new_york2018
Kshivets aats new_york2018Kshivets aats new_york2018
Kshivets aats new_york2018
 
Kshivets iaslc toronto2018
Kshivets iaslc toronto2018Kshivets iaslc toronto2018
Kshivets iaslc toronto2018
 

Recently uploaded

Introduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxIntroduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxMarbahunJalaKharbhih
 
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...PeerVoice
 
Bioavailability & Bioequivalence Studies- Definitions, Methods of Measureme...
Bioavailability & Bioequivalence  Studies- Definitions, Methods  of Measureme...Bioavailability & Bioequivalence  Studies- Definitions, Methods  of Measureme...
Bioavailability & Bioequivalence Studies- Definitions, Methods of Measureme...Rajshri
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSDr.Shrikrushna Sobaji
 
Hydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxHydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxSizan Thapa
 
gynae pcd pharma franchise - Solace Biotech Limited
gynae pcd pharma franchise -  Solace Biotech Limitedgynae pcd pharma franchise -  Solace Biotech Limited
gynae pcd pharma franchise - Solace Biotech LimitedSBL DIGITAL
 
Influenza.pptx Department of Physiotherapy, SHUATS, Prayagraj
Influenza.pptx Department of Physiotherapy, SHUATS, PrayagrajInfluenza.pptx Department of Physiotherapy, SHUATS, Prayagraj
Influenza.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Materials for Spectacle Lenses​ UG STUDENTS.pptx
Materials for Spectacle Lenses​ UG STUDENTS.pptxMaterials for Spectacle Lenses​ UG STUDENTS.pptx
Materials for Spectacle Lenses​ UG STUDENTS.pptxKAUSAR NAHID
 
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...semualkaira
 
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.ppt
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.pptGROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.ppt
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.pptDr Vinay KV Shetty
 
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Radicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystRadicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystJani253068
 
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptx
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptxEUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptx
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptxDr. Sumit KUMAR
 
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Golden Helix
 
Dasha vidha Pareeksha.pptx Dr Akshay Shetty
Dasha vidha Pareeksha.pptx Dr Akshay ShettyDasha vidha Pareeksha.pptx Dr Akshay Shetty
Dasha vidha Pareeksha.pptx Dr Akshay ShettyAkshay Shetty
 
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, PrayagrajPoliomyelitis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
 
Dental Cements in conservative dentistry
Dental Cements in conservative dentistryDental Cements in conservative dentistry
Dental Cements in conservative dentistryaknawaz5591
 
Anatomy of Female Reproductive System.pptx
Anatomy of Female Reproductive System.pptxAnatomy of Female Reproductive System.pptx
Anatomy of Female Reproductive System.pptxMathew Joseph
 
RASASHALA IN ACCORDANCE WITH GMP....pptx
RASASHALA IN ACCORDANCE WITH GMP....pptxRASASHALA IN ACCORDANCE WITH GMP....pptx
RASASHALA IN ACCORDANCE WITH GMP....pptxDr. Anusha Baseganni
 

Recently uploaded (20)

Introduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptxIntroduction to anatomy and physioligy.pptx
Introduction to anatomy and physioligy.pptx
 
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...
Disruption at the Neuromuscular Junction: Relevance of Autoantibodies to Ther...
 
Bioavailability & Bioequivalence Studies- Definitions, Methods of Measureme...
Bioavailability & Bioequivalence  Studies- Definitions, Methods  of Measureme...Bioavailability & Bioequivalence  Studies- Definitions, Methods  of Measureme...
Bioavailability & Bioequivalence Studies- Definitions, Methods of Measureme...
 
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICSPAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
PAEDIATRICS RHEMATOLOGY PROTOCOLS SHEET FOR PEDIATRICS ORTHOPAEDICS
 
Hydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptxHydrocele and tumors of testis Introduction.pptx
Hydrocele and tumors of testis Introduction.pptx
 
gynae pcd pharma franchise - Solace Biotech Limited
gynae pcd pharma franchise -  Solace Biotech Limitedgynae pcd pharma franchise -  Solace Biotech Limited
gynae pcd pharma franchise - Solace Biotech Limited
 
Influenza.pptx Department of Physiotherapy, SHUATS, Prayagraj
Influenza.pptx Department of Physiotherapy, SHUATS, PrayagrajInfluenza.pptx Department of Physiotherapy, SHUATS, Prayagraj
Influenza.pptx Department of Physiotherapy, SHUATS, Prayagraj
 
Materials for Spectacle Lenses​ UG STUDENTS.pptx
Materials for Spectacle Lenses​ UG STUDENTS.pptxMaterials for Spectacle Lenses​ UG STUDENTS.pptx
Materials for Spectacle Lenses​ UG STUDENTS.pptx
 
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
Bedside Utility of Liaoning Score a Non-Invasive As Predictor of Esophageal V...
 
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.ppt
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.pptGROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.ppt
GROSS ANATOMY OF CAECUM & APPENDIX DR VKVS.ppt
 
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
(DENGUE).pptx Department of Physiotherapy, SHUATS, Prayagraj
 
Radicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cystRadicular cyst or periapical odontogenic cyst
Radicular cyst or periapical odontogenic cyst
 
A Comprehensive Fatty Liver Program .pptx
A Comprehensive Fatty Liver Program .pptxA Comprehensive Fatty Liver Program .pptx
A Comprehensive Fatty Liver Program .pptx
 
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptx
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptxEUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptx
EUTHANASIA: WORLD AND INDIAN PERSPECTIVEpptx
 
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
Analyzing Performance of the Twist Exome with CNV Backbone at Various Probe D...
 
Dasha vidha Pareeksha.pptx Dr Akshay Shetty
Dasha vidha Pareeksha.pptx Dr Akshay ShettyDasha vidha Pareeksha.pptx Dr Akshay Shetty
Dasha vidha Pareeksha.pptx Dr Akshay Shetty
 
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, PrayagrajPoliomyelitis.pptx Department of Physiotherapy, SHUATS, Prayagraj
Poliomyelitis.pptx Department of Physiotherapy, SHUATS, Prayagraj
 
Dental Cements in conservative dentistry
Dental Cements in conservative dentistryDental Cements in conservative dentistry
Dental Cements in conservative dentistry
 
Anatomy of Female Reproductive System.pptx
Anatomy of Female Reproductive System.pptxAnatomy of Female Reproductive System.pptx
Anatomy of Female Reproductive System.pptx
 
RASASHALA IN ACCORDANCE WITH GMP....pptx
RASASHALA IN ACCORDANCE WITH GMP....pptxRASASHALA IN ACCORDANCE WITH GMP....pptx
RASASHALA IN ACCORDANCE WITH GMP....pptx
 

Kshivets barcelona2019

  • 1. 21WCGIC Poster presented at: Gastric Cancer: System Approach Kshivets Oleg Surgery Department, Roshal Hospital, Roshal, Moscow, Russia OBJECTIVE: Search of optimal diagnosis and treatment strategies for gastric cancer (GC) patients (GCP) (T1-4N0-2M0) realized. METHODS: We analyzed data of 788 consecutive GCP (age=57±9.4 years; tumor size=5.4±3.1 cm) radically operated (R0) and monitored in 1975-2019 (m=550, f=238; distal gastrectomies=460, proximal gastrectomies=163, total gastrectomies=165, combined gastrectomies with resection of pancreas, liver, diaphragm, colon transversum, esophagus, duodenum, splenectomy, small intestine, kidney, adrenal gland=241; D2- lymphadenectomy=513, D3-4=275; T1=235, T2=219, T3=179, T4=155; N0=432, N1=108, N2=248; G1=222, G2=161, G3=405; early GC=162, invasive=626; only surgery=620, adjuvant chemoimmunotherapy-AT=168 (5-FU + thymalin/taktivin). 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 2136.6±2311.4 days and cumulative 5-year survival (5YS) reached 58.4%, 10 years – 52.3%, 20 years – 40.3%. 314 GCP lived more than 5 years (LS=4323.2±2297.4 days), 171 GCP – more than 10 years (LS=5855.4±2083.6 days). 286 GCP died because of GC (LS=650.7±345.1 days). AT significantly improved 5YS (69% vs. 56.4%) (P=0.0176 by log-rank test). Cox modeling displayed that 5YS of GCP significantly depended on: phase transition (PT) early—invasive GC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G, AT, procedure type, blood cell circuit, prothrombin index, hemorrhage time, residual nitrogen, ESS, gender (P=0.000-0.046). 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 (3); erythrocytes/CC (4), thrombocytes/CC (5), glucose (6), prothrombin index (7); monocytes/CC (8), lymphocytes/CC (9), eosinophils/CC (10), stick neutrophils/CC (11), segmented neutrophils/CC (12), leucocytes/CC (13). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: Survival outcomes 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) procedure type; 10) anthropometric data. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection; 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. P-143 Cox Proportional Hazards Results, n=788 Parameter Estimate Standard Error Chi- square P value 95% Lower CL 95% Upper CL Hazard Ratio ESS -0.012758 0.005051 6.38089 0.011536 -0.02266 -0.002859 0.987323 Hemorrhage Time 0.001282 0.000382 11.27865 0.000784 0.00053 0.002031 1.001283 Residual Nitrogen 0.046850 0.009246 25.67652 0.000000 0.02873 0.064972 1.047965 Prothrombin Index 0.020024 0.005074 15.57157 0.000079 0.01008 0.029969 1.020225 Phase Transition N0—N12 0.843907 0.129833 42.24932 0.000000 0.58944 1.098374 2.325434 Gender 0.329383 0.125060 6.93693 0.008443 0.08427 0.574495 1.390110 Operation Type 0.149964 0.075202 3.97667 0.046135 0.00257 0.297358 1.161793 Adjuvant Chemoimmunotherapy -0.619714 0.183454 11.41118 0.000730 -0.97928 -0.260152 0.538098 Phase Transition Early GC—Invasive GC 0.747383 0.298512 6.26851 0.012290 0.16231 1.332455 2.111467 Segmented Neutrophils (tot) 0.844260 0.355982 5.62466 0.017710 0.14655 1.541971 2.326255 Lymphocytes (tot) 0.799475 0.355328 5.06234 0.024451 0.10305 1.495904 2.224372 Segmented Neutrophils/Cancer Cells -0.079159 0.031775 6.20620 0.012730 -0.14144 -0.016881 0.923893 Eosinophils (tot) 0.878755 0.358639 6.00373 0.014276 0.17584 1.581675 2.407901 Stick Neutrophils (tot) 0.761365 0.357698 4.53056 0.033295 0.06029 1.462441 2.141197 Leucocytes (tot) -0.827333 0.355348 5.42068 0.019900 -1.52380 -0.130864 0.437214 Monocytes (tot) 0.930051 0.368213 6.37993 0.011542 0.20837 1.651734 2.534638 G1-3 0.136446 0.067229 4.11909 0.042402 0.00468 0.268213 1.146193 Bootstrap Simulation Rank Kendall’Tau-A P< Healthy Cells/Cancer Cells 1 0.240 0.000 Tumor Size 2 -0.234 0.000 Leucocytes/Cancer Cells 3 0.228 0.000 PT N0---N12 4 -0.227 0.000 Erythrocytes/Cancer Cells 5 -0.217 0.000 Residual Nitrogen 6 -0.217 0.000 Lymphocytes/Cancer Cells 7 0.216 0.000 T1-4 8 -0.214 0.000 Segmented Neutrophils/Cancer Cells 9 0.211 0.000 Thrombocytes/Cancer Cells 10 0.206 0.000 Hemorrhage Time 11 -0.199 0.000 PT Early---Invasive Cancer 12 -0.192 0.000 Monocytes/Cancer Cells 13 0.147 0.000 Tumor Growth 14 -0.133 0.000 G1-3 15 -0.117 0.001 Localization 16 -0.116 0.000 Chlorides 17 0.105 0.001 Histology 18 -0.084 0.01 Operation Type 19 -0.083 0.01 Combined Operation 20 0.064 0.05 Prothrombin Index 21 -0.055 0.05 Glucose 22 0.054 0.05 Neural Networks: Baseline Error=0.000 Area under ROC Curve=1.000 Correct Classification Rate=100%, n=600 Rank Sensitivity Phase Transition Early-Invasive Cancer Phase Transition N0-N12 Healthy Cells/Cancer Cells Erythrocytes/Cancer Cells Thrombocytes/Cancer Cells Glucose Prothrombin Index Monocytes/Cancer Cells Lymphocytes/Cancer Cells Eosinophils/Cancer Cells Stick Neutrophils/Cancer Cells Segmented Neutrophils/Cancer Cells Leucocytes/Cancer Cells 1 2 3 4 5 6 7 8 9 10 11 12 13 27747 18185 16386 10503 6864 4610 4542 4431 3744 3539 2974 2803 2430 Survival Function 5-Year Survival=58.4%; 10-Year Survival=52.3%; 20-Year Survival=40.3%; n=788; T1-4N0-2M0 Complete Censored -5 0 5 10 15 20 25 30 35 40 Years after Gastrectomies 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 CumulativeProportionSurviving Cumulative Proportion Surviving (Kaplan-Meier) 5-Year Survival of Early Gastric Cancer Patients=97.2%; 5-Year Survival of Invasive Gastric Cancer Patients=47%; P=0.000 by Log-Rank Test Complete Censored 0 5 10 15 20 25 30 35 40 Years after Gastrectomies 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 CumulativeProportionSurviving Invasive GCP=626 Early GCP=162 Cumulative Proportion Surviving (Kaplan-Meier) 5-Year Survival of GCP with N0=76.5; 5-Year Survival of GCP with N1-2=34.9%, P=0.000 by Log-Rank Test Complete Censored 0 5 10 15 20 25 30 35 40 Years after Gastrectomies 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 CumulativeProportionSurviving GCP with N1-2=356 GCP with N0=432 Cumulative Proportion Surviving (Kaplan-Meier) 5-Year Survival of GCP after Adjuvant Treatment=69%; 5-Year Survival of GCP after Surgery=56.4%, P=0.0176 by Log-Rank Test Complete Censored 0 5 10 15 20 25 30 35 40 Years after Gastrectomies 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 CumulativeProportionSurviving Only Surgery, n=620 Adjuvant Chemoimmunotherapy, n=168 143--P Oleg Kshivets DOI: 10.3252/pso.eu.21wcgic.2019 Clinical Gastric Cancer