Kaplan-Meier curves of overall survival (A) and disease-free survival (B).

<p>The early group consisted of patients who received early initiation of adjuvant treatment (<35 days), and the delayed group consisted of patients who received delayed initiation of adjuvant treatment (≥35 days).</p

Early versus delayed initiation of adjuvant treatment for pancreatic cancer

<div><p>Background</p><p>Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor showing a tendency for early recurrence, even after curative resection. Although adjuvant treatment improves survival, it is unclear whether early adjuvant treatment initiation yields better outcomes in patients with PDAC.</p><p>Methods</p><p>We retrospectively enrolled 113 patients who underwent chemotherapy or chemoradiotherapy after curative resection of PDAC: Fifty-six and 57 patients were in the early and delayed groups, respectively based on the median time of treatment initiation (35 days [range, 20–83 days]).</p><p>Results</p><p>Patient baseline characteristics were comparable in both groups, except for grade III or IV postoperative complications (5.4% in the early group vs. 22.8% in the delayed group). With a median 20.3-month follow-up, the overall survival (OS) and disease-free survival (DFS) times were 29.5 and 14.7 months, respectively. The early group had significantly prolonged OS (39.1 vs. 21.1 months, p = 0.018) and DFS (18.8 vs. 10.0 months, p = 0.034), compared to the delayed group. Among 71 patients who completed planned adjuvant treatment, patients in the early group tended to have longer, though not statistically significant, OS and DFS times than those in the delayed group. In 67 patients without postoperative complications, patients in the early group had longer OS (42.8 vs. 20.5 months, p = 0.002) and DFS (19.6 vs. 9.1 months, p = 0.005) than those in the delayed group. By multivariate analysis, incompletion of treatment (hazard ratio [HR]: 4.039, 95% confidence interval [CI]: 2.334–6.992), delayed treatment initiation (HR: 1.822, 95% CI: 1.081–3.070), and positive angiolymphatic invasion (HR: 2.116, 95% CI: 1.160–3.862) were significantly associated with shorter OS.</p><p>Conclusions</p><p>Adjuvant treatment should be delivered earlier and completed for better outcomes in resected PDAC patients, especially without postoperative complications.</p></div

Risk factors for overall survival.

<p>Risk factors for overall survival.</p

Kaplan-Meier curves of overall survival (A) and disease-free survival (B) in patients who received all six planned cycles of treatment and those who did not.

<p>There was no difference in overall or disease-free survival for patients who received all six planned cycles of therapy (P = 0.129 and = 0.195, respectively) and those who did not (P = 0.206 and = 0.133, respectively).</p

Kaplan-Meier curves of overall survival (A) and disease-free survival (B) based on the starting point of the survival interval (date of adjuvant treatment).

<p>Kaplan-Meier curves of overall survival (A) and disease-free survival (B) based on the starting point of the survival interval (date of adjuvant treatment).</p

The effect of time to adjuvant treatment initiation on overall survival (A, C) and disease-free survival (B, D) in patients without or with postoperative complications, respectively.

<p>The effect of time to adjuvant treatment initiation on overall survival (A, C) and disease-free survival (B, D) in patients without or with postoperative complications, respectively.</p

Patient flow diagram.

<p>Enrolled patients were divided into early and delayed groups, according to the median time of adjuvant treatment initiation.</p

Self-Organized One-Dimensional Cobalt Compound Nanostructures from CoC₂O₄ for Superior Oxygen Evolution Reaction

In this work, we reported that a self-organized cobalt oxalate (CoC₂O₄) with one-dimensional structures was applied to investigate the electrocatalytic behavior of an oxygen evolution reaction (OER) in alkaline media. The one-dimensional CoC₂O₄ structure was fabricated by a facile anodization process, i.e., reacting the Co metal surface with oxalate ions. The dense CoC₂O₄ nanowires were evenly distributed on the Co substrate. By thermal treatment, Co₃O₄ one-dimensional structures were easily formed from CoC₂O₄ structures. In addition, we confirmed that fabricated CoC₂O₄ could also be transformed to Co­(OH)₂ with one-dimensional structures via a spontaneous chemical reaction in alkaline, which serves better electrocatalytic performance for an OER

Tumor Heterogeneity in Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced Gastric Cancer Assessed by CT Texture Analysis: Association with Survival after Trastuzumab Treatment

<div><p>Background</p><p>Image texture analysis is a noninvasive technique for quantifying intratumoral heterogeneity, with derived texture features reported to be closely related to the treatment outcome of tumors. Gastric cancer is one of the most common tumors and the third leading cause of cancer-related deaths worldwide. Although trastuzumab is associated with a survival gain among patients with human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer, optimal patient selection is challenging. The purpose of this study was to determine whether CT texture features of HER2-positive gastric cancer were related to the survival rate after trastuzumab treatment.</p><p>Methods and Findings</p><p>Patients diagnosed with HER2-positive advanced gastric cancer from February 2007 to August 2014 were retrospectively selected. Using in-house built software, histogram features (kurtosis and skewness) and gray-level co-occurrence matrices (GLCM) features (angular second moment [ASM], contrast, entropy, variance, and correlation) were derived from the CT images of HER2-positive advanced gastric cancer in 26 patients. All the patients were followed up for more than 6 months, with no confirmed deaths. The patients were dichotomized into a good and poor survival group based on cutoff points of overall survival of 12 months. A receiver-operating characteristics (ROC) analysis was performed to test the ability of each texture parameter to identify the good survival group. Kaplan–Meier curves for patients above and below each threshold were constructed. Using a threshold of >265.8480 for contrast, >488.3150 for variance, and ≤0.1319×10^−3. for correlation, all of the area under the ROC curves showed fair accuracy (>0.7). Kaplan–Meier analysis showed statistically significant survival difference between two groups according to optimal cutoff values of contrast, variance, correlation and ASM. However, as this study had a small number of patients, a further study with a larger population will be needed to validate the results.</p><p>Conclusions</p><p>Heterogeneous texture features on CT images were associated with better survival in patients with HER2-positive advanced gastric cancer who received trastuzumab-based treatment. Therefore, texture analysis shows potential to be a clinically useful imaging biomarker providing additional prognostic information for patient selection.</p></div

Comparisons of predicted 3- (A) and 5-year (B) mortality by geriatric prognostic index (GPI) score.

<p>Dotted lines show the 95% confidence interval. Predicted 3-year mortality (%) = 100 * exp(-4.903 + 0.726 * [GPI]) / (1 + exp(-4.903 + 0.726 * [GPI])); Predicted 5-year mortality (%) = 100 * exp(-4.247 + 0.784 * [GPI]) / (1 + exp(-4.247 + 0.784 * [GPI])) KLoSHA, Korean Longitudinal Study on Health and Aging; SNUBH, Seoul National University Bundang Hospital</p