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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
View publication stats

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Kshivets_WCGIC2023.pdf

  • 1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/370398205 Gastric Cancer: Artificial Intelligence, Complex System Analysis and Simulation for Best Management. #5 Poster · April 2023 DOI: 10.13140/RG.2.2.32721.20324 CITATIONS 0 READ 1 2 authors, including: Some of the authors of this publication are also working on these related projects: prognosis of esophageal cancer cell dynamics View project World Journal of Advanced Research and Reviews, 2021, 12(02), 246–260 View project Oleg Kshivets Roshal Hospital, Roshal, Moscow, Russia 104 PUBLICATIONS 55 CITATIONS SEE PROFILE All content following this page was uploaded by Oleg Kshivets on 29 April 2023. The user has requested enhancement of the downloaded file.
  • 2. Add your logos here 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 View publication stats