A new monoclonal antibody (MAb), 22‐1‐1, acts against a novel tumor‐associated antigen (Ag) strongly expressed in human uterine cervical adenocarcinomas. A cDNA encoding the Ag recognized by the 22‐1‐1 MAb has been isolated and called RCAS1 (receptor‐binding cancer antigen expressed on SiSo cells). RCAS1 can induce growth arrest and apoptosis in RCAS1 receptor‐positive cells including T cells and natural killer cells in vitro. These results suggest that RCAS1 is involved in tumor escape from the immune system. Immunohistochemical analysis revealed the relationship between RCAS1 expression and clinicopathological variables (age, sex, smoking, histology, differentiation grade, pathological T factor, N factor and stage) and the prognostic significance of RCAS1 in 66 lung‐cancer patients who underwent curative operations: 33 adenocarcinomas, 24 squamous‐cell carcinomas, 3 large‐cell carcinomas, 4 adenosquamous carcinomas and 2 small‐cell carcinomas. Median follow‐up period of 64 non‐small‐cell carcinomas (NSCLCs) was 67.4 months. RCAS1 was expressed in 74.2% of lung cancers. RCAS1 in NSCLC cases with advanced T factor or pathological stage or in poorly differentiated adenocarcinomas was highly expressed. Furthermore, RCAS1 expression inducing apoptosis of tumor‐infiltrating lymphocytes was a significant prognostic factor in NSCLC (p < 0.03). Int. J. Cancer 89:488–493, 2000. © 2000 Wiley‐Liss, Inc.

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The correlation between preoperative nutritional parameters and postoperative complications in 440 patients with gastric cancer were analyzed. All the nutritional parameters reflected a significant deterioration as the stages of cancer progressed, and the frequency of postoperative complications was highest in patients with stage IV gastric cancer. The incidence of anastomotic leaks was increased in patients undergoing total gastrectomy with no relation to the clinical stage or nutritional status. However, there was a close relationship between nutritional status and immunocompetence, lung complications, and infection. The nutritional indices which reliably predicted preoperatively the nutritional status of cancer patients were the serum protein concentrations including the serum albumin (Alb) and prealbumin (PA). The indices predicting postoperative complications were the Alb, PA, and total lymphocyte count. These results suggest that preoperative nutritional assessment can be beneficial for the prediction of postoperative complications.

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To clarify the risk factors contributing to postoperative complications in the elderly patients (over 70 years) undergoing esophagectomy and/or gastrectomy, 364 patients with primary cancer seen were evaluated. As a result, some characteristic patterns of stress response in the elderly could be detected as follows: the disorders of the vital organs were more important indices for the development of postoperative complications rather than age, and a reduction in the maximum response of the stress hormones to surgical procedures in aged patients was noted; moreover, the functional variability of target organ in the aged group was confirmed. Studies on the hormonal response to surgery suggest that the restriction of fluid replacement is advisable until the third postoperative day, maintaining the host on the dry side, to prevent cardiopulmonary complications. As the nutritional status in the patients with esophageal and gastric cancer goes from bad to worse with the advancing clinical stages, adequate perioperative nutrition is imperative to prevent complications such as anastomotic leakage, wound dehiscence, and/or infections. For the treatment of anastomotic leaks after esophagectomy and esophagogastrectomy, more than 45 kcal/kg/d must be provided, and the serum albumin level must be restored to 3.5 g/dL in order to achieve spontaneous healing of small anastomotic leakages.