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Gastric Cancer: Artificial Intelligence, Complex System Analysis and Simulation for Best Management. #5
Poster · April 2023
DOI: 10.13140/RG.2.2.32721.20324
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Oleg Kshivets
Roshal Hospital, Roshal, Moscow, Russia
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RESULTS
INTRODUCTION
METHOD
CONCLUSIONS
CONTACT INFORMATION
O. Kshivets1, N. Urazov2
1 Roshal Hospital, Surgery Dep., Moscow, Russia
2 Omsk Cancer Center, Thoracoabdominal Surgery Dep., Omsk, Russia
Gastric Cancer: Artificial Intelligence, Complex System
Analysis and Simulation for Best Management.
#5
We examined cell ratio factors (CRF) significantly
affecting gastric cancer (EC) patients (GCP) survival.
CRF - ratio between cancer cells (CC) and blood cells
subpopulations.
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 1975-2023 (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.
5-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) GC cell
dynamics; 10) tumor localization; 11) anthropometric
data; 12) surgery type. Best 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.
• 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).
e-mail: okshivets@yahoo.com
http://ctsnet.org/home/okshivets
http://slideshare.net/Kshivets
http://youtube.com/user/Kshivets002
Survival Function
GCP=799; 5YS=58.4%;
10YS=52.2%; 20YS=40.3%; 30YS=27.2%.
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
Cumulative
Proportion
Surviving
Cumulative Proportion Surviving (Kaplan-Meier)
Complete Censored
10-Year Survival of Early GCP=88.4%;
10-Year Survival of Invasive GCP=41.5%;
P=0.000 by Log Rank Test.
0 5 10 15 20 25 30 35
Years after Gastrectomies
0,3
0,4
0,5
0,6
0,7
0,8
0,9
1,0
Cumulative
Proportion
Surviv
Invasive GCP
Early GCP
Cumulative Proportion Surviving (Kaplan-Meier)
Complete Censored
10-Year survival GCP N0=69.7%;
10-Year Survival GCP N1-2=29.5%;
P=0.000 by Log Rank.
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
Cumulative
Proportion
Survivi
GCP N1-2
GCP N0
Cumulative Proportion Surviving (Kaplan-Meier)
10-Year Survival GCP after AT=59.7%;
10-Year Survival after Surgery=50.6%;
P=0.032 by Log Rank Test.
Complete Censored
0 5 10 15 20 25 30
Years after Gastrectomies
0,1
0,2
0,3
0,4
0,5
0,6
0,7
0,8
Cumulative
Proportion
Survivin
only Surgery
A T
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