• Title/Summary/Keyword: Transplant

Search Result 660, Processing Time 0.034 seconds

Commensal Microbiota and Cancer Immunotherapy: Harnessing Commensal Bacteria for Cancer Therapy

  • Jihong Bae; Kwangcheon Park;You-Me Kim
    • IMMUNE NETWORK
    • /
    • v.22 no.1
    • /
    • pp.3.1-3.21
    • /
    • 2022
  • Cancer is one of the leading causes of death worldwide and the number of cancer patients is expected to continuously increase in the future. Traditional cancer therapies focus on inhibiting cancer growth while largely ignoring the contribution of the immune system in eliminating cancer cells. Recently, better understanding of immunological mechanisms pertaining to cancer progress has led to development of several immunotherapies, which revolutionized cancer treatment. Nonetheless, only a small proportion of cancer patients respond to immunotherapy and maintain a durable response. Among multiple factors contributing to the variability of immunotherapy response rates, commensal microbiota inhabiting patients have been identified as one of the most critical factors determining the success of immunotherapy. The functional diversity of microbiota differentially affects the host immune system and controls the efficacy of immunotherapy in individual cancer patients. Moreover, clinical studies have demonstrated that changing the gut microbiota composition by fecal microbiota transplantation in patients who failed a previous immunotherapy converts them to responders of the same therapy. Consequently, both academic and industrial researchers are putting extensive efforts to identify and develop specific bacteria or bacteria mixtures for cancer immunotherapy. In this review, we will summarize the immunological roles of commensal microbiota in cancer treatment and give specific examples of bacteria that show anticancer effect when administered as a monotherapy or as an adjuvant agent for immunotherapy. We will also list ongoing clinical trials testing the anticancer effect of commensal bacteria.

Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center

  • Andreas Probst;Alanna Ebigbo;Stefan Eser;Carola Fleischmann;Tina Schaller;Bruno Markl;Stefan Schiele;Bernd Geissler;Gernot Muller;Helmut Messmann
    • Clinical Endoscopy
    • /
    • v.56 no.1
    • /
    • pp.55-64
    • /
    • 2023
  • Background/Aims: Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophageal squamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyze long-term survival in a Western center. Methods: Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collected database. Results: R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria (M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%) had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It was not performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during a mean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resection was 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overall survival was significantly worse after non-curative resection (p=0.038). Conclusions: Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited and mainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved.

Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis

  • Shahab Hajibandeh;Ahmed Kotb;Louis Evans;Emily Sams;Andrew Naguib;Shahin Hajibandeh;Thomas Satyadas
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.27 no.1
    • /
    • pp.6-19
    • /
    • 2023
  • A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

Neoadjuvant chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: Meta-analysis and trial sequential analysis of randomized controlled trials

  • Shahab Hajibandeh;Shahin Hajibandeh;Christina Intrator;Karim Hassan;Mantej Sehmbhi;Jigar Shah;Eshan Mazumdar;Ambareen Kausar;Thomas Satyadas
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.27 no.1
    • /
    • pp.28-39
    • /
    • 2023
  • We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

Predictive modeling algorithms for liver metastasis in colorectal cancer: A systematic review of the current literature

  • Isaac Seow-En;Ye Xin Koh;Yun Zhao;Boon Hwee Ang;Ivan En-Howe Tan;Aik Yong Chok;Emile John Kwong Wei Tan;Marianne Kit Har Au
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.28 no.1
    • /
    • pp.14-24
    • /
    • 2024
  • This study aims to assess the quality and performance of predictive models for colorectal cancer liver metastasis (CRCLM). A systematic review was performed to identify relevant studies from various databases. Studies that described or validated predictive models for CRCLM were included. The methodological quality of the predictive models was assessed. Model performance was evaluated by the reported area under the receiver operating characteristic curve (AUC). Of the 117 articles screened, seven studies comprising 14 predictive models were included. The distribution of included predictive models was as follows: radiomics (n = 3), logistic regression (n = 3), Cox regression (n = 2), nomogram (n = 3), support vector machine (SVM, n = 2), random forest (n = 2), and convolutional neural network (CNN, n = 2). Age, sex, carcinoembryonic antigen, and tumor staging (T and N stage) were the most frequently used clinicopathological predictors for CRCLM. The mean AUCs ranged from 0.697 to 0.870, with 86% of the models demonstrating clear discriminative ability (AUC > 0.70). A hybrid approach combining clinical and radiomic features with SVM provided the best performance, achieving an AUC of 0.870. The overall risk of bias was identified as high in 71% of the included studies. This review highlights the potential of predictive modeling to accurately predict the occurrence of CRCLM. Integrating clinicopathological and radiomic features with machine learning algorithms demonstrates superior predictive capabilities.

Impact of the extent of resection of neuroendocrine tumor liver metastases on survival: A systematic review and meta-analysis

  • Rugved Kulkarni;Irfan Kabir;James Hodson;Syed Raza;Tahir Shah;Sanjay Pandanaboyana;Bobby V. M. Dasari
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.26 no.1
    • /
    • pp.31-39
    • /
    • 2022
  • In patients with neuroendocrine tumors with liver metastases (NETLMs), complete resection of both the primary and liver metastases is a potentially curative option. When complete resection is not possible, debulking of the tumour burden has been proposed to prolong survival. The objective of this systematic review was to evaluate the effect of curative surgery (R0-R1) and debulking surgery (R2) on overall survival (OS) in NETLMs. For the subgroup of R2 resections, outcomes were compared by the degree of hepatic debulking (≥ 90% or ≥ 70%). A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines using PubMed, Medline, CINAHL, Cochrane, and Embase databases. Hazard ratios (HRs) were estimated for each study and pooled using a random-effects inverse-variance meta-analysis model. Of 538 articles retrieved, 11 studies (1,729 patients) reported comparisons between curative and debulking surgeries. After pooling these studies, OS was found to be significantly shorter in debulking resections, with an HR of 3.49 (95% confidence interval, 2.70-4.51; p < 0.001). Five studies (654 patients) compared outcomes between ≥ 90% and ≥ 70% hepatic debulking approaches. Whilst these studies reported a tendency for OS and progression-free survival to be shorter in those with a lower degree of debulking, they did not report sufficient data for this to be assessed in a formal meta-analysis. In patients with NETLM, OS following surgical resection is the best to achieve R0-R1 resection. There is also evidence for a progressive reduction in survival benefit with lesser debulking of tumour load.

Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia (소아 급성 백혈병 환자에서 주조직적합항원 일치 부모자식간 조혈모세포 이식 후 임상경과)

  • Cha, Eun Young;Lee, Moon Hee;Lee, Jae Wook;Kwon, Young Joo;Lee, Dae Hyoung;Park, Young-Shil;Chung, Nak Gyun;Jeong, Dae Chul;Cho, Bin;Kim, Hack Ki
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.1
    • /
    • pp.67-72
    • /
    • 2008
  • Purpose : In this study, we retrospectively analyzed the clinical outcomes of patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) grafted from HLA-matched parents. Methods : Seven children with acute leukemia (4 acute lymphoblastic leukemia, 3 acute myeloid leukemia) in first complete remission received allogeneic HSCT from their respective parents at the St. Marys Hospital between April, 1999 and October, 2005. The median age of patients at transplantation was 5 years (range, 1-11 years; 2 male, 5 female) and the median age of donors was 35 years (range, 30-41 years; 5 male, 2 female). We investigated the clinical outcomes such as engraftment, acute and chronic graft-versus-host disease (GVHD), transplant-related morbidity and mortality, relapse and survival. Results : Median time from transplantation to last follow-up was 69.5 months (range, 18.8-96.5 months). All patients were successfully engrafted, with a median time of 11 days (range, 10-16 days) and 26 days (range, 13-39 days) for neutrophil and platelet recovery, respectively. Grade II acute GVHD occurred in 3, and grade III acute GVHD in 1 of 7 recipients. Extensive chronic GVHD developed in 2, and limited chronic GVHD in 1 of 7 recipients. Death from transplant-related complications occurred in 1, and relapse occurred in 1 of 7 recipients. Estimated 5-year overall survival was $83{\pm}15%$. Conclusion : The clinical outcomes of recipients who underwent HSCT from HLA-matched parents were comparable to those of patients who received HSCT grafted from HLA-matched sibling donors in childhood leukemia. HLA typing of parents, as well as siblings will increase the likelihood of finding an HLA-matched family donor for patients who need HSCT.

Effect of Timing of Nutrient Starvation during Transplant Production on the Growth of Runner Plants and Yield of Strawberry 'Seolhyang' (딸기 '설향' 육묘기 양분 공급 중단 시기가 자묘 생육 및 수량에 미치는 영향)

  • Kim, Dae-Young;Chae, Won Byoung;Kwak, Jung-Ho;Park, Suhyung;Cheong, Seung-Ryong;Choi, Jong Myung;Yoon, Moo Kyoung
    • Journal of Bio-Environment Control
    • /
    • v.22 no.4
    • /
    • pp.421-426
    • /
    • 2013
  • This study was conducted to investigate the effects of timing of nutrient starvation during transplant production on growth of runner plants and yield of strawberry 'Seolhyang' (Fragaria ${\times}$ ananassa). Nutrient solution supply at the level of EC (electrical conductivity) 0.8 $dS{\cdot}m^{-1}$ was terminated at interval about 10 days between July 25 and September 5. As a result, the growth of above-ground part was inhibited while root growth increased when the nutrient starvation treatment had been brought forward to July 25. It also reduced the T/R ratio significantly and chlorophyll content was tended to be lower than the other treatment. In addition, it significantly promoted the budding, flowering and harvest of first flower cluster. On the other hand, the period of harvest was delayed more than two weeks when the nutrients were continuously supplied after the middle of August. An accumulated marketable fruit yield per plant until the end of January and February was 169 and 266g, respectively in the treatment of nutrient starvation on July 25, which was 71 and 12% increase, respectively, as compared with those in the treatment of September 5. Therefore, the appropriate nutrient starvation in the late season of strawberry nursery period could be expected the increase in yield and income during the winter season by promoting the flower bud differentiation as reducing the endogenous nitrate level of the plantlet.

Optimum Grain Filling Temperature for Yield Improvement of Rice Varieties Originated from High-Altitude Areas (고위도 지역 재배 벼 품종의 수량 향상을 위한 등숙적온 분석)

  • Yang, Woonho;Kang, Shingu;Choi, Jong-Seo;Park, Jeong-Hwa;Kim, Sukjin
    • KOREAN JOURNAL OF CROP SCIENCE
    • /
    • v.65 no.3
    • /
    • pp.182-191
    • /
    • 2020
  • A field test and a phytotron study were performed over two years to examine whether rice varieties originated from higher altitude areas have lower optimum grain filling temperatures for yield improvement than the varieties from South Korea. Three varieties originated from North Korea and three varieties from northern China were compared to the same number of varieties from South Korea. In a field study, the optimum grain filling temperatures over 40 days after heading were 22.6 - 23.0℃, 21.5 - 22.3℃, and 21.5 - 23.6℃ for the varieties from North Korea, northern China, and South Korea, respectively, resulting in no significant difference among varietal groups. Meanwhile, the heading dates of the early maturing varieties from North Korea and China were 7 - 12 days earlier than that of the early maturing Odae variety from South Korea during the first transplant of 2017. The phytotron study, in which different temperature regimes were imposed from flowering/fertilization to harvest with constant daily mean temperatures, revealed that milled rice weight did not decrease under low temperatures, even at 16℃, compared to that at 22℃. At the fourth transplant in the field study, mean temperature lower than 10℃ appeared before rice grains were fully developed, resulting in yield reductions. It was concluded that rice varieties adaptable to high-altitude areas do not have lower optimum grain filling temperatures but, instead, possess shorter growth durations. It was further suggested that the optimum grain filling temperature of rice observed under natural conditions could be attributed to the lowering temperature at the late filling stage under temperate climatic conditions.

Effect of Seeding Methods and Nitrogen Fertilizer Rates on the Forage Quality and Productivity of Whole Crop Rice (파종방법 및 질소시비량이 총체 벼의 수량 및 사료가치에 미치는 영향)

  • Kim, Jong Geun;Park, Hyung Soo;Lee, Sang Hoon;Jung, Jeong Sung;Ko, Han Jong
    • Journal of The Korean Society of Grassland and Forage Science
    • /
    • v.35 no.2
    • /
    • pp.87-92
    • /
    • 2015
  • This experiment was conducted to evaluate the effect of seeding methods and application levels of nitrogen fertilizer on the yield and forage quality of whole crop rice (WCR). The WCR variety "Namil" was directly seeded on April 25 and transplanted on May 25. Five levels of nitrogen fertilizer were applied (90, 110, 140, 170 and 200 kg/ha). There were no significant differences (p<0.05) of the emergence date, heading date and disease resistance based on the nitrogen fertilizer rates; however, the WCR became dark at higher nitrogen fertilizer rates. The plant height increased at higher nitrogen fertilizer rates and the tiller number showed the same trend. In contrast to a direct seeding method, transplanting increased the tiller number. The dry matter (DM) content did not show a certain tendency based on nitrogen fertilizer rates, while the fresh and dry matter yields increased with incremental changes of the nitrogen fertilizer rates (p<0.01), and the transplant method increased the yield size. In yield analysis, the plot direct-seeded with 140 kg N/ha and the transplanting with 170kg N/ha showed the highest yields. The crude protein (CP) content increased with higher nitrogen fertilizer rate, but there was no significant differences between transplant and direct-seeding methods. The content of ADF (acid detergent fiber) and NDF (neutral detergent fiber) increased with higher nitrogen fertilizer rate, but total digestible nutrient (TDN) content decreased with increased nitrogen levels. Although high nitrogen applications increased the fresh and DM yields, the 140 kg/ha nitrogen fertilizer level is recommended as the proper nitrogen fertilizer level, considering both yield and the environments.