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At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
DOE OSTI2025

Velocity- and pressure-based metrics for estimating strike injuries during fish passage through hydro turbines

Hydropower is a crucial source of clean and reliable energy worldwide, and its importance will continue to grow. To enhance the environmental sustainability of hydropower development and operations, it is essential to predict the strike injury rates of fish passing through turbines accurately and cost-effectively. However, conventional experiments involving a large number of live fish are still commonly conducted in practice, and previous attempts mainly focused on the dose-response relationships at an individual level or relative comparisons of biological characterization between different conditions. Thus, this study proposes two novel strike metrics based on velocity and pressure (M V and M P ) measured by the cutting-edge Sensor Fish (SF) technology, designed to quantify the biological effects of strikes and collisions between fish and rigid hydraulic structures. SF measurements and 48-hour survival rates of live fish from a study conducted at the Ice Harbor Dam on the Snake River were used to establish thresholds for the two proposed metrics. These metrics and thresholds were then applied to three additional SF studies conducted at hydropower facilities featuring Kaplan turbines within the Columbia River basin. Results from the application of the strike metrics indicate that the estimated survival rates derived from both metrics agree well with previously reported live fish survival rates. Furthermore, the study identified specific passage regions with elevated risks of fish mortality due to strikes and collisions. Overall, the proposed strike metrics present a reliable and cost-effective approach to reducing reliance on live fish and lowering costs in fish passage studies.

Biological characterization↗
DOE OSTI2024

Unconventional Error Cancellation Explains the Success of Hartree–Fock Density Functional Theory for Barrier Heights

Energy barriers, which control the rates of chemical reactions, are seriously underestimated by computationally efficient semilocal approximations for the exchange-correlation energy. The accuracy of a semilocal density functional approximation is strongly boosted for reaction barrier heights by evaluating that approximation non-self-consistently on Hartree–Fock electron densities, which has been known for ~30 years. Here, the conventional explanation is that the Hartree–Fock theory yields the more accurate density. This work presents a benchmark Kohn–Sham inversion of accurate coupled-cluster densities for the reaction H 2 + F → HHF → H + HF and finds a strong, understandable cancellation between positive (excessively overcorrected) density-driven and large negative functional-driven errors (expected from stretched radical bonds in the transition state) within this Hartree–Fock density functional theory. This confirms earlier conclusions (Kaplan, A. D., et al. J. Chem. Theory Comput. 2023, 19, 532–543) based on 76 barrier heights and three less reliable, but less expensive, fully nonlocal density functional proxies for the exact density.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2020

Convergence of nuclear effective field theory with perturbative pions

The classic paper by Fleming, Mehen, and Stewart (FMS) cast doubts on the convergence of spin-triplet nucleon-nucleon partial wave scattering amplitudes when following the proposal of Kaplan, Savage, and Wise to construct nuclear effective field theory (EFT) around the unitary fermion limit with perturbative pion exchange. FMS identified the subclass of iterated one-pion exchange potential graphs as the cause of this poor convergence, which they showed persisted in the chiral limit. Theoretical tools are developed in this work to compute these Feynman graphs analytically to high order in all angular momentum channels simultaneously, examining the amplitudes computed to seven loops in the $\textit{L = J}$ channels and three loops in the coupled $\textit{L = J}$ ± 1 channels. One finds that there is nothing pathological about the perturbative expansion of a 1/$r^3$ potential in general and that the expansion converges satisfactorily in all partial waves except those with the lowest angular momentum, particularly the $^3P_0$ and the coupled $^3S_1 - ^3D_1$ channels. The results corroborate work by Birse, which suggests possible avenues to explore for improving the range of validity of the EFT expansion.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2021

Uranium Immobility in Tims Branch Wetland

The objective of this study was to address an item identified by the Low-Level Waste Disposal Facility Federal Review Group (LFRG) panel during their review of the Savannah River Site’s Composite Analysis. Their concern was that the Tims Branch wetland, which has elevated levels of uranium (U) originating from site operations between 1952 to 1985, may be a secondary source term, posing a human health risk. This report briefly describes three studies dealing with: 1) quantifying the mass of U remaining in the wetland, 2) quantifying the tendency of U to release from Tims Branch sediment, and 3) describing the distribution of U in aqueous and suspended solids in Tims Branch water during episodic storm events. The Tims Branch wetland has been extremely effective for the last 50 years at immobilizing U released to the system. A detailed map including 270,000 gamma spectra of the U distribution in the wetland indicated that 84% of the initial 43,500 kg U introduced in the system remain there after 50 years (Kaplan et al., 2020). The effectiveness of immobilizing U is supported by stream water measurements collected over the last several decades indicating that U concentrations have been consistently below drinking water regulatory limits (i.e., the EPA Maximum Contaminant Level, 30 pg/L (SRNS, 2019)). Furthermore, using contaminated Tims Branch sediments, in situ desorption Kd values (ratio of U sediment/U Water) were extremely high, ranging from 104to 106 L/kg, suggesting the U is strongly bound to these wetland sediments. Finally, a detailed study of Tims Branch stream water properties during episodic rain events indicated that essentially all the U transported in this stream was associated with suspended solids (Batson et al., 1996). Together these findings indicate that the Tims Branch wetland is extremely effective in its present state at immobilizing U and that the small masses of U released downstream will be predominantly in association with suspended solids.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2025

Self-Lubricating Bushing Testing for John Day Dam Ka plan Turbine Replacement

The goal of this testing program is to find suitable self-lubricated alternatives to replace the in use oil lubricated grooved-bronze bushing in Kaplan runner hubs that are currently being utilized at John Day Dam operated by the U.S. Army Corps of Engineers (USACE). Scaled bushing testing utilizing a Pacific Northwest National Laboratory designed, fabricated, and operated Bushing Test Stand under the direction and funding from USACE determined that self-lubricated bushings tested appear capable of outperforming the current oil-lubricated bronze bushings. Performance tests are focused on durability which includes cyclic load bearing properties and articulations under various loading scenarios. This testing was performed at nominally 1/5 th scale. A scaling sensitivity analysis determined that scaled testing results apply to prototypic size. This report shows the direct comparison between the current baseline bronze bushing to self-lubricated bushings from various manufacturers. Bushing data like coefficient of friction and bushing material loss (associated with bushing wear) was determined. Self-lubricated bushings tested include products manufactured specifically for hydropower applications by the following companies: Trelleborg, Kamatics, Anonymous, and Tenneco/Deva.

42 ENGINEERING↗
DOE OSTI2022

Prognostic importance of the preoperative New‐Naples prognostic score for patients with gastric cancer

Abstract Background The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New‐NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis. Methods This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t‐ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan–Meier method and log‐rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C‐index), and decision curve. Results A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New‐NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA ( P = 0.026), Borrmann type ( P = 0.001), pTNM ( P < 0.001), New‐NPS ( P < 0.001), and nerve infiltration ( P = 0.035) were independent risk factors for prognosis. Conclusion The New‐NPS based on the cutoff values of NLR, LMR, Alb, and TC is not only suitable for predicting prognosis but can also be combined with clinicopathological characteristics to construct a nomogram model for GC patients.

Wang, Hao↗
DOE OSTI2023

The Association Between Baseline Hepatic or Renal Function and Clinical Outcomes for Patients With Non–Small Cell Lung Cancer Treated With a PD –1/PD– L1 Blocking Antibody Using Real–World and Trial Data

Clinical trials have demonstrated the benefit of PD-1/PD-L1 blocking antibodies for the treatment of patients with advanced non-small cell lung cancer (NSCLC) in defined patient populations that often exclude patients with moderate or severe hepatic or renal impairment. We assessed the association between overall survival (OS) and baseline organ function in patients with advanced NSCLC treated with PD-1/PD-L1 blocking antibodies in real-world data (RWD; patient-level data from electronic health records) and pooled clinical trial data submitted to the US Food and Drug Administration (FDA). The Kaplan–Meier estimator was used to estimate OS in different subgroups based on organ function. Unadjusted and adjusted Cox proportional hazards models were used to estimate the association between OS and organ function. In this hypothesis-generating study, baseline renal impairment did not appear to be associated with OS, while patients with baseline liver impairment had shorter OS. RWD provided information on a broader range of renal and hepatic function than was evaluated in clinical trials and hold promise to complement trial data in better understanding populations not represented in clinical trials.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Safe passage of American Eels through a novel hydropower turbine

Abstract Objective Study the effects of downstream passage through a novel turbine designed for fish safety, the Restoration Hydro Turbine (RHT), on American Eels Anguilla rostrata in a recirculating turbine test facility. Methods A 55‐cm‐diameter RHT was operated under 10 m of hydraulic head and 667 revolutions/min. In total, 131 eels were passed through the turbine and 43 eels were used as experimental controls (length = 33.9–65.5 cm). High‐speed video of passage through the runner region was captured for 89% of turbine‐passed eels, and injury and behavioral effects were recorded immediately before and after passage, as well as after a 48‐h holding period. A subset of 37 eels was additionally examined with X‐ray imaging for internal injuries. Result The 48‐h survival rate for both treatment and control groups was 100%, with no major internal or external injuries present after the holding period. Conclusion This is a substantial improvement over eel survival rates through conventional Kaplan and Francis turbines, which may range from 40% to 95%, and suggests that hydropower turbines designed for safe downstream fish passage could be implemented without major impacts to eels.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

The effect of tumor size and location on efficacy and safety of US- and CT- guided percutaneous microwave ablation in renal cell carcinomas

Purpose: To evaluate the effect of size and central location of the tumor on safety and efficacy of percutaneous CEUS- and CT-guided MWA in biopsy-proven renal cell carcinomas (RCCs). Materials and methods: In this IRB-approved retrospective study, 69 biopsy-proven renal tumors in 56 patients, who underwent MWA in our institution from January 2013 to March 2017, were evaluated. Data collection included demographics, tumor characteristics, procedural protocols, and follow-up visits within 6 months post procedure. Primary outcomes were assessed by technical success (TS), local tumor progression (LTP), and complications. The Kaplan–Meier analysis was used for survival rate. Results: Overall technical success was achieved for all 69 lesions (92.8% primary TS, 100% overall). Median nephrometry score was 8 (4–11) and median tumor size was 2.5 cm (0.8–7). Five lesions which required second ablation had significantly higher median tumor size 4 cm (P = 0.039) with the same nephrometry score. Renal function remained stable with no significant change in eGFR before or after ablation. The LTP rate was 5.8%. The most recurrent tumors were clear cell (50%) followed by papillary tumors (25%). The complication rate was 5.8% with minor complications (hematoma and pain) and no major issues. There was no significant association between nephrometry score and technical success, recurrence, or complication rates. Overall and tumor-specific survival rates were 96.7% and 100% at 11.9 months. Conclusions: Image-guided MWA appears to be a safe and effective treatment regardless of nephrometry score and tumor location with high technical success, low recurrence, and complication rates.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Correlation between SACE (Subjective Angiographic Chemoembolization Endpoint) score and tumor response and its impact on survival after DEB-TACE in patients with hepatocellular carcinoma

Purpose: To asses angiographic and computed tomographic success criteria during and after transcatheter arterial drug-eluting bead chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC) and its impact on progression-free survival (PFS) and overall survival (OS). Methods: In this retrospective single-center study, 50 patients with unresectable HCC having undergone DEB-TACE from January 2010 to July 2015 were assessed. The angiographic endpoint was classified by Subjective Angiographic Chemoembolization Endpoint (SACE) scale. Relative tumor density in arterial (D{sub Art}) and portal venous phase (D{sub PV}) computed tomography post- versus pre-DEB-TACE were calculated, respectively. Tumor response according to modified Response Criteria in Solid Tumors (mRECIST) was assessed. Univariate Kaplan–Meier and Cox regression analysis were carried out. Results: SACE scores I, II, III, and IV were found in 1 (2%), 20 (40%), 15 (30%), and 14 (28%) patients, respectively. Median OS and PFS were 14.2 and 5.5 months, respectively. Death rates at 6 months, 1 year and 2 years were 24%, 38%, and 52%, respectively. SACE score during DEB-TACE significantly correlated with local and overall mRECIST results (local: p < 0.001, r = 0.49, overall: p = 0.042, r = 0.29) and inversely correlated with D{sub PV} (p = 0.005, r = − 0.40). In univariate analysis, progressive disease (PD) according to mRECIST and increase of D{sub Art} and D{sub PV} were associated with significantly shorter PFS. Modified RECIST independently predicted OS (hazard ratio for complete remission vs. PD = 0.15, 95% confidence interval 0.03–0.68, p = 0.014). Conclusions: A direct impact of SACE on PFS or OS could not be shown. However, SACE significantly correlated with local and overall mRECIST tumor response that again significantly predicted OS. We therefore postulate an indirect impact of SACE on OS. Consequently, complete embolization should be attempted.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Endovascular Recanalization of Thromboangiitis Obliterans (Buerger’s Disease) in Twenty-Eight Consecutive Patients and Combined Antegrade–Retrograde Intervention in Eight Patients

Purpose: The aim of the study was to evaluate the technical success of the procedure and the clinical efficacy of treatment in patients with thromboangiitis obliterans (TAO) (Buerger’s disease) based on a change in the Rutherford classification. Materials and Methods: A total of 28 consecutive patients (26 males, 2 females, mean age 43.3 ± 5.32 years) underwent endovascular recanalization with a diagnosis of TAO, between April 2015 and July 2018. After unsuccessful attempts using the antegrade approach, retrograde approaches were used in 8 patients under ultrasound guidance. Clinical follow-up was routinely performed at 1-month, 3-month, 6-month, and 1-year intervals. Results: A total of 28 TAO patients underwent 40 procedures in 32 limbs. Technical success was achieved in 28 of the 32 limbs (87.5%). In total, 45 of 59 (76.2%) below the knee arteries were treated successfully. One major amputation was performed, providing a 96.8% rate for limb salvage both at 12 and 24 months. Amputation-free survival estimated by Kaplan–Meier analysis was 84% at 12 and 24 months. Primary patency rates at 12, 24, and 36 months were 84%, 78%, and 75%, respectively. Secondary patency rates were 87.5% both at 12 and 24 months. Conclusion: Endovascular treatment is a technically feasible and potentially effective treatment modality for Buerger’s disease. Combined antegrade and retrograde interventions in TAO patients may improve technical success and clinical recovery, especially in cases where the antegrade approach has failed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Two-Year Mortality After Angioplasty of the Femoro-Popliteal Artery with Uncoated Balloons and Paclitaxel-Coated Balloons—A Pooled Analysis of Four Randomized Controlled Multicenter Trials

Purpose: In view of a recent meta-analysis reporting increased mortality following angioplasty with paclitaxel-coated devices in peripheral arteries, we performed a patient-level 2-year mortality analysis based on pooled original data of four randomized controlled trials (THUNDER, FEMPAC, PACIFIER and CONSEQUENT). Methods and Results: Clinical data of four randomized controlled trial were pooled to assess 2-year mortality following paclitaxel-coated balloon (PCB) angioplasty compared to angioplasty without paclitaxel (control group). A logistic regression model was applied to identify potential predictors of mortality. At two years, 13 of 185 (7.0%) patients had died in the control group and 16/184 (8.7%) in the PBC group, p = 0.55. Kaplan–Meier analysis revealed no significant difference from all-cause death at 2 years (log rank p = 0.54). Causes of death were well balanced between the groups with no pattern or trend in favour of any specific causes in the PBC group. Logistic regression revealed that treatment groups (controls or PBC) were not a predictor of 2-year mortality. The only predictor for mortality was patient age ≥ 75 years. The delivered paclitaxel doses per patient were not significantly different in patients that died and those who did not die during the 24-month follow-up (5.300 ± 4.224 μg vs. 6.248 ± 4.629 μg, p = 0.433). Conclusions: Based on original patient-level data of four pooled randomized controlled trials, we found no increase in 2-year mortality in patients treated with PCB compared to control patients treated with uncoated balloons. Causes of death were well balanced between PCB and control patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Drug-Eluting Balloon Angioplasty for Juxta-Anastomotic Stenoses in Distal Radiocephalic Hemodialysis Fistulas: Long-Term Patency Results

Purpose: To evaluate long-term primary and secondary patency results of drug-eluting balloon angioplasty for the treatment of juxta-anastomotic stenoses in distal radiocephalic arteriovenous fistulas. Materials and Methods: Thirty-eight patients with juxta-anastomotic stenotic distal radiocephalic arteriovenous fistulas who underwent endovascular treatment with drug-eluting balloons between January 2014 and August 2016 in our interventional radiology department were included in this retrospective study. Color Doppler examination for follow-up was performed 15 days, 6 months, 12 months, 18 months, 24 months, 36 months, and 48 months after the procedure. Kaplan–Meier analysis was used to estimate primary and secondary patency rates. Results: Totally, 42 angioplasty with drug-eluting balloons was performed in 38 patients (20 men and 18 women; mean age 66.42 ± 12.01). Technical and clinical success rate was 100% (42/42). The mean follow-up period was 27.71 months ± 12.98 (range, 1–54 months). The estimated primary patency rates at 6 months were 94.7% (95% CI, 80.9%–99.0%), at 12 months were 81.2% (95% CI, 64.6%–91.4%), at 24 months were 60.7% (95% CI, 43.6%–75.7%), and at 48 months were 53.1% (95% CI, 36.5%–69.1%). The estimated secondary patency rates at 6 months were 97.3% (95% CI, 84.5%–99.8%), at 12 months were 86.5% (95% CI, 70.7%–94.8%), at 24 months were 69.0% (95% CI, 51.8%–82.4%), and at 48 months were 61.7% (95% CI, 44.6%–76.5%). Conclusion: Drug-eluting balloon angioplasty is a useful, effective technique in dysfunctional radiocephalic fistulas due to juxta-anastomotic stenoses. We demonstrated remarkably high primary patency rates at 6, 12, 24, and 48 months.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Percutaneous Cryoablation of Stage T1b Renal Cell Carcinoma: Safety, Technical Results, and Clinical Outcomes

Purpose: The use of percutaneous cryoablation for T1b (4.1–7.0 cm) renal cell carcinoma, has not yet been widely adopted. The purpose of this study was to describe our experience in the cryoablation of stage T1b tumors with an emphasis on safety, technical results, and clinical outcomes. Materials and Methods: A retrospective review of hospital records identified 37 patients who underwent cryoablation for T1b lesions from 2008 to 2018. Patient demographics, comorbidities, tumor characteristics, technical parameters, and outcomes were recorded and analyzed. Recurrence-free, overall, and cancer-specific survival rates were estimated using the Kaplan–Meier method. Results: Thirty-seven patients (22 males, 15 females; mean age 66.5 ± 11.3) with 37 T1b tumors (mean diameter 47.3 ± 6.3 mm) were included. A median of 3 probes were used (range: 1–7). Angio-embolization was used in 3/37 (8.1%) and 2/37 patients (5.4%) required hydrodissection. The mean number of total cryoablation procedures for each patient was 1.5 (median 1; range: 1–4). Technical success was achieved in 88.2% of patients. Recurrence-free survival was 96.5%, 86.1%, and 62.6% at 1, 2, and 3 years respectively. Cancer-specific survival was 100% at 1, 2, and 3 years respectively. Overall survival was 96.7%, 91.8%, and 77.6% at 1, 2, and 3 years respectively. Complications classified as CIRSE grade 2 or higher occurred in 6/37 (16.2%) patients. Conclusion: T1b cryoablation is associated with high rates of technical success, excellent cancer-specific survival, and an acceptable safety profile. Level of Evidence: Level 4, Case Series.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Restenosis Rates After Drug-Eluting Stent Treatment for Stenotic Small-Diameter Renal Arteries

Purpose: To determine primary rates in small-diameter renal arteries, including complex bifurcation lesions, treated with drug-eluting stents (DES) in patients with atherosclerotic renal artery stenosis. Materials and Methods: This is a retrospective single-institution study. A total of 37 patients with 39 stented renal arteries were included. Patient and procedural data were obtained from the electronic medical record. Survival free from restenosis was estimated using the Kaplan–Meier method with patients stratified into two groups based on renal artery diameters (≤ 3.5 mm or > 3.5 mm). Univariate Cox proportional models were used to estimate hazard ratios associated with clinical and angiographic variables. Results: Average renal artery diameter at time of treatment was 3.4 mm ± 0.4 mm. The median survival free from restenosis was 992 days, with 11 out of 37 (29.7%) developing an in-stent restenosis. Renal arteries < 3.5 mm in diameter had similar patency rates as renal arteries > 3.5 mm (P = 0.33). The 1-, 2-, and 5-year patency rates were 71%, 63%, and 38%, respectively. History of stroke was the only comorbidity to portend a significantly greater rate of restenosis (hazard ratio 3.77; 95%CI, 1.05–13.6; P = 0.04). Medications did not statistically alter the risk of restenosis. Conclusion: Revascularization of renal arteries with DES achieved similar primary patency rates irrespective of renal artery diameter. Stent configuration was not associated with time to renal replacement therapy or all-cause mortality. Level of Evidence: Level 3, Cohort Study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2024

Risk-Aware Framework Development for Disruption Prediction: Alcator C-Mod and DIII-D Survival Analysis

Abstract Survival regression models can achieve longer warning times at similar receiver operating characteristic performance than previously investigated models. Survival regression models are also shown to predict the time until a disruption will occur with lower error than other predictors. Time-to-event predictions from time-series data can be obtained with a survival analysis statistical framework, and there have been many tools developed for this task which we aim to apply to disruption prediction. Using the open-source Auton-Survival package we have implemented disruption predictors with the survival regression models Cox Proportional Hazards, Deep Cox Proportional Hazards, and Deep Survival Machines. To compare with previous work, we also include predictors using a Random Forest binary classifier, and a conditional Kaplan-Meier formalism. We benchmarked the performance of these five predictors using experimental data from the Alcator C-Mod and DIII-D tokamaks by simulating alarms on each individual shot. We find that developing machine-relevant metrics to evaluate models is an important area for future work. While this study finds cases where disruptive conditions are not predicted, there are instances where the desired outcome is produced. Giving the plasma control system the expected time-to-disruption will allow it to determine the optimal actuator response in real time to minimize risk of damage to the device.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗
DOE OSTI2019

Outcomes in patients ≥ 80 years with a diagnosis of a hepatopancreaticobiliary (HPB) malignancy

Older patients are underrepresented in oncological clinical trials. The incidence of hepatopancreaticobiliary (HPB) malignancies is higher in older patients, but data on outcomes are lacking. This study assessed patient outcomes in those < 80 and ≥ 80 years with a HPB malignancy seen at a tertiary referral centre, The Christie NHS Foundation Trust. Data on patients with a HPB malignancy were collected retrospectively between 2012 and 2017 via on-line case-note review. Survival was calculated using the Kaplan–Meier method and prognostic factors using log-rank analysis. Of 1421 patients, 10% were ≥ 80 years. Of patients < 80 and ≥ 80 years, 56% and 57% had pancreas cancer, 39% and 36% biliary tract cancer, and 5% and 7% had hepatocellular carcinoma, respectively. Amongst patients ≥ 80 years, 75% had an Eastern Cooperative Oncology Group performance status (ECOG PS) 0–2. Patients ≥ 80 years had higher rates of comorbidity; 28% received systemic anti-cancer therapy (SACT), compared with 62% of patients < 80 years. Best supportive care (BSC) was instituted in 44% of older patients, compared with 13% in those < 80 years. Of patients ≥ 80 years who received SACT, 82% received monotherapy. Median overall survival (OS) for patients receiving palliative SACT was 10.07 months (95% CI 8.89–11.08) and 10.10 months (95% CI 6.30–12.30) in patients < 80 and ≥ 80 years, respectively, p 0.41; ECOG PS (p < 0.001) was prognostic for OS in older patients but Adult Comorbidity Evaluation-27 comorbidity score (p = 0.07, when comparing groups of ACE score ≤ 1 and > 1) was not. Baseline factors were similar in both age cohorts, but more comorbidities were present in older patients. Older patients were less likely to receive SACT, but when they did, they had an equivalent benefit in OS to younger patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2020

Clinically applicable 53-Gene prognostic assay predicts chemotherapy benefit in gastric cancer: A multicenter study

BACKGROUND:We previously established a 53-gene prognostic signature for overall survival (OS) of gastric cancer patients. This retrospective multi-center study aimed to develop a clinically applicable gene expression detection assay and to investigate the prognostic value of this signature. METHODS:A TCGA gastric adenocarcinoma cohort (TCGA-STAD) was used for comparing 53-gene signature with other gene signatures. A high-throughput mRNA hybridization gene expression assay was developed to quantify the expression of 53-genes in formalin-fixed paraffin-embedded tissues of 540 patients enrolled from three hospitals. 180 patents were randomly selected from two hospitals to build a prognostic prediction model based on the 53-gene signature using leave-p-out (one-third out) cross-validation method together with Cox regression and Kaplan-Meier analysis, and the model was assessed on three validation cohorts. FINDINGS:In the evaluation phase, studies based on TCGA-STAD showed that the 53-gene signature was significantly superior to other three prognostic signatures and was independent of TCGA molecular subtypes and clinical factors. For clinical validation and utility, the prognostic scores were generated using the newly developed assay, which was reliable and sensitive, in 100 sampling training sets and were significantly associated with OS in 100 sampling validation sets. The scores were significantly associated with OS in three independent and combined validation cohorts, and in patients with stages II and III/IV. The multivariate Cox regression demonstrated that the prognostic power of the score was independent of clinical factors, consistent with those findings in the TCGA dataset. Finally, patients with good prognostic scores exhibited significantly a better 5-year OS rate from adjuvant FOLFOX chemotherapy after surgery than from other chemotherapies. INTERPRETATION:The 53-gene prognostic score system is clinically applicable for predicting the OS of patients independent of clinical factors in gastric cancers, which could also be a promising predictive biomarker for FOLFOX regimen. FUNDING:Chinese National Science and Technology, National Natural Science Foundation and Natural Science Foundation of Jiangsu Province.

60 APPLIED LIFE SCIENCES↗