Proteins
have gained increasing success as therapeutic agents;
however, challenges exist in effective and efficient delivery. In
this work, we present a simple and versatile method for encapsulating
proteins via complex coacervation with oppositely charged polypeptides,
poly(l-lysine) (PLys) and poly(d/l-glutamic
acid) (PGlu). A model protein system, bovine serum albumin (BSA),
was incorporated efficiently into coacervate droplets via electrostatic
interaction up to a maximum loading of one BSA per PLys/PGlu pair
and could be released under conditions of decreasing pH. Additionally,
encapsulation within complex coacervates did not alter the secondary
structure of the protein. Lastly the complex coacervate system was
shown to be biocompatible and interact well with cells in vitro. A
simple, modular system for encapsulation such as the one presented
here may be useful in a range of drug delivery applications.
Negative margins and bone resection (where needed) were identified as the most important factors influencing overall survival. Neoadjuvant therapy before pelvic exenteration did not affect survival, but was associated with higher rates of readmission, complications and radiological reintervention.
Background: According to the American Joint Committee on Cancer staging for cancer of the colon, a minimum of 12 lymph nodes (LN) has to be sampled for accurate staging. This has bearing on the long-term prognosis and the need for adjuvant chemotherapy. The aim of this study was to revisit the association of lymph node yield and the long-term survival in patients with stages I and II, i.e. node-negative, colon cancer. Method: Consecutive patients who underwent elective or emergency curative resections for cancer of colon between the years 2003 and 2012 were retrospectively reviewed. Only patients with stage I or II diseases (AJCC 8th edition) were included. They were analysed in three groups, LN<12, LN12-19 and LN≥20. Their clinic-pathological characteristics were compared. The disease-free (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with the log-rank test. Results: There was a total of 659 patients included in the analysis. Twelve or more LN were found in 65.6% of the specimens. The mean follow-up was 83.9 months. LN≥20 had significantly better DFS (p = 0.015) and OS (p = 0.036), whereas LN<12 had similar DFS and OS when compared to LN12-19. The advantage in DFS and OS were mainly seen in those with stage II diseases. A lymph node yield of greater than 20 was one of the predictors of favourable DFS, hazard ratio 0.358; 95% CI 0.170-.756, p = 0.007. Conclusion: The lymph node yield had a significant association with survival outcomes. A lymph node yield of 20 or more was associated with better survival outcomes. On the other hand, lymph node yield less than 12 was not shown to have inferior survival outcomes when compared to those between 12 and 19.
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