SlideShare a Scribd company logo
Esophageal Cancer:
Precise Prediction
KSHIVETS OLEG, MD, PHD
SURGERY DEPARTMENT, ROSHAL HOSPITAL, ROSHAL,
MOSCOW, RUSSIA
ABSTRACT
OBJECTIVE: 5-survival (5YS) and life span after radical surgery for esophageal cancer (EC) patients (ECP) (T1-
4N0-2M0) was analyzed.
METHODS: We analyzed data of 556 consecutive ECP (age=56.5±8.9 years; tumor size=6±3.5 cm) radically
operated (R0) and monitored in 1975-2022 (m=415, f=141; esophagogastrectomies (EG) Garlock=287, EG
Lewis=269, combined EG with resection of pancreas, liver, diaphragm, aorta, VCS, colon transversum, lung, trachea,
pericardium, splenectomy=167; adenocarcinoma=318, squamous=228, mix=10; T1=129, T2=115, T3=184, T4=128;
N0=281, N1=70, N2=205; G1=157, G2=141, G3=258; early EC=110, invasive=446; only surgery=424, adjuvant
chemoimmunoradiotherapy-AT=132: 5-FU+thymalin/taktivin+radiotherapy 45-50Gy). 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 1877±2221.6 days and cumulative 5-year survival (5YS) reached 52%, 10
years – 45%, 20 years – 33.4%, 30 years – 27%. 186 ECP lived more than 5 years (LS=4283.3±2412.6 days), 99
ECP – more than 10 years (LS=5883±2296.6 days). 227 ECP died because of EC (LS=631.8±323.4 days). AT
significantly improved 5YS (60.3% vs. 42%) (P=0.0029 by log-rank test). Cox modeling displayed that 5YS of ECP
significantly depended on: phase transition (PT) N0—N12 in terms of synergetics, cell ratio factors (ratio between
cancer cells- CC and blood cells subpopulations), T, G, histology, age, AT, localization, prothrombin index,
hemorrhage time, residual nitrogen, protein (P=0.000-0.021). Neural networks, genetic algorithm selection and
bootstrap simulation revealed relationships between 5YS and P PT early-invasive EC (rank=1); healthy cells/CC (2),
erythrocytes/CC (3), PT N0—N12 (4) thrombocytes/CC (5); segmented neutrophils/CC (6), stick neutrophils/CC (7),
lymphocytes/CC (8), monocytes/CC (9); leucocytes/CC (10); eosinophils/CC (11). Correct prediction of 5YS was
100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5-year survival of ECP 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) EC characteristics; 9) tumor localization; 10) anthropometric data; 11) surgery type. Optimal diagnosis and
treatment strategies for EC are: 1) screening and early detection of EC; 2) availability of experienced
thoracoabdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and
adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for
ECP with unfavorable prognosis.
Data:
 Males…………………………………………………...415
 Females………..……………………………...............141
 Age=56.5±8.9 years
 Tumor Size=6±3.5 cm
 Only Surgery.……………………………………........424
 Adjuvant Chemoimmunoradiotherapy
 (5FU+thymalin/taktivin, 5-6 cycles+ Radiotherapy
 45-50Gy)………………………..................................132
Radical Procedures:
 Esophagogastrectomies Lewis (R0)…………………269
 Esophagogastrectomies Garlock (R0)………...........287
 Combined Esophagogastrectomies with Resection
 of Pancreas, Liver, Trachea, Lung, Aorta, Vena
 Cava Superior, Colon Transversum, Diaphragm,
Pericardium, Splenectomy (R0)……………...............167
 2-Field Lymphadenectomy…………………………….366
 3-Field Lymphadenectomy.………………………….…190
Staging:
 T1……129 N0..….281 G1…………157
 T2……115 N1….....70 G2…………141
 T3……184 N2…...205 G3…………258
 T4……128 M0…..556
 Adenocarcinoma…………………………….318
 Squamos Cell Carcinoma…………………..228
 Mix………………….....…………………...........10
 Early Cancer……………………………...…...110
 Invasive Cancer…………………………..…..446
Survival Rate:
 Alive……………………………………….....292 (52.5%)
 5-Year Survivors…………..……………….186 (33.5%)
 10-Year Survivors…………………………...99 (17.8%)
 Losses………………………………………..227 (40.8%)
 General Life Span=1877±2221.6 days
 For 5-Year Survivors=4283.3±2412.6 days
 For 10-Year Survivors=5883±2296.6 days
 For Losses=631.8±323.4 days
 Cumulative 5-Year Survival……………………..52%
 Cumulative 10-Year Survival…………………....45%
 Cumulative 20-Year Survival…………………....33.4%
General Esophageal Cancer Patients Survival after Complete
Esophagogastrectomies (Kaplan-Meier) (n=556):
Survival Function
5YS=52%; 10YS=45%; 20YS=33.4%.
Complete Censored
-5 0 5 10 15 20 25 30 35 40
Years after Esophagogastrectomy
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
Results of Univariate Analysis of Phase Transition Early—Invasive Cancer in
Prediction of Esophageal Cancer Patients Survival (n=556):
Cumulative Proportion Surviving (Kaplan-Meier)
5YS of Early ECP=100%; 5YS of Invasive ECP=39.2%;
P=0.0000 by Log-Rank Test.
Complete Censored
0 5 10 15 20 25 30 35 40
Years after Esophagogastrectomy
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
Invasive ECP=446
Early ECP=110
Results of Univariate Analysis of Phase Transition N0—N1-2
in Prediction of Esophageal Cancer Patients Survival (n=556):
Cumulative Proportion Surviving (Kaplan-Meier)
5YS of ECP with N0=73.4%; 5YS of ECP with N12=29%;
P=0.0000 byLog-Rank Test.
Complete Censored
0 5 10 15 20 25 30 35 40
Years after Esophagogastrectomy
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
ECP with N12
ECP with N0
Results of Univariate Analysis of Adjuvant Chemoimmunoradiotherapy
in Prediction of Esophageal Cancer Patients Survival (n=556):
Cumulative Proportion Surviving (Kaplan-Meier)
5YS of ECP after Adjuvant Chemoimmunoradiotherapy=68.4%;
5YS of ECP after Surgery along=48.6%;
P=0.0005 by Log-Rank Test.
Complete Censored
0 5 10 15 20 25 30
Years after Esophagogastrectomy
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
ECP after Adjuvant Chemoimmunoradiotherapy
ECP after Surgery along
Results of Univariate Analysis of Localization (Upper/3 vs. Others) in
Prediction of Esophageal Cancer Patients Survival (n=556):
Cumulative Proportion Surviving (Kaplan-Meier)
5YS of ECP in Upper/3=65%; 5YS of Others ECP=49.6%;
P=0.00297 by Log-Rank Test.
Complete Censored
0 5 10 15 20 25
Years after Esophagogastrectomy
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
Others
ECP with Upper/3
Results of Cox Regression Modeling in Prediction of Esophageal Cancer Patients
Survival after Complete Esophagogastrectomies (n=556):
Cox Regression, n=556
Parameter
Estimate
Standard
Error
Chi-square P value
Hazard
Ratio
Hemorrhage Time 0.00149 0.000397 14.05790 0.000177 1.00149
Residual Nitrogen 0.04793 0.010884 19.39363 0.000011 1.04910
Protein 0.02047 0.008585 5.68498 0.017111 1.02068
Prothrombin Index 0.02498 0.006343 15.50974 0.000082 1.02529
T1-4 0.42183 0.085559 24.30742 0.000001 1.52475
Phase Transition N0--N12 0.61686 0.160454 14.78006 0.000121 1.85311
Age 0.02866 0.007712 13.80670 0.000203 1.02907
Histology -0.28849 0.124708 5.35127 0.020707 0.74940
G1-3 0.42478 0.088723 22.92255 0.000002 1.52926
Adjuvant Treatment -0.86575 0.189974 20.76792 0.000005 0.42074
Segmented Neutrophils/Cancer Cells 3.68226 1.601024 5.28972 0.021452 39.73610
Localization -0.55622 0.190510 8.52432 0.003504 0.57337
Monocytes/Cancer Cells 3.96567 1.658738 5.71581 0.016813 52.75566
Lymphocytes/Cancer Cells 3.54668 1.621453 4.78447 0.028717 34.69776
Stick Neutrophils/Cancer Cells 3.97424 1.661423 5.72201 0.016754 53.20991
Leucocytes/Cancer Cells -3.74966 1.608956 5.43121 0.019780 0.02353
EEosinophils/Cancer Cells 3.89197 1.687090 5.32184 0.021060 49.00719
Results of Neural Networks Computing in Prediction of Esophageal Cancer
Patients Survival after Complete esophagogastrectomies (n=413):
Corect Classification Rate=100%
Error=0.000
Area under ROC Curve=1.000
Factors (n=413) Rank Sensitivity
Phase Transition Early---Invasive Cancer 1 24671
Healthy Cells/Cancer Cells
Erythrocytes/Cancer Cells
Phase Transition N0—N12
Thrombocytes/Cancer Cells
Segmented Neutrophils/Cancer Cells
Stick Neutrophils/Cancer Cells
Lymphocytes/Cancer Cells
Monocytes/Cancer Cells
Leucocytes/Cancer Cells
Eosinophils/Cancer Cells
2
3
4
5
6
7
8
9
10
11
23071
18425
18188
12766
7861
7164
6424
6229
5643
4982
Results of Bootstrap Simulation in Prediction of esophageal Cancer Patients Survival after
esophagogastrectomies (n=413):
Significant Factors (Number of Samples=3333) Rank Kendal Tau-A P
Tumor Size 1 -0.308 0.000
Healthy Cells/Cancer Cells 2 0.305 0.000
T1-4 3 -0.299 0.000
Erythrocytes/Cancer Cells 4 0.299 0.000
Leucocytes/Cancer Cells 5 0.290 0.000
Thrombocytes/Cancer Cells 6 0.285 0.000
Lymphocytes/Cancer Cells 7 0.281 0.000
Residual Nitrogen 8 -0.275 0.000
Segmented Neutrophils/Cancer Cells 9 0.273 0.000
Phase Transition N0---N12 10 -0.239 0.000
Hemorrhage Time 11 -0.228 0.000
Monocytes/Cancer Cells 12 0.227 0.000
Phase Transition Early---Invasive Cancer 13 -0.222 0.000
Esophageal/Cardioesophageal Cancer 14 -0.191 0.000
Operation Type 15 -0.187 0.000
Eosinophils/Cancer Cells 16 0.173 0.000
Stick Neutrophils/Cancer Cells 17 0.144 0.001
G1-3 18 -0.140 0.001
Tumor Growth 19 -0.113 0.01
Erythrocytes 20 0.100 0.01
Combined Procedure 21 0.095 0.01
Weight 22 0.092 0.01
Localization 23 0.069 0.05
Results of Kohonen Self-Organizing Neural Networks Computing in Prediction of
Esophageal Cancer Patients Survival after Complete Esophagogastrectomies (n=413):
Esophageal Cancer Dynamics:
Prognostic SEPATH-Model of Esophageal Cancer Patients Survival
after Complete Esophagogastrectomies (n=413):
5-year survival of ECP after radical
procedures significantly depended on:
1) PT “Early-Invasive Ccancer”;
2) PT N0--N12;
3) Cell Ratio Factors;
4) Blood Cell Circuit;
5) Biochemical Factors;
6) Hemostasis System;
7) Adjuvant Treatment;
8) EC Characteristics;
9) Tumor Localization;
10) Anthropometric Data;
11) Surgery Type.
CONCLUSION:
Address:
Oleg Kshivets, M.D.,Ph.D.
Consultant Thoracic, Abdominal,
General Surgeon & Surgical
Oncologist
 e-mail: okshivets@yahoo.com
 skype: okshivets
 http: //www.ctsnet.org/home/okshivets

More Related Content

Similar to Esophageal Cancer: Precise Prediction

Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
Oleg 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 Surgery
Oleg Kshivets
 
Kshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdfKshivets_SPB_WSCTS2022Lung.pdf
Kshivets_SPB_WSCTS2022Lung.pdf
Oleg 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 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
 
Kshivets esmo2021
Kshivets esmo2021Kshivets esmo2021
Kshivets esmo2021
Oleg Kshivets
 
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Oleg Kshivets
 
Kshivets milan2014
Kshivets milan2014Kshivets milan2014
Kshivets milan2014
Oleg Kshivets
 
Kshivets iaslc denver2021
Kshivets iaslc denver2021Kshivets iaslc denver2021
Kshivets iaslc denver2021
Oleg Kshivets
 
Kshivets barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020
Oleg Kshivets
 
Kshivets iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015
Oleg Kshivets
 
Kshivets barcelona2017
Kshivets barcelona2017Kshivets barcelona2017
Kshivets barcelona2017
Oleg Kshivets
 
Kshivets barcelona2019
Kshivets barcelona2019Kshivets barcelona2019
Kshivets barcelona2019
Oleg Kshivets
 
• Gastric cancer prognosis and cell ratio factors
•	Gastric cancer prognosis and cell ratio factors           •	Gastric cancer prognosis and cell ratio factors
• Gastric cancer prognosis and cell ratio factors
Oleg Kshivets
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021
Oleg Kshivets
 
Kshivets sso2013
Kshivets sso2013Kshivets sso2013
Kshivets sso2013
Oleg Kshivets
 
Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016
Oleg Kshivets
 
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
Oleg Kshivets
 
Lung Cancer: Precise Prediction
Lung Cancer: Precise PredictionLung Cancer: Precise Prediction
Lung Cancer: Precise Prediction
Oleg Kshivets
 
Kshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
Oleg Kshivets
 

Similar to Esophageal Cancer: Precise Prediction (20)

Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
 
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_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 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 esmo2021
Kshivets esmo2021Kshivets esmo2021
Kshivets esmo2021
 
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
 
Kshivets milan2014
Kshivets milan2014Kshivets milan2014
Kshivets milan2014
 
Kshivets iaslc denver2021
Kshivets iaslc denver2021Kshivets iaslc denver2021
Kshivets iaslc denver2021
 
Kshivets barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020
 
Kshivets iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015
 
Kshivets barcelona2017
Kshivets barcelona2017Kshivets barcelona2017
Kshivets barcelona2017
 
Kshivets barcelona2019
Kshivets barcelona2019Kshivets barcelona2019
Kshivets barcelona2019
 
• Gastric cancer prognosis and cell ratio factors
•	Gastric cancer prognosis and cell ratio factors           •	Gastric cancer prognosis and cell ratio factors
• Gastric cancer prognosis and cell ratio factors
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021
 
Kshivets sso2013
Kshivets sso2013Kshivets sso2013
Kshivets sso2013
 
Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016Kshivets IASLC_Vienna2016
Kshivets IASLC_Vienna2016
 
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
Local Advanced Esophageal Cancer (T3-4N0-2M0): Artificial Intelligence, Syner...
 
Lung Cancer: Precise Prediction
Lung Cancer: Precise PredictionLung Cancer: Precise Prediction
Lung Cancer: Precise Prediction
 
Kshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
 

More from Oleg Kshivets

Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Oleg Kshivets
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Oleg Kshivets
 
Kshivets Oleg Optimization of Management for Esophageal Cancer Patients (T1-...
Kshivets Oleg  Optimization of Management for Esophageal Cancer Patients (T1-...Kshivets Oleg  Optimization of Management for Esophageal Cancer Patients (T1-...
Kshivets Oleg Optimization of Management for Esophageal Cancer Patients (T1-...
Oleg Kshivets
 
Kshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdfKshivets_IASLC_Singapore2023.pdf
Kshivets_IASLC_Singapore2023.pdf
Oleg Kshivets
 
Kshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdfKshivets_WCGIC2023.pdf
Kshivets_WCGIC2023.pdf
Oleg Kshivets
 
Kshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
Oleg Kshivets
 
Kshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfKshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdf
Oleg Kshivets
 
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
Oleg Kshivets
 
Kshivets elcc2022
Kshivets elcc2022Kshivets elcc2022
Kshivets elcc2022
Oleg 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-2021-0659
Oleg Kshivets
 
Kshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarrKshivets lc10 ys_wjarr
Kshivets lc10 ys_wjarr
Oleg Kshivets
 
2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets
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 iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020
Oleg Kshivets
 

More from Oleg Kshivets (15)

Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
 
Kshivets Oleg Optimization of Management for Esophageal Cancer Patients (T1-...
Kshivets Oleg  Optimization of Management for Esophageal Cancer Patients (T1-...Kshivets Oleg  Optimization of Management for Esophageal Cancer Patients (T1-...
Kshivets Oleg Optimization of Management for Esophageal Cancer Patients (T1-...
 
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_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
 
Kshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfKshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdf
 
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
Lung cancer cell dynamics significantly depended on blood cell circuit, bioch...
 
Kshivets elcc2022
Kshivets elcc2022Kshivets elcc2022
Kshivets elcc2022
 
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
 
2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets
 
Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival           Lung Cancer: 10-Year Survival
Lung Cancer: 10-Year Survival
 
Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020
 

Recently uploaded

RESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiyaRESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiya
Bhavyakelawadiya
 
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Kunj Vihari
 
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory projectNano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
SIVAVINAYAKPK
 
Local anesthetics 2024/ Medicinal Chemistry pdf
Local anesthetics 2024/ Medicinal Chemistry pdfLocal anesthetics 2024/ Medicinal Chemistry pdf
Local anesthetics 2024/ Medicinal Chemistry pdf
NarminHamaaminHussen
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
MuskanShingari
 
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga
 
Foundation of Yoga, YCB Level-3, Unit-1
Foundation of Yoga, YCB Level-3, Unit-1 Foundation of Yoga, YCB Level-3, Unit-1
Foundation of Yoga, YCB Level-3, Unit-1
Jyoti Bhaghasra
 
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
ayushrajshrivastava7
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
FFragrant
 
Debunking Nutrition Myths: Separating Fact from Fiction"
Debunking Nutrition Myths: Separating Fact from Fiction"Debunking Nutrition Myths: Separating Fact from Fiction"
Debunking Nutrition Myths: Separating Fact from Fiction"
AlexandraDiaz101
 
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl MumbaiCall Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Mobile Problem
 
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOWPune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Get New Sim
 
Introduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptxIntroduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptx
taiba qazi
 
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
Gokuldas Hospital
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
Gokuldas Hospital
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
NX Healthcare
 
What are the different types of Dental implants.
What are the different types of Dental implants.What are the different types of Dental implants.
What are the different types of Dental implants.
Gokuldas Hospital
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
NX Healthcare
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
Planet Ayurveda
 
How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.
Gokuldas Hospital
 

Recently uploaded (20)

RESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiyaRESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiya
 
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.
 
Nano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory projectNano-gold for Cancer Therapy chemistry investigatory project
Nano-gold for Cancer Therapy chemistry investigatory project
 
Local anesthetics 2024/ Medicinal Chemistry pdf
Local anesthetics 2024/ Medicinal Chemistry pdfLocal anesthetics 2024/ Medicinal Chemistry pdf
Local anesthetics 2024/ Medicinal Chemistry pdf
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
 
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
 
Foundation of Yoga, YCB Level-3, Unit-1
Foundation of Yoga, YCB Level-3, Unit-1 Foundation of Yoga, YCB Level-3, Unit-1
Foundation of Yoga, YCB Level-3, Unit-1
 
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
 
Debunking Nutrition Myths: Separating Fact from Fiction"
Debunking Nutrition Myths: Separating Fact from Fiction"Debunking Nutrition Myths: Separating Fact from Fiction"
Debunking Nutrition Myths: Separating Fact from Fiction"
 
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl MumbaiCall Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
 
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOWPune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
Pune Call Girls 7339748667 AVAILABLE HOT GIRLS AUNTY BOOK NOW
 
Introduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptxIntroduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptx
 
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
 
What are the different types of Dental implants.
What are the different types of Dental implants.What are the different types of Dental implants.
What are the different types of Dental implants.
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
 
How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.
 

Esophageal Cancer: Precise Prediction

  • 1. Esophageal Cancer: Precise Prediction KSHIVETS OLEG, MD, PHD SURGERY DEPARTMENT, ROSHAL HOSPITAL, ROSHAL, MOSCOW, RUSSIA
  • 2. ABSTRACT OBJECTIVE: 5-survival (5YS) and life span after radical surgery for esophageal cancer (EC) patients (ECP) (T1- 4N0-2M0) was analyzed. METHODS: We analyzed data of 556 consecutive ECP (age=56.5±8.9 years; tumor size=6±3.5 cm) radically operated (R0) and monitored in 1975-2022 (m=415, f=141; esophagogastrectomies (EG) Garlock=287, EG Lewis=269, combined EG with resection of pancreas, liver, diaphragm, aorta, VCS, colon transversum, lung, trachea, pericardium, splenectomy=167; adenocarcinoma=318, squamous=228, mix=10; T1=129, T2=115, T3=184, T4=128; N0=281, N1=70, N2=205; G1=157, G2=141, G3=258; early EC=110, invasive=446; only surgery=424, adjuvant chemoimmunoradiotherapy-AT=132: 5-FU+thymalin/taktivin+radiotherapy 45-50Gy). 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 1877±2221.6 days and cumulative 5-year survival (5YS) reached 52%, 10 years – 45%, 20 years – 33.4%, 30 years – 27%. 186 ECP lived more than 5 years (LS=4283.3±2412.6 days), 99 ECP – more than 10 years (LS=5883±2296.6 days). 227 ECP died because of EC (LS=631.8±323.4 days). AT significantly improved 5YS (60.3% vs. 42%) (P=0.0029 by log-rank test). Cox modeling displayed that 5YS of ECP significantly depended on: phase transition (PT) N0—N12 in terms of synergetics, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), T, G, histology, age, AT, localization, prothrombin index, hemorrhage time, residual nitrogen, protein (P=0.000-0.021). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and P PT early-invasive EC (rank=1); healthy cells/CC (2), erythrocytes/CC (3), PT N0—N12 (4) thrombocytes/CC (5); segmented neutrophils/CC (6), stick neutrophils/CC (7), lymphocytes/CC (8), monocytes/CC (9); leucocytes/CC (10); eosinophils/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0). CONCLUSIONS: 5-year survival of ECP 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) EC characteristics; 9) tumor localization; 10) anthropometric data; 11) surgery type. Optimal diagnosis and treatment strategies for EC are: 1) screening and early detection of EC; 2) availability of experienced thoracoabdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for ECP with unfavorable prognosis.
  • 3. Data:  Males…………………………………………………...415  Females………..……………………………...............141  Age=56.5±8.9 years  Tumor Size=6±3.5 cm  Only Surgery.……………………………………........424  Adjuvant Chemoimmunoradiotherapy  (5FU+thymalin/taktivin, 5-6 cycles+ Radiotherapy  45-50Gy)………………………..................................132
  • 4. Radical Procedures:  Esophagogastrectomies Lewis (R0)…………………269  Esophagogastrectomies Garlock (R0)………...........287  Combined Esophagogastrectomies with Resection  of Pancreas, Liver, Trachea, Lung, Aorta, Vena  Cava Superior, Colon Transversum, Diaphragm, Pericardium, Splenectomy (R0)……………...............167  2-Field Lymphadenectomy…………………………….366  3-Field Lymphadenectomy.………………………….…190
  • 5. Staging:  T1……129 N0..….281 G1…………157  T2……115 N1….....70 G2…………141  T3……184 N2…...205 G3…………258  T4……128 M0…..556  Adenocarcinoma…………………………….318  Squamos Cell Carcinoma…………………..228  Mix………………….....…………………...........10  Early Cancer……………………………...…...110  Invasive Cancer…………………………..…..446
  • 6. Survival Rate:  Alive……………………………………….....292 (52.5%)  5-Year Survivors…………..……………….186 (33.5%)  10-Year Survivors…………………………...99 (17.8%)  Losses………………………………………..227 (40.8%)  General Life Span=1877±2221.6 days  For 5-Year Survivors=4283.3±2412.6 days  For 10-Year Survivors=5883±2296.6 days  For Losses=631.8±323.4 days  Cumulative 5-Year Survival……………………..52%  Cumulative 10-Year Survival…………………....45%  Cumulative 20-Year Survival…………………....33.4%
  • 7. General Esophageal Cancer Patients Survival after Complete Esophagogastrectomies (Kaplan-Meier) (n=556): Survival Function 5YS=52%; 10YS=45%; 20YS=33.4%. Complete Censored -5 0 5 10 15 20 25 30 35 40 Years after Esophagogastrectomy 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving
  • 8. Results of Univariate Analysis of Phase Transition Early—Invasive Cancer in Prediction of Esophageal Cancer Patients Survival (n=556): Cumulative Proportion Surviving (Kaplan-Meier) 5YS of Early ECP=100%; 5YS of Invasive ECP=39.2%; P=0.0000 by Log-Rank Test. Complete Censored 0 5 10 15 20 25 30 35 40 Years after Esophagogastrectomy 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving Invasive ECP=446 Early ECP=110
  • 9. Results of Univariate Analysis of Phase Transition N0—N1-2 in Prediction of Esophageal Cancer Patients Survival (n=556): Cumulative Proportion Surviving (Kaplan-Meier) 5YS of ECP with N0=73.4%; 5YS of ECP with N12=29%; P=0.0000 byLog-Rank Test. Complete Censored 0 5 10 15 20 25 30 35 40 Years after Esophagogastrectomy 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving ECP with N12 ECP with N0
  • 10. Results of Univariate Analysis of Adjuvant Chemoimmunoradiotherapy in Prediction of Esophageal Cancer Patients Survival (n=556): Cumulative Proportion Surviving (Kaplan-Meier) 5YS of ECP after Adjuvant Chemoimmunoradiotherapy=68.4%; 5YS of ECP after Surgery along=48.6%; P=0.0005 by Log-Rank Test. Complete Censored 0 5 10 15 20 25 30 Years after Esophagogastrectomy 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving ECP after Adjuvant Chemoimmunoradiotherapy ECP after Surgery along
  • 11. Results of Univariate Analysis of Localization (Upper/3 vs. Others) in Prediction of Esophageal Cancer Patients Survival (n=556): Cumulative Proportion Surviving (Kaplan-Meier) 5YS of ECP in Upper/3=65%; 5YS of Others ECP=49.6%; P=0.00297 by Log-Rank Test. Complete Censored 0 5 10 15 20 25 Years after Esophagogastrectomy 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving Others ECP with Upper/3
  • 12. Results of Cox Regression Modeling in Prediction of Esophageal Cancer Patients Survival after Complete Esophagogastrectomies (n=556): Cox Regression, n=556 Parameter Estimate Standard Error Chi-square P value Hazard Ratio Hemorrhage Time 0.00149 0.000397 14.05790 0.000177 1.00149 Residual Nitrogen 0.04793 0.010884 19.39363 0.000011 1.04910 Protein 0.02047 0.008585 5.68498 0.017111 1.02068 Prothrombin Index 0.02498 0.006343 15.50974 0.000082 1.02529 T1-4 0.42183 0.085559 24.30742 0.000001 1.52475 Phase Transition N0--N12 0.61686 0.160454 14.78006 0.000121 1.85311 Age 0.02866 0.007712 13.80670 0.000203 1.02907 Histology -0.28849 0.124708 5.35127 0.020707 0.74940 G1-3 0.42478 0.088723 22.92255 0.000002 1.52926 Adjuvant Treatment -0.86575 0.189974 20.76792 0.000005 0.42074 Segmented Neutrophils/Cancer Cells 3.68226 1.601024 5.28972 0.021452 39.73610 Localization -0.55622 0.190510 8.52432 0.003504 0.57337 Monocytes/Cancer Cells 3.96567 1.658738 5.71581 0.016813 52.75566 Lymphocytes/Cancer Cells 3.54668 1.621453 4.78447 0.028717 34.69776 Stick Neutrophils/Cancer Cells 3.97424 1.661423 5.72201 0.016754 53.20991 Leucocytes/Cancer Cells -3.74966 1.608956 5.43121 0.019780 0.02353 EEosinophils/Cancer Cells 3.89197 1.687090 5.32184 0.021060 49.00719
  • 13. Results of Neural Networks Computing in Prediction of Esophageal Cancer Patients Survival after Complete esophagogastrectomies (n=413): Corect Classification Rate=100% Error=0.000 Area under ROC Curve=1.000 Factors (n=413) Rank Sensitivity Phase Transition Early---Invasive Cancer 1 24671 Healthy Cells/Cancer Cells Erythrocytes/Cancer Cells Phase Transition N0—N12 Thrombocytes/Cancer Cells Segmented Neutrophils/Cancer Cells Stick Neutrophils/Cancer Cells Lymphocytes/Cancer Cells Monocytes/Cancer Cells Leucocytes/Cancer Cells Eosinophils/Cancer Cells 2 3 4 5 6 7 8 9 10 11 23071 18425 18188 12766 7861 7164 6424 6229 5643 4982
  • 14. Results of Bootstrap Simulation in Prediction of esophageal Cancer Patients Survival after esophagogastrectomies (n=413): Significant Factors (Number of Samples=3333) Rank Kendal Tau-A P Tumor Size 1 -0.308 0.000 Healthy Cells/Cancer Cells 2 0.305 0.000 T1-4 3 -0.299 0.000 Erythrocytes/Cancer Cells 4 0.299 0.000 Leucocytes/Cancer Cells 5 0.290 0.000 Thrombocytes/Cancer Cells 6 0.285 0.000 Lymphocytes/Cancer Cells 7 0.281 0.000 Residual Nitrogen 8 -0.275 0.000 Segmented Neutrophils/Cancer Cells 9 0.273 0.000 Phase Transition N0---N12 10 -0.239 0.000 Hemorrhage Time 11 -0.228 0.000 Monocytes/Cancer Cells 12 0.227 0.000 Phase Transition Early---Invasive Cancer 13 -0.222 0.000 Esophageal/Cardioesophageal Cancer 14 -0.191 0.000 Operation Type 15 -0.187 0.000 Eosinophils/Cancer Cells 16 0.173 0.000 Stick Neutrophils/Cancer Cells 17 0.144 0.001 G1-3 18 -0.140 0.001 Tumor Growth 19 -0.113 0.01 Erythrocytes 20 0.100 0.01 Combined Procedure 21 0.095 0.01 Weight 22 0.092 0.01 Localization 23 0.069 0.05
  • 15. Results of Kohonen Self-Organizing Neural Networks Computing in Prediction of Esophageal Cancer Patients Survival after Complete Esophagogastrectomies (n=413):
  • 17. Prognostic SEPATH-Model of Esophageal Cancer Patients Survival after Complete Esophagogastrectomies (n=413):
  • 18. 5-year survival of ECP after radical procedures significantly depended on: 1) PT “Early-Invasive Ccancer”; 2) PT N0--N12; 3) Cell Ratio Factors; 4) Blood Cell Circuit; 5) Biochemical Factors; 6) Hemostasis System; 7) Adjuvant Treatment; 8) EC Characteristics; 9) Tumor Localization; 10) Anthropometric Data; 11) Surgery Type. CONCLUSION:
  • 19. Address: Oleg Kshivets, M.D.,Ph.D. Consultant Thoracic, Abdominal, General Surgeon & Surgical Oncologist  e-mail: okshivets@yahoo.com  skype: okshivets  http: //www.ctsnet.org/home/okshivets