SlideShare a Scribd company logo
P815. Local Advanced Lung Cancer: Artificial Intelligence, Complex System Analysis,
Simulation of Alive Supersysems for Optimal Management
INTRODUCTION
The survival of patients with local advanced of
lung cancer (LC) takes several months. Radical
operations are extremely complex and remain the
prerogative of several top thoracic surgeons of the
world. The search of optimal treatment plan for LC
patients (LCP) with stage T3-4N0-2M0 was realized.
We examined factors in terms of precise prediction
of 5-year survival (5YS) of local advanced LCP
after complete (R0) combined lobectomies/pneu-
monectomies (LP).
METHODS
We analyzed data of 198 consecutive LCP
(age=58.1±8.2 years; tumor size=6.8±2.6 cm) radically
operated and monitored in 1985-2024 (m=173, f=25;
bi/lobectomies=84, pneumonectomies=114,
mediastinal lymph node dissections=198; combined
LP with resection of trachea, carina, atrium, aorta,
VCS, vena azygos, pericardium, liver, diaphragm, ribs,
esophagus=198; only surgery-S=117, adjuvant
chemoimmunoradiotherapy-AT=81: CAV/gemzar +
cisplatin + thymalin/taktivin + radiotherapy 45-50Gy;
T3=137, T4=61; N0=94, N1=44, N2=60, M0=198; G1=42,
G2=53, G3=103; squamous=118, adenocarcinoma=65,
large cell=15, central=115, peripheral=83. Multivariate
Cox modeling, clustering, SEPATH, Monte Carlo,
synergetics, bootstrap and neural networks
computing were used to determine any significant
dependence.
DISCUSSION AND CONCLUSION
Conclusion 1: 5YS of local advanced non-
small cell LCP after combined radical procedures
significantly depended on: 1) tumor
characteristics; 2) LC cell dynamics; 3) blood cell
circuit; 4) cell ratio factors; 5) biochemical
factors; 6) hemostasis system; 7) anthropometric
data; 8) adjuvant treatment; 9) procedure type.
Conclusion 2: Optimal strategies for local
advanced LCP are: 1) availability of very
experienced thoracic surgeons because of
complexity radical procedures; 2) aggressive en
block surgery and adequate lymph node
dissection for completeness; 3) precise
prediction; 4) AT for LCP with unfavorable
prognosis.
Poster Presenter1: Kshivets Oleg, MD, PhD
1Bagrationovsk Hospital1, Bagrationovsk, Kaliningrad, Russia
Correspondence: okshivets@yahoo.com
RESULTS
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20
years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10
years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved
5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly
depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood
cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein,
AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation
revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented
neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick
neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural
networks computing (error=0.000; area under ROC curve=1.0).
Cumulative Proportion Surviving (Kaplan-Meier)
P=0.00018
Complete Censored
0 5 10 15 20 25 30 35
Years after Surgery
-0.1
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
Procedures
Combined Procedures
Significant Factors
(Number of Samples=3333)
Rank Kendal
Tau-A
P<
Prothrombin Index 1 -0.209 0.001
Phase Transition N0---N12 2 -0.176 0.01
Glucose 3 0.133 0.05
Weight 4 0.125 0.05
Erythrocytes/Cancer Cells 5 0.124 0.05
Age 6 -0.118 0.05
Heparin Tolerance 7 -0.118 0.05
Healthy Cells/Cancer Cells 8 0.117 0.05
Monocytes/Cancer Cells 9 0.117 0.05
Eosinophils/Cancer Cells 10 0.115 0.05
ESS 11 -0.112 0.05
Erythrocytes tot. 12 0.112 0.05
Cox Regression, n=198
Parameter
Estimate
Standard
Error
Chi-
square
P value
95%
Lower CL
95%
Upper CL
T3-4 0.93365 0.314224 8.82851 0.002966 0.31778 1.54951
N0---N12 0.61808 0.156019 15.69404 0.000074 0.31229 0.92387
LC Cell Dynamics 0.29571 0.069786 17.95520 0.000023 0.15893 0.43249
Eosinophils (abs) 17.67339 4.625182 14.60098 0.000133 8.60820 26.73858
Prothrombin Index 0.04784 0.015436 9.60378 0.001942 0.01758 0.07809
Protein 0.04103 0.016873 5.91247 0.015034 0.00796 0.07410
Recalcification Time -0.00720 0.003105 5.37561 0.020420 -0.01329 -0.00111
Heparin Tolerance 0.00420 0.001189 12.47949 0.000411 0.00187 0.00653
Adjuvant
Chemoimmunoradiotherapy
-0.76183 0.354651 4.61434 0.031706 -1.45693 -0.06672
Thrombocytes/Cancer Cells 0.00870 0.002040 18.18890 0.000020 0.00470 0.01270
Eosinophils (tot) -3.65060 0.972359 14.09531 0.000174 -5.55638 -1.74481
Lymphocytes (tot) -0.08709 0.038280 5.17614 0.022899 -0.16212 -0.01206
Pneumonectomies/Lobectomies -0.63257 0.261220 5.86418 0.015452 -1.14455 -0.12059
Neural Networks: Baseline Error=0.000; Area
under ROC Curve=1.000; Correct
Classification Rate=100%; n=192
Rank Sensitivity
Phase Transition N0---N12 1 1199
Thrombocytes/Cancer Cells
Eosinophils/Cancer Cells
Healthy Cells/Cancer Cells
Stick Neutrophils/Cancer Cells
Lymphocytes/Cancer Cells
Segmented Neutrophils/Cancer Cells
2
3
4
5
6
7
637
474
437
376
372
333
Erythrocytes/Cancer Cells 8 299
Monocytes/Cancer Cells
Leucocytes/Cancer Cells
9
10
261
159
Cumulative Proportion Surviving (Kaplan-Meier)
5YS LCP after AT=74.5%; 5YS LCP after Surgery along=55% P=0.00195.
Complete Censored
0 5 10 15 20 25 30 35
Years after Surgery
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
Only Surgery
Adjuvant Chemoimmunoradiotherapy
Cumulative Proportion Surviving (Kaplan-Meier)
5YS LCP with N0=74.5%; 5YS LCP wih N1-2=50.7% P=0.00086.
Complete Censored
0 5 10 15 20 25 30 35
Years after Surgery
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Cumulative
Proportion
Surviving
N12
N0
Survival Function
5YS=62.4%; 10YS=50.4%; 20YS=44.6%.
Complete Censored
-5 0 5 10 15 20 25 30
Years after Surgery
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
Cumulative
Proportion
Surviving
Results of Kohonen Self-Organizing Neural Networks Computing
in Prediction of Advanced Lung Cancer Patients Survival, n=160
REFERENCES AND ACKNOWLEDGEMENTS
RESULTS
Lung cancer Cell Dynamics
SEPATH Model
REFERENCES AND ACKNOWLEDGEMENTS
RESULTS
Lung Cancer Cell Dynamics

More Related Content

Similar to Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis and Simulation of Alive Supersystems for Optimal Management

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 barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020
Oleg Kshivets
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
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
 
Kshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
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
 
• 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 yokohama iaslc2017
Kshivets yokohama iaslc2017Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017
Oleg Kshivets
 
Kshivets barcelona2016
Kshivets barcelona2016Kshivets barcelona2016
Kshivets barcelona2016
Oleg Kshivets
 
Kshivets barcelona2019
Kshivets barcelona2019Kshivets barcelona2019
Kshivets barcelona2019
Oleg Kshivets
 
Kshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdfKshivets_SPB_WSCTS2022Eso.pdf
Kshivets_SPB_WSCTS2022Eso.pdf
Oleg Kshivets
 
Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction      Esophageal Cancer: Precise Prediction
Esophageal Cancer: Precise Prediction
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
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
Oleg Kshivets
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
Oleg Kshivets
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
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 iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015
Oleg Kshivets
 
Kshivets chicago2016
Kshivets chicago2016Kshivets chicago2016
Kshivets chicago2016
Oleg Kshivets
 

Similar to Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis and Simulation of Alive Supersystems for Optimal Management (20)

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 barcelona2020
Kshivets barcelona2020Kshivets barcelona2020
Kshivets barcelona2020
 
Kshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer SurgeryKshivets O. Lung Cancer Surgery
Kshivets O. Lung Cancer Surgery
 
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
 
Kshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdfKshivets_ELCC2023.pdf
Kshivets_ELCC2023.pdf
 
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...
 
• 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 yokohama iaslc2017
Kshivets yokohama iaslc2017Kshivets yokohama iaslc2017
Kshivets yokohama iaslc2017
 
Kshivets barcelona2016
Kshivets barcelona2016Kshivets barcelona2016
Kshivets barcelona2016
 
Kshivets barcelona2019
Kshivets barcelona2019Kshivets barcelona2019
Kshivets barcelona2019
 
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
 
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
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
 
KshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdfKshivetsWSCTS2023_Brazil.pdf
KshivetsWSCTS2023_Brazil.pdf
 
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 iaslc denver2015
Kshivets iaslc denver2015Kshivets iaslc denver2015
Kshivets iaslc denver2015
 
Kshivets chicago2016
Kshivets chicago2016Kshivets chicago2016
Kshivets chicago2016
 

More from 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
 
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
 
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
 
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
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021
Oleg Kshivets
 
Kshivets ny2021aats
Kshivets ny2021aatsKshivets ny2021aats
Kshivets ny2021aats
Oleg Kshivets
 
Kshivets esmo2021
Kshivets esmo2021Kshivets esmo2021
Kshivets esmo2021
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
 
Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020
Oleg Kshivets
 

More from Oleg Kshivets (15)

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...
 
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...
 
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
 
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
 
Kshivets eso10 y2021
Kshivets eso10 y2021Kshivets eso10 y2021
Kshivets eso10 y2021
 
Kshivets ny2021aats
Kshivets ny2021aatsKshivets ny2021aats
Kshivets ny2021aats
 
Kshivets esmo2021
Kshivets esmo2021Kshivets esmo2021
Kshivets esmo2021
 
2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets2021 esmo world_gi_poster_kshivets
2021 esmo world_gi_poster_kshivets
 
Kshivets iaslc singapore2020
Kshivets iaslc singapore2020Kshivets iaslc singapore2020
Kshivets iaslc singapore2020
 

Recently uploaded

vaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Alivaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Ali
RewAs ALI
 
Text Book of Critical Care Nursing ICU NURSING
Text Book of Critical Care Nursing  ICU NURSINGText Book of Critical Care Nursing  ICU NURSING
Text Book of Critical Care Nursing ICU NURSING
BP KOIRALA INSTITUTE OF HELATH SCIENCS,, NEPAL
 
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptxPULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
neeti70
 
Article - Design and evaluation of novel inhibitors for the treatment of clea...
Article - Design and evaluation of novel inhibitors for the treatment of clea...Article - Design and evaluation of novel inhibitors for the treatment of clea...
Article - Design and evaluation of novel inhibitors for the treatment of clea...
Trustlife
 
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
FFragrant
 
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
Kanhu Charan
 
lessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical educationlessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical education
DrJALAGAMTHIRUPATHIR
 
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptxPICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
Aloy Okechukwu Ugwu
 
Clinical examination of- CRANIAL.- nerves
Clinical examination of- CRANIAL.- nervesClinical examination of- CRANIAL.- nerves
Clinical examination of- CRANIAL.- nerves
DrpoonamHealthclinic
 
Types of Hypoxia, Hypercapnia, and Cyanosis
Types of Hypoxia, Hypercapnia, and CyanosisTypes of Hypoxia, Hypercapnia, and Cyanosis
Types of Hypoxia, Hypercapnia, and Cyanosis
MedicoseAcademics
 
Hand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing BookHand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing Book
BP KOIRALA INSTITUTE OF HELATH SCIENCS,, NEPAL
 
Building a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical TeamBuilding a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical Team
bkling
 
Respiratory system at glance- Neonatology
Respiratory system at glance- NeonatologyRespiratory system at glance- Neonatology
Respiratory system at glance- Neonatology
Dr. Habibur Rahim
 
Drug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptxDrug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptx
drebrahiim
 
medical law and ethics presentation .ppt
medical law and ethics presentation .pptmedical law and ethics presentation .ppt
medical law and ethics presentation .ppt
PseudoPocket
 
anthelmintic-drugs.pptx pharmacology dep
anthelmintic-drugs.pptx pharmacology depanthelmintic-drugs.pptx pharmacology dep
anthelmintic-drugs.pptx pharmacology dep
sapnasirswal
 
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
DRPREETHIJAMESP
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
MatsikoAlex
 
symblephoron types etiology management.pptx
symblephoron types etiology management.pptxsymblephoron types etiology management.pptx
symblephoron types etiology management.pptx
mohammadsumairah
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Dr. Jagroop Singh
 

Recently uploaded (20)

vaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Alivaginal thrush presentation by Dr. Rewas Ali
vaginal thrush presentation by Dr. Rewas Ali
 
Text Book of Critical Care Nursing ICU NURSING
Text Book of Critical Care Nursing  ICU NURSINGText Book of Critical Care Nursing  ICU NURSING
Text Book of Critical Care Nursing ICU NURSING
 
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptxPULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
 
Article - Design and evaluation of novel inhibitors for the treatment of clea...
Article - Design and evaluation of novel inhibitors for the treatment of clea...Article - Design and evaluation of novel inhibitors for the treatment of clea...
Article - Design and evaluation of novel inhibitors for the treatment of clea...
 
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
Safeguarding Reproductive Health- Preventing Fallopian Tube Blockage After a ...
 
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan PatroJULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
JULY 2024 Oncology Cartoons by Dr Kanhu Charan Patro
 
lessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical educationlessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical education
 
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptxPICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY-Aloy Okechukwu Ugwu.pptx
 
Clinical examination of- CRANIAL.- nerves
Clinical examination of- CRANIAL.- nervesClinical examination of- CRANIAL.- nerves
Clinical examination of- CRANIAL.- nerves
 
Types of Hypoxia, Hypercapnia, and Cyanosis
Types of Hypoxia, Hypercapnia, and CyanosisTypes of Hypoxia, Hypercapnia, and Cyanosis
Types of Hypoxia, Hypercapnia, and Cyanosis
 
Hand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing BookHand Book of Oncology Nursing - Cancer Nursing Book
Hand Book of Oncology Nursing - Cancer Nursing Book
 
Building a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical TeamBuilding a Strong Partnership with Your Medical Team
Building a Strong Partnership with Your Medical Team
 
Respiratory system at glance- Neonatology
Respiratory system at glance- NeonatologyRespiratory system at glance- Neonatology
Respiratory system at glance- Neonatology
 
Drug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptxDrug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptx
 
medical law and ethics presentation .ppt
medical law and ethics presentation .pptmedical law and ethics presentation .ppt
medical law and ethics presentation .ppt
 
anthelmintic-drugs.pptx pharmacology dep
anthelmintic-drugs.pptx pharmacology depanthelmintic-drugs.pptx pharmacology dep
anthelmintic-drugs.pptx pharmacology dep
 
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
THE REVIEW OF THE ENCYCLOPEDIA OF PURE MATERIA MEDICA.BHMS.MATERIA MEDICA.HOM...
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
 
symblephoron types etiology management.pptx
symblephoron types etiology management.pptxsymblephoron types etiology management.pptx
symblephoron types etiology management.pptx
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
 

Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis and Simulation of Alive Supersystems for Optimal Management

  • 1. P815. Local Advanced Lung Cancer: Artificial Intelligence, Complex System Analysis, Simulation of Alive Supersysems for Optimal Management INTRODUCTION The survival of patients with local advanced of lung cancer (LC) takes several months. Radical operations are extremely complex and remain the prerogative of several top thoracic surgeons of the world. The search of optimal treatment plan for LC patients (LCP) with stage T3-4N0-2M0 was realized. We examined factors in terms of precise prediction of 5-year survival (5YS) of local advanced LCP after complete (R0) combined lobectomies/pneu- monectomies (LP). METHODS We analyzed data of 198 consecutive LCP (age=58.1±8.2 years; tumor size=6.8±2.6 cm) radically operated and monitored in 1985-2024 (m=173, f=25; bi/lobectomies=84, pneumonectomies=114, mediastinal lymph node dissections=198; combined LP with resection of trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=198; only surgery-S=117, adjuvant chemoimmunoradiotherapy-AT=81: CAV/gemzar + cisplatin + thymalin/taktivin + radiotherapy 45-50Gy; T3=137, T4=61; N0=94, N1=44, N2=60, M0=198; G1=42, G2=53, G3=103; squamous=118, adenocarcinoma=65, large cell=15, central=115, peripheral=83. Multivariate Cox modeling, clustering, SEPATH, Monte Carlo, synergetics, bootstrap and neural networks computing were used to determine any significant dependence. DISCUSSION AND CONCLUSION Conclusion 1: 5YS of local advanced non- small cell LCP after combined radical procedures significantly depended on: 1) tumor characteristics; 2) LC cell dynamics; 3) blood cell circuit; 4) cell ratio factors; 5) biochemical factors; 6) hemostasis system; 7) anthropometric data; 8) adjuvant treatment; 9) procedure type. Conclusion 2: Optimal strategies for local advanced LCP are: 1) availability of very experienced thoracic surgeons because of complexity radical procedures; 2) aggressive en block surgery and adequate lymph node dissection for completeness; 3) precise prediction; 4) AT for LCP with unfavorable prognosis. Poster Presenter1: Kshivets Oleg, MD, PhD 1Bagrationovsk Hospital1, Bagrationovsk, Kaliningrad, Russia Correspondence: okshivets@yahoo.com RESULTS Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0). Cumulative Proportion Surviving (Kaplan-Meier) P=0.00018 Complete Censored 0 5 10 15 20 25 30 35 Years after Surgery -0.1 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 Procedures Combined Procedures Significant Factors (Number of Samples=3333) Rank Kendal Tau-A P< Prothrombin Index 1 -0.209 0.001 Phase Transition N0---N12 2 -0.176 0.01 Glucose 3 0.133 0.05 Weight 4 0.125 0.05 Erythrocytes/Cancer Cells 5 0.124 0.05 Age 6 -0.118 0.05 Heparin Tolerance 7 -0.118 0.05 Healthy Cells/Cancer Cells 8 0.117 0.05 Monocytes/Cancer Cells 9 0.117 0.05 Eosinophils/Cancer Cells 10 0.115 0.05 ESS 11 -0.112 0.05 Erythrocytes tot. 12 0.112 0.05 Cox Regression, n=198 Parameter Estimate Standard Error Chi- square P value 95% Lower CL 95% Upper CL T3-4 0.93365 0.314224 8.82851 0.002966 0.31778 1.54951 N0---N12 0.61808 0.156019 15.69404 0.000074 0.31229 0.92387 LC Cell Dynamics 0.29571 0.069786 17.95520 0.000023 0.15893 0.43249 Eosinophils (abs) 17.67339 4.625182 14.60098 0.000133 8.60820 26.73858 Prothrombin Index 0.04784 0.015436 9.60378 0.001942 0.01758 0.07809 Protein 0.04103 0.016873 5.91247 0.015034 0.00796 0.07410 Recalcification Time -0.00720 0.003105 5.37561 0.020420 -0.01329 -0.00111 Heparin Tolerance 0.00420 0.001189 12.47949 0.000411 0.00187 0.00653 Adjuvant Chemoimmunoradiotherapy -0.76183 0.354651 4.61434 0.031706 -1.45693 -0.06672 Thrombocytes/Cancer Cells 0.00870 0.002040 18.18890 0.000020 0.00470 0.01270 Eosinophils (tot) -3.65060 0.972359 14.09531 0.000174 -5.55638 -1.74481 Lymphocytes (tot) -0.08709 0.038280 5.17614 0.022899 -0.16212 -0.01206 Pneumonectomies/Lobectomies -0.63257 0.261220 5.86418 0.015452 -1.14455 -0.12059 Neural Networks: Baseline Error=0.000; Area under ROC Curve=1.000; Correct Classification Rate=100%; n=192 Rank Sensitivity Phase Transition N0---N12 1 1199 Thrombocytes/Cancer Cells Eosinophils/Cancer Cells Healthy Cells/Cancer Cells Stick Neutrophils/Cancer Cells Lymphocytes/Cancer Cells Segmented Neutrophils/Cancer Cells 2 3 4 5 6 7 637 474 437 376 372 333 Erythrocytes/Cancer Cells 8 299 Monocytes/Cancer Cells Leucocytes/Cancer Cells 9 10 261 159 Cumulative Proportion Surviving (Kaplan-Meier) 5YS LCP after AT=74.5%; 5YS LCP after Surgery along=55% P=0.00195. Complete Censored 0 5 10 15 20 25 30 35 Years after Surgery 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving Only Surgery Adjuvant Chemoimmunoradiotherapy Cumulative Proportion Surviving (Kaplan-Meier) 5YS LCP with N0=74.5%; 5YS LCP wih N1-2=50.7% P=0.00086. Complete Censored 0 5 10 15 20 25 30 35 Years after Surgery 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Cumulative Proportion Surviving N12 N0 Survival Function 5YS=62.4%; 10YS=50.4%; 20YS=44.6%. Complete Censored -5 0 5 10 15 20 25 30 Years after Surgery 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2 Cumulative Proportion Surviving
  • 2. Results of Kohonen Self-Organizing Neural Networks Computing in Prediction of Advanced Lung Cancer Patients Survival, n=160 REFERENCES AND ACKNOWLEDGEMENTS RESULTS Lung cancer Cell Dynamics
  • 3. SEPATH Model REFERENCES AND ACKNOWLEDGEMENTS RESULTS Lung Cancer Cell Dynamics