The publication investigates the impact of cell ratio factors on the survival of gastric cancer patients, analyzing data from 799 cases over several decades. Survival rates were significantly influenced by various factors, including age, tumor characteristics, and the presence of healthy blood cells. The study highlights the importance of early detection, experienced surgical intervention, and tailored treatment strategies to improve patient outcomes.

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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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