Treatment Of T1 Research Articles

‘Folfirinox’ chemotherapy combined with contact x-ray brachytherapy 50 kVp and ‘CAP50’ chemoradiotherapy aiming at organ preservation for selected intermediate distal-middle cT2-T3 rectal cancers: A feasibility study

PurposeThe standard treatment of T2–T3 rectal adenocarcinoma is radical proctectomy by total mesorectal excision often combined with some neoadjuvant treatment. To reduce morbidity of this surgery, organ preservation strategy using various combination of radiotherapy, chemotherapy and local excision is gaining interest. Some randomized trials have proven the feasibility of such approaches. The OPERA trial demonstrated, for T2 T3<5cm diameter low-middle rectum, that a contact X-ray brachytherapy boost of 90Gy in three fractions over 4 weeks was able to achieve a planned organ preservation in 81% of patients at 3years with 97% success for tumour smaller than 3cm treated with contact X-ray brachytherapy boost first. To try to expand organ preservation to larger tumours we set up a feasibility trial in T2–T3 tumours using total neoadjuvant treatment and a contact X-ray brachytherapy boost. Material and methodThe trial was approved by the institutional review board of Nice. Inclusion criteria were operable patients, 75years or less, adenocarcinoma of the low-middle rectum staged T2c-T3N0 larger than 3.5cm and less than 6cm in diameter or T2-T3N1 less than 6cm in diameter. Treatment started in all cases with neoadjuvant chemotherapy associating 5-fluoro-uracile, irinotecan and oxaliplatin (‘folfirinox’ regimen, four to six cycles). In case of good tumour response after four cycles, a contact X-ray brachytherapy boost (delivering 90Gy in three fractions) was given followed by chemoradiotherapy (external beam radiotherapy delivering 50Gy, with concurrent capecitabine). After six cycles if only a partial response (tumour still larger than 3cm) was seen, chemoradiotherapy was given and contact X-ray brachytherapy boost was delivered after that. At the end of this total neoadjuvant treatment a watch and wait strategy was decided in case of clinical complete response or radical proctectomy by total mesorectal excision for partial response. ResultsBetween July 2019 and October 2022, 14 patients were included; median age was 66years (range: 51–77years), there were nine male and five female, two T2 N1 tumours, seven T3N0, and five T3N1, all were M0. Median tumour diameter was 40mm (range: 11–50mm); three tumours had a circumferential extension greater than 50%. Seven patients received four folfirinox cycles and seven had six cycles. Contact X-ray brachytherapy boost was given during folfirinox chemotherapy before chemoradiotherapy in 11 patients (and after in three). The tolerance was good, with no grade 4–5 toxicity. The main grade 3 early toxicity was in relation with the folfirinox regimen. A clinical complete response was seen in 12 patients at the end of the total neoadjuvant treatment (85%). All these patients are alive and have preserved their rectum with a mean follow-up time of 17.8months (range: 6–48months) and a good bowel function (low anterior rectal resection syndrome score below 30). The main contact X-ray brachytherapy boost toxicity was radiation ulceration in three patients that usually healed within 6 months, sometimes necessitating hyperbaric oxygen. ConclusionThe preliminary results of this feasibility study show that early tolerance of these intensive total neoadjuvant treatment is compatible with an acceptable toxicity. The high rate of organ preservation in this intermediate group of T2–T3 tumours is encouraging and is a good argument to start the next randomized TRESOR trial that will aim at achieving a 65% of 3-year survival with organ preservation in this intermediate tumour group.

Potassium Management for Corn Growth, Yield and Sweetness under Sabah Sandy Soil

A study was conducted to determine the effect of potassium (K) with organic fertilizers on the growth, yield and sweetness of reddish waxy corn. The treatments were: (T1) standard fertilizer rate of 60 kg ha-1 K2O without organic fertilizer (control); (T2) 30 kg ha-1 K with organic fertilizer; (T3) 90 kg ha-1 K with organic fertilizer and (T4) 120 kg ha-1 K with organic fertilizer. Organic fertilizer used was 1.5 t ha-1 Bokashi and 20 t ha-1 chicken manure biochar (CMB). The planted corn received 120 kg ha-1 N and 60 kg ha-1 P2O5. The experimental design was Completely Randomized Design (CRD) with six replications. Stem girth, number of leaves, the height of the first cob, fresh weight of the first cob, 100 grains weight, cob girth, cob length and sweetness (Brix scale, %) data were analyzed using ANOVA (Analysis of Variance) at 5% significant levels. The Least Significant Different (LSD) was used to compare the means for significantly different results. Significant differences in growth were obtained at (p&lt;0.05) in waxy corn for the number of leaves, the height of the first cob, length of cob, and girth between the control and all treatments. However, there is no significant difference for the sweetness of waxy corn for all treatments. Mean total for growth parameters; the number of leaves, stem girth and height of the first cob from soil surfaces and mean total for yield parameters; cob girth, length of cob, fresh weight of cob, 100 grains weight and the number of kernels was significantly higher for all treatments of T2, T3 and T4 compared to control the treatment of T1. The study showed no significant difference in the sweetness of waxy corn with increasing potassium application, resulting in increased total soluble content. Similar studies for a different rate of organic fertilizers and soil analysis can be done to ascertain further the effects on growth, yield, and sweetness parameters of reddish waxy corn with selected soil properties.

Effect of Protein Concentrate Withdrawal and Reducing the Crude Protein in Diets and Supporting Them with a Mixtures of Essential Amino Acids on some Physiological Traits of Laying Hens

The study was conducted to show Effect of protein concentrate Withdrawal and reducing the crude Protein in diets and supporting them with a mixtures of essential amino acids on some physiological traits of laying hens. (128) laying hens, type Lohmann Brown, at the age of (21) weeks, was randomly distributed among 8 treatments, with 8 replications for each treatment, as each replication was carried out on (2) hen (16 chickens/treatment), And the experimental treatments were as follows: T1 control (standard diet) and T2 (a treatment devoid of protein concentration ), and treatments T3, T4, and T5 (in which the percentage of crude protein was reduced by 1% and add on a mixture of amino acids consisting of methionine, lysine, and threonine was added by 1, 1.5, and 2%, respectively), and treatments T6, T7, and T8 (in which the percentage of crude protein was reduced by 2%, and add on a mixture of amino acids consisting of methionine, lysine, and threonine was added by 1, 1.5, and 2%, respectively). The results showed that there were no significant differences between the treatments of the experiment, but it was noted that there was a significant superiority (P < 0.05) for the treatments of adding the mixture of amino acids in favor of the treatments T1 and T10 in terms of cholesterol, total protein and albumin, compared with the treatment of T1 and T2 control, as well as treatment recorded T1, T2 and T3 Highly significant (P<0.01) superiority in IgM and IgA traits. It can be concluded from this study that adding the mixture of amino acids by 1.5 and 2% and reducing the protein percentage by (1 and 2%) led to a significant improvement in some physiological characteristics compared with the control treatment

Konsumsi BETN, SK, dan Lemak Kasar Kambing Kacang Jantan yang Mengalami Tingkat Pembatasan Pakan yang Berbeda

This study aims to determine the consumption of nitrogen free extract (NFE), crude fiber (CF) and extract eter (EE) of male kacang goats in the feed restriction phase after experiencing different levels of feed restriction. The study used an experimental method with a completely randomized design (CRD) which consisted of 3 treatments and 5 replications, namely: T0: Cattle without food restrictions, T1: Cattle were limited to 100% feed according to maintenance life and T2: Cattle were limited to 50% of maintenance life. The results showed that the consumption NFE of natural grass of treatment T0 and T1 was relatively the same, but higher than T2 (P&lt;0.05); conversely the consumption of NFE of concentrate was relatively the same (P&gt;0.05) among the treatments; while the total consumption of NFE of natural grass and concentrate treatment T1 and T2 was relatively the same (P&gt;0.05) and lower (P&lt;0.05) than treatment T0. Consumption CF of natural grass in the T0 and T1 treatments was relatively the same (P&gt;0.05) and higher (P&lt;0.05) than the T2 treatment; On the other hand, the total consumption CF of natural grass and concentrates in the T1 and T2 treatments was relatively the same (P&gt;0.05) and lower (P&lt;0.05) than the T0 treatment. Likewise, the consumption EE of natural grass in the treatment of T0 and T1 was relatively the same (P&gt;0.05) and higher (P&lt;0.05) than treatment T2. The consumption of NFE and CF concentrates from the three treatments was relatively the same (P&gt;0.05); Likewise, the consumption EE of concentrate and total consumption EE of natural grass and concentrate from male kacang goats in the feed restriction phase of the 3 different groups was not significant (P&gt;0.05). Consumption of NFE for each treatment was T0 of 131.66 ± 41.42, T1 of 84.85 ± 38.88 and T2 of 83.70 ± 0.03. Consumption of crude fiber (g/head/day) for each treatment was T0 of 42.89 ± 6.33, T1 of 33.73 ± 9.52 and T2 of 26.96 ± 0.03. Consumption of extract eter (g/head/day) for each treatment was T0 of 5.52 ± 2.24, T1 of 3.23 ± 1.85, and T2 of 3.53 ± 0.00. It can be concluded that the restriction of feed (feed restriction) up to 50% of the maintenance life does hinder the livestock growth process, but does not interfere with the health status of goats (indicated and physiological status are in the normal range).

Cauliflower Cultivation on Rooftop Garden Using Various Composts: Morphological and Economic Analysis

Cauliflower is one of the most important and commercial cole crop in Bangladesh. Cauliflower is a very tasty and much popular vegetable in Bangladesh as well as all over the world. Therefore, the present study was undertaken to investigate the impacts of vermicompost, sawdust, and cowdung on the growth and yield of cauliflower on rooftops, as well as to evaluate the economic performance of various organic manures on cauliflower yield. The experiment was carried out on the sixth floor of housing no. 64, road no. 6/A, Dhanmondi 13 during the period from November 2019 to July 2020. The experiment was designed in CRD having single factor with three replications. The treatments of this experiment were T0= Control (recommended dose of chemical fertilizers), T1= Vermicompost (10 t ha-1) + recommended dose of chemical fertilizers, T2= Sawdust (15 t ha-1) + recommended dose of chemical fertilizers and T3= Cowdung (20 t ha-1) + recommended dose of chemical fertilizers. The seedlings of the cole crop (BARI Fulkopi-2) were collected from Bangladesh Agricultural Research Institute, Joydebpur, Gazipur. Results revealed that the maximum pure curd weight per plant (551.60 g), yield per plot (3.95 kg) and yield per hectare (19.75 t) were obtained from T1 (vermicompost @ 10 t ha-1 + recommended dose of chemical fertilizers) treatment. The benefit cost ratio (BCR) was found to be the highest (3.33) in the treatment of T1 (vermicompost @ 10 t ha-1 + recommended dose of chemical fertilizers). Thus, it was apparent that the vermicompost treatment gave the highest yield per hectare (19.75 t) than the other treatments (sawdust and cowdung) and the highest gross return (Tk. 395000.00). The results clearly showed that rooftops are suitable for cauliflower vegetable production using vermicompost manure to maintain yield as well.

Consideration for reclassification of pathologically upstaged T3a renal cell carcinomas.

644 Background: Pathological upstaging to pT3a disease can occur after the surgical treatment of clinical T1 and T2 Renal Cell Carcinomas (RCCs), and this upstaging has been previously shown to be associated with poorer outcomes. With an intent to delve deeper into the disparateness in outcomes of pT3a disease, we investigated the survival of patients with an initial clinical stage of cT1, cT2 and cT3a. Methods: Using the National Cancer Database (NCDB), patients with RCC were categorized by pathological and clinical staging of RCC according to the American Joint Committee on Cancer Guidelines (AJCC). The primary outcome was measured as overall survival (OS) at the end of follow up. Five-year survival rates and Kaplan-Meier Analysis assessed the differences between cT1 → pT3a, cT2 → pT2, cT2 → pT3a, and cT3a → pT3a. Multivariable cox regression (MVA) assessed predictors OS with age, sex, ethnicity, Charlson Score, socioeconomic status, geography, tumor size histology and grade, lymph node metastasis, surgical margins, and surgery type (partial versus radical nephrectomy) as covariates. Results: 53908 patients were analyzed (10789 cT1 → pT3a, 22183 cT2 → pT2, 9676 cT2 → pT3a, 11260 cT3a → pT3a, mean follow up 62.3 months). Of all pT3a patients, 64.5% were upstaged from cT1-2. MVA for OS demonstrated Hispanic ethnicity to be protective (hazard ratio [HR]=0.88, P&lt;0.001) and revealed different histologic risks. MVA for OS demonstrated that cT2 → pT3a (HR=1.33, P&lt;0.001, cT1 → pT3a [ref]) and cT3a → pT3a (HR=1.35, P&lt;0.001, cT1 → pT3a [ref]) were associated with worsened OS, and that cT1 → pT3a and cT2 → pT2 (HR=0.96, P&lt;0.052, cT1 → pT3a [ref]) were associated with improved OS. Kaplan-Meier analysis revealed a difference in 5 year overall survival as well (cT1→pT3a 72%, cT2→pT2 77%, cT2→pT3a 61%, and cT3a→pT3a 59%, p &lt; 0.001). Conclusions: Patients with cT1 upstaged to pT3a have similar outcomes to cT2 staged to pT2 and better outcomes than cT2 upstaged with the latter’s outcomes being more like cT3a staged to pT3a. The TNM staging system from AJCC for RCCs should consider these outcomes and adjust the grouping for RCCs accordingly.

Noninferiority multicenter prospective randomized controlled study of rectal cancer T2–T3s (superficial) N0, M0 (T2T3sN0M0) undergoing neoadjuvant treatment and local excision (TEM) versus total mesorectal excision (TME): Preoperative, surgical, and pathological outcomes—The TAUTEM-study.

3501 Background: The standard surgical treatment of rectal adenocarcinoma above T1 is total mesorectal excision (TME), but it is associated with high morbidity and quality of life disorders. Transanal endoscopic microsurgery (TEM) achieves minimal postoperative morbidity rates. The treatment of T2, T3 superficial, N0, M0 rectal cancers is TME due to local excision achieving high recurrence rates. Initial reports of preoperative chemoradiotherapy (CRT) in association with TEM shows reduction in local recurrence. The TAU-TEM study aims to demonstrate the non-inferiority of the oncological outcomes and the improvement in morbidity and quality of life achieved with CRT-TEM compared with TME. Methods: Prospective, multicenter, randomized controlled non-inferiority trial including patients with rectal adenocarcinoma less than 10 cm from the anal verge and up to 4 cm in size, staged as T2T3sN0M0. Patients were randomized to: CRT-TEM (Arm A) or TME (Arm B). Postoperative morbidity and mortality were recorded and patients in both arms completed quality of life questionnaires when starting treatment and 6 months after surgery. Patients attended follow-up controls for local and systemic relapse. Trial registration: ClinicalTrials.gov Identifier: NCT01308190. Results: From July/2010 to October/2021, 173 patients from 17 Spanish hospitals were included (Arm A: 86, Arm B: 87). Ten were excluded after randomization (Arm A: 4, [3 re-staged &gt; T2T3sN0M0, 1 refused follow-up study]; Arm B: 6 [4 refused the arm, 2 re-staged &gt; T2T3sN0M0]). Therefore, the patients with modified intention to treat analysis were: TME, 81 and CRT-TEM, 82. There was no mortality after CRT. In this group, 2 patients abandoned neoadjuvant therapy; thus 80/82 (97.6%) completed CRT. The CRT-morbidity was low (25/82, 30%) and of low grade (95% G1-2). In the CRT-TEM group, MRI showed disease progression in 3 patients who were treated with TME. Finally, 77 patients underwent TEM surgery. One patient died in each arm (1.2%). Postoperative morbidity was 41/81 (50.6%) (Arm B) and 17/82 (20.7%) (Arm A) (p &lt; 0.001, 95 CI% 43.9 to 15.9). Median Comprehensive Complication Index was 8.7 (IQR 20.9) Arm B and 0 (IQR 0) Arm A (p &lt; 0.001). Median hospital stay was 7 days (IQR 7) Arm B and 2 days (IQR 2) Arm A (p &lt; 0.001). Complete response in Arm A was 45.3% (34/75 patients) with 5.3% ypT3 (4/75 patients) and in Arm B: pT1 (12.3%; 10/81patients), deep-pT3 (4.95; 4/81patients), pN1 (21%; 17/81). Conclusions: CRT-TEM treatment obtains high pathological complete response rates (45.3%), with a high CRT compliance rate (97.6%) and low morbidity. Postoperative complications and hospitalization are significantly lower in the CRT-TEM group. We await the results of the follow-up. Clinical trial information: NCT01308190.

Effect of Partial Replacement of Raw and Treated Rice Bran with Hydrochloric Acid, Ascorbic Acid and Bakery Yeast for Wheat in Broiler Diets on Production Performance

This study was conducted in a poultry farm belonging to the private sector, which has a license to practice a profession issued by the Ministry of Agriculture, the Department of Livestock Resources, in the city of Nasiriyah, Dhi Qar Governorate. This experiment aimed to study the effect of partial replacement of raw rice bran and treatment with HCL acid, bakery yeast (Saccharomyces cerevisiae), and ascorbic acid in place of wheat on the productive performance of broilers. For the period from 28/9/2020 to 11/8/2020, 405 unsexed chickens were used—Ross 308 at the age of two weeks. The study included nine treatments, whereby (25 and 50) percent of raw rice bran and treated were replaced and inserted into the diets of broilers 15 days after the rearing. In addition to the control treatment, the results of the experiment showed: There were no significant differences between (T1) and the replacement treatments for raw rice bran with their percentages of 25% and 50%, as well as the replacement treatment for rice bran treated with bakery yeast (Saccharomyces cerevisiae) by 25% and replacement treatment treated with ascorbic acid by 50% in the average live body weight and weight gain at the end of the experiment. Also, there were no significant differences between the replacement treatments for raw bran and the treatment in the cumulative feed intake trait compared to (T1). The treatment of rice bran treated with yeast with a replacement rate of 25% achieved the best feed conversion factor, No significant differences (P &lt; 0.05) were recorded between the 25% substitution treatments for the raw and treated rice bran compared to the control in the feed conversion factor trait, Furthermore, treatment of T2 (raw rice bran 25%) instead of wheat was superior in the Dressing percentage (%)and relative breast weight, Also, no significant differences were recorded in the percentage of fatalities. The 25% treatment of rice bran treated with bakery yeast (Saccharomyces cerevisiae) achieved the highest significant value (P&lt;0.01) for the economic indicator and production index. And it did not differ significantly from the control treatment and the replacement treatment for raw rice bran by 25%.

Influence of different methods of application of effective microorganisms in nutrition of wheat on weight by 1000 grains, yield, and content of crude wheat proteins (TRITICUM SP)

The research was carried out in three vegetative seasons 2015/16, 2016/17, and 2018/19, on an experimental plot in Padinska Skela, Belgrade, Serbia. The supplement included four NPK treatments (kg ha−1) and foliar treatment with effective microorganisms (EM 7 l ha−1) T1-129: 60: 60; T2-129: 60: 60 + 1 EM; T3-106: 60: 60 + 2 EM ; T4-83: 60: 60 + 3 EM. Four wheat genotypes were sown (Ratarica, Pobeda, Nogal, and Apache). Thousand grain weight and grain yield were determined. The thousand grain weight (TGW) was in the variety Pobeda 43.73 g, and the highest grain yield was in the variety Ratarica 7.02 tha−1. Both varieties are medium late, bread varieties. The treatments have different effects on the studied variables. The TGW was the highest in the T2 treatment of 40.81 g and the grain yield in T3 of 6.62 t ha−1, which was at the level of statistical significance of p > 0.01. The crude protein content was highest in the treatment of T2 13.93% (p > 0.01).

Quality of life and complications after nephron-sparing treatment of renal cell carcinoma stage T1\u2014a systematic review

BackgroundDespite the fact that nephron-sparing treatment is considered preferable from a surgical perspective patients’ quality of life (QoL) following different types of nephron-sparing treatments remains unclear.PurposeTo investigate the quality of life and complications after nephron-sparing treatment of renal cell carcinomas of stage T1.Materials and methodsA systematic search of six databases was carried out. We included studies that reported the quality of life and complications in patients aged 18 years or older following nephron-sparing treatment of renal cell carcinoma stage T1. The quality assessment was performed using the Critical Appraisal Skills Programme (CASP) checklist for cohort studies and the CASP Randomized Controlled Trial Checklist. Data were analyzed using a narrative approach.ResultsEight studies were included, six of which investigated QoL after partial nephrectomy and two after ablation therapies. Seven studies reported complications. Three studies reported higher QoL scores after partial nephrectomy compared to radical nephrectomy. Two studies showed that QoL increased or returned to baseline levels up to 12 months following partial nephrectomy. One study reported a gradual increase in QoL after radiofrequency ablation, and one study reported that all patients recovered to baseline QoL following cryoablation. Across studies, we found a complication rate up to 20% after partial nephrectomy and up to 12.5% after ablation therapy.ConclusionsThe results of this systematic review suggest that nephron-sparing treatment appears to be superior or comparable to other treatment alternatives with regard to QoL outcomes. Additionally, based on the studies included in this review, partial nephrectomy appears to have a higher complication rate compared with ablation therapies.Systematic review registrationPROSPERO CRD42020155594

Robotic-assisted surgery versus conventional laparoscopic surgery in treatment of T2 and T3 rectal cancer

Robotic-assisted surgery versus conventional laparoscopic surgery in treatment of T2 and T3 rectal cancer

ASO Visual Abstract: A 5-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1–4N1–3M0 Breast Cancer

ASO Visual Abstract: A 5-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1–4N1–3M0 Breast Cancer

The Role of Nano-Silicon and Other Soil Conditioners in Improving Physiology and Yield of Drought Stressed Barley Crop

Abstract A field experiment was conducted in sandy soil to assess the effect of different sources of soil conditioners on barley (Hordeum vulgare L. cv. Giza 137) growth and its yield under drought stress. Plants were exposed to two levels of drought stress until grain maturity: (A) drought at 75% available water (AW) with NPK as control (treatment, T1); (B) mild drought stress at 50% AW with foliar spray of nano-silicon at 75 ppm (treatment, T2), foliar spray of nano-zeolite at 75 ppm (treatment, T3), perlite at 4 tons/h (treatment, T4), natural zeolite at 600 kg/ha (treatment, T5), bentonite at 4 tons/h (treatment, T6), and a combined treatment of T2+T3+T4+T5+T6 at the half amount of each material (T7). All the treatments received the recommended doses of organic matter. Vegetative growth and yield characters as well as anatomical characters were recorded. The physical and chemical soil properties were significantly improved by both foliar and soil conditioners application. The nutrients content of the barley crop were augmented under combined treatment (T7) as compared to other treatments. Under that treatment, barley crop chemical components, i.e. protein, ash, chlorophylls, amino acids, vitamins, and fibre were significantly higher compared to other treatments. In addition, gibberellic acid (GA3) and abscisic acid (ABA) content besides antioxidant enzymes catalase (CAT) and superoxide dismutase (SOD) activities were significantly affected by all treatments. The economical profits were achieved, as reflected by an investment factor value equal to or higher than 3, and this was achieved for all tested nanosilicon, zeolite, and soil conditioners indicated the effectiveness and profitability of studied treatments.

Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1-4N1-3M0 Breast Cancer.

Breast cancer-related lymphedema (BCRL) is a source of postoperative morbidity for breast cancer survivors. Lymphatic microsurgical preventive healing approach (LYMPHA) is a technique used to prevent BCRL at thetime of axillary lymph node dissection (ALND). We report the 5-year experience of a breast surgeon trained in LYMPHA and investigate the outcomes of patients who underwent LYMPHA following ALND for treatment of cT1-4N1-3M0 breast cancer. A retrospective review of patients with cT1-4N1-3M0 breast cancer was performed in patients who underwent ALND with and without LYMPHA. Diagnosis of BCRL was made by certified lymphedema therapists. Descriptive statistics and lymphedema surveillance data were analyzed using results of Fisher's exact or Wilcoxon rank-sum tests. Logistic regression and propensity matching were performed to assess the reduction of BCRL occurrence following LYMPHA. In a 5-year period, 132 patients met inclusion criteria with 76 patients undergoing LYMPHA at thetime of ALND and 56 patients undergoing ALND alone. Patients who underwent LYMPHA at thetime of ALND were significantly less likely to develop BCRL than those who underwent ALND alone (p = 0.045). Risk factors associated with BCRL development were increased patient age (p = 0.007), body mass index (BMI) (p = 0.003), and, in patients undergoing LYMPHA, number of positive nodes (p = 0.026). LYMPHA may be successfully employed by breast surgeons trained in lymphatic-venous anastomosis atthe time of ALND. While research efforts should continue to focus on prevention and surveillance of BCRL, LYMPHA remains an option to reduce BCRL and improve patient quality of life.

VATS Versus Open Lobectomy in Pathological T1 SCLC: A Multi-Center Retrospective Analysis

BackgroundVideo-assisted thoracic surgery (VATS) has been widely used in the surgical treatment of thoracic diseases, and it suggested surgical and oncological advantages compared with open surgery. However, reports on the application of VATS in surgery of small cell lung cancer (SCLC) are scarce. This study aimed to explore the advantages and disadvantages of different surgical approaches in the treatment of pathological stage T1(pT1) SCLC in terms of safety, clinical outcomes, and lymph node dissection. Patients and MethodsPatients who underwent lobectomy for pT1 SCLC between January 2014 and September 2017 were identified from the National Collaborative Lung Cancer Database (LinkDoc Database). The patients were stratified based on the surgery approach (VATS or open lobectomy). Perioperative outcomes and long-term survival were analyzed using SPSS software. ResultsA total of 169 patients with pT1 SCLC met the criteria and were enrolled for this study, including 110 cases of VATS lobectomies and 59 cases of open lobectomies. VATS lobectomy was associated with less blood loss than open surgery (168.1 ± 237.4 vs. 340.0 ± 509.8 mL, P = .002). Open lobectomy harvested more N2 LNs (11.8 ± 8.2 vs. 8.4 ± 5.8, P = .048) and identified more metastasis positive LNs (3.1 ± 6.0 vs. 1.4 ± 3.0, P = .050). Open lobectomy associated with longer overall survival (OS) but has no statistical difference (23.4 ± 13.2 vs. 20.2 ± 10.9, P = .070). ConclusionOpen lobectomy had better lymph node dissection results, and comparable postoperative complications, postoperative hospital stay, and OS to VATS lobectomy. Further studies may still be needed to confirm the recommendation of thoracoscopic approach as a routine surgical procedure for operable SCLC, and until then, open surgery should still be considered.

The Effectiveness Colonized System of Ganoderma Vaccine Compared to Trichoderma on Oil Palm Plantations That Infected by Ganoderma boninense

Basal stem rot caused by Ganoderma boninense causes fall and death of oil palm crops, and will drastically reduce plantation productivity by up to 50% and become one of the most serious problems in oil palm cultivation. This study aims to determine the effectiveness of the Colonized System of Ganoderma Vaccine (CHIPS&amp;reg;), as a biocontrol agent against the suppression of Ganoderma disease that infects oil palm trees in-field conditions. This research was conducted from early 2016 to the end of 2020 in a plantation located in Langkat area, North Sumatra by using 216 trees on 1 block as a sample experiment. Plants that infected with Ganoderma is treated with T1 treatment (MOAF&amp;trade; &amp;amp; CHIPS&amp;reg;) shows the value of Disease Severity Index (DSI) decreasing to 37.50%, compare to T2 treatment (NPK Granular Fertilizer 13-6-27 &amp;amp; Trichoderma bio fungicides) which has DSI value of 100% in week 232 (in 2020) and C1 treatment (control) with the highest DSI value of 100% in week 212 (in 2020). The conclusions of this study shows that the treatment of T1 (MOAF&amp;trade; &amp;amp; CHIPS&amp;reg;) is more successful in eradicating Ganoderma and have the highest profit ratio than any other treatments. The results of this study are useful as references for in-field inspection and large-scale production.

Effect of integrated nutrient management practices on the physical and chemical properties of soil under soybean-vegetable system in a Vertisol

The field experimental was conducted at the Research cum Instructional Farm, Indira Gandhi Krishi Vishwavidyalaya, Raipur (Chhattisgarh) during Kharif 2018-2019. The soil sample was collected at 0-15cm and 15-30cm soil depth. The treatments consisted of organic and inorganic combination of T1[Control(N0P0K0), T2 [100% N through Organic Source (1/3 FYM, 1/3 vermicompost, 1/3 Neem cake)], T3 (75% N through Organic Source + 10% foliar spray of Vermiwash and Cow Urine at 25 – 30 DAS and 50-60 DAS), T4 (50% N through Inorganic + 50% N through Organic), T5 (75% N through Organic + 25% N through Inorganic), T6 (100% N through Inorganic). The highest BD was recorded in T1 and T6 treatments (1.33Mgm-3) at 0-15 cm and at 15-30cm T4, T5, T6 (1.42Mgm-3). Lowest BD was recorded in T2 treated plot at both depth of the soil the value was 1.31 Mgm-3 (0-15 cm) and 1.40 Mg m-3 (15- 30 cm). The maximum pH was recorded in the treatment plot of T4 and T6 that was 7.74 in surface soil, while the maximum value (7.78) of sub-surface soil pH was recorded in the T1 and T4. Similarly, the minimum soil pH was recorded in the treatment of T2 at 0-15cm depth and T6 at 15-30cm depth, the value was (7.71) and (7.75) respectively. The EC observed in T4 at both depth of soil compare with other treatments the value was 0-15cm (0.245dSm-1) and 15-30cm (0.183 dSm-1). The soil organic carbon was maximum observed in T2 at both 0-15cm (6.97 g kg-1) and 15-30cm (6.71g kg-1) depth. The available N higher in T3 (258.64 kg ha-1) at 0-15 cm and T4 (247.49 kg ha-1) at 15-30 cm. The available P was maximum in treatment T2 at 0- 15cm (20.82 kg ha-1) available Phosphorous at 15-30cm treatment T3 recorded maximum which was (19.27 kg ha-1). The value of available potassium was maximum recorded in treatment T4 (378.86kg ha-1) at surface soil and T2 at subsurface soil (349.05 kg ha-1).

T1 Rectal Adenocarcinoma: a Different Way to Measure Tumoral Invasion Based on the Healthy Residual Submucosa with Its Prognosis and Therapeutic Implications

BackgroundSurgical treatment of early rectal cancer T1 is either local excision or total mesorectal excision. The choice of surgery is based on the risk of metastatic lymph node involvement. The most important factor to consider is the degree of submucosal invasion. We present a different way to measure tumoral invasion derived from the measurement of the healthy residual submucosa with its prognosis and therapeutic implications MethodsObservational study of tumor submucosal invasion in patients undergoing transanal endoscopic microsurgery was conducted. Parameters evaluated are submucosal invasion, measuring the healthy residual submucosa at the point of maximum invasion; macroscopic morphology of the tumor; presence of muscularis mucosa, muscularis propria, and measurement of submucosa in the tumor area and the healthy area. The classification proposed is compared with the ones previously published. ResultsEighty consecutive patients diagnosed with T1 rectal cancer underwent transanal endoscopic microsurgery. Seventeen tumors (21.3%) were polypoid. En bloc resection was achieved in 77 (96.3%). The muscularis mucosa was present in 28 (35%), and the muscularis propria in 77 (96.3%) (p < 0.001). The healthy residual submucosa in the tumor area measured 2,343 ± 1,869 μm. Agreement was moderate with the Kikuchi classification (kappa 0.58) and very good with the Kudo classification (kappa 0.87). ConclusionsWe describe a method for measuring submucosal invasion in T1 rectal cancer which does not depend on the morphology of the lesion or on the presence of the muscularis mucosa. It can be applied to all T1 classifications of the digestive tract in which the muscularis propria is present.

Phase I Trial of DNA Methyltransferase Inhibitor Guadecitabine Combined with Cisplatin and Gemcitabine for Solid Malignancies Including Urothelial Carcinoma (SPIRE)

Abstract Purpose: Preclinical data indicate that DNA methyltransferase inhibition will circumvent cisplatin resistance in various cancers. Patient and Methods: SPIRE comprised a dose-escalation phase for incurable metastatic solid cancers, followed by a randomized dose expansion phase for neoadjuvant treatment of T2–4a N0 M0 bladder urothelial carcinoma. The primary objective was a recommended phase II dose (RP2D) for guadecitabine combined with gemcitabine and cisplatin. Treatment comprised 21-day gemcitabine and cisplatin cycles (cisplatin 70 mg/m2, i.v., day 8 and gemcitabine 1,000 mg/m2, i.v., days 8 + 15). Guadecitabine was injected subcutaneously on days 1–5, within escalation phase cohorts, and to half of 20 patients in the expansion phase. Registration ID: ISRCTN 16332228. Results: Within the escalation phase, dose-limiting toxicities related predominantly to myelosuppression requiring G-CSF prophylaxis from cohort 2 (guadecitabine 20 mg/m2, days 1–5). The most common grade ≥3 adverse events in 17 patients in the dose-escalation phase were neutropenia (76.5%), thrombocytopenia (64.7%), leukopenia (29.4%), and anemia (29.4%). Addition of guadecitabine to gemcitabine and cisplatin in the expansion phase resulted in similar rates of severe hematologic adverse events, similar cisplatin dose intensity, but modestly reduced gemcitabine dose intensity. Radical treatment options after chemotherapy were not compromised. Pharmacodynamics evaluations indicated guadecitabine maximal target effect at the point of cisplatin administration. Pharmacokinetics were consistent with prior data. No treatment-related deaths occurred. Conclusions: The guadecitabine RP2D was 20 mg/m2, days 1–5, in combination with gemcitabine and cisplatin and required GCSF prophylaxis. Gene promoter methylation pharmacodynamics are optimal with this schedule. Addition of guadecitabine to gemcitabine and cisplatin was tolerable, despite some additional myelosuppression, and warrants further investigation to assess efficacy.

Effects of tillage practices and fertility levels on crop growth, yield and quality of sugarcane (Saccharum officinarum L.) under South Gujarat conditions

Field experiments were conducted during rabi season of 2017-2018 and 2018-2019 at College farm, N. M. College of Agriculture, Navsari Agricultural University, Navsari to study the “Effects of tillage practices and fertility levels on growth, yield and quality of sugarcane (Saccharum officinarum L.) under South Gujarat conditions”. Total sixteen treatment combinations consisting of four treatment of tillage practices T1: Cultivation with cultivator, T2: Sub soiling (45 cm depth & at 2 m distance in square) + Cultivation with cultivator, T3: Deep ploughing (22.5) + Cultivation with cultivator T4: Rotavator + Cultivation with cultivator and four treatment of fertilizer levels F1: 75% RDN (187.5 N kg/ha), F2: 100% RDN (250 N kg/ha), F3: 125% RDN (312.5 N kg/ha), F4: 150% RDN (375 N kg/ha) was laid out in Split Plot Design with three replications. The sugarcane cultivar used in the study was Co N 13073. Germination of sugar cane setts at 30 & 45 DAP and girth of millable cane at harvest were not differed significantly during both the years due to different tillage practices. While, plant height, number of tillers, number of internode, single cane weight, millable cane length and millable canes per hectare were found significantly higher under treatment the T2 (Sub soiling 45 cm depth & at 2 m distance in square + Cultivation with cultivator). While, treatment having cultivation with cultivator (T1) recorded significantly lower growth parameters and yield attributes than rest of the treatments during both the years as well as in pooled result. The results of present investigation further revealed that growth and yield attributing characters, viz germination of sugar cane setts and girth of millable cane at harvest were not differs significantly during both the years due to different fertilizer levels. While, plant height, number of tillers, number of internode, single cane weight, millable cane length, millable canes per hectare, cane yield were found significantly higher under the treatment 125% RDN (F3) followed by the fertility level 150% RDN (F4). However, treatment 75% RDN (F1) recorded lowest value of all growth parameters and yield attributes during both the years as well as in pooled analysis.Treatment T2 (Sub soiling 45 cm depth & at 2 m distance in square + Cultivation with cultivator) registered maximum gross realization (₹ 4,87,243/ha) and net realization (₹ 3,79,832/ha) with B:C ratio of 3.54. While, the lowest gross realization (₹ 3,73,651/ha) and net realization (₹ 2,70,240/ha) with B: C ratio of 2.61 was obtained under T1 (Cultivation with cultivator) treatment. The highest gross realization (₹ 4,72,537/ha), net-realization (₹ 3,69,535/ha) and B:C ratio (3.52) were obtained with the treatment F3 (125% RDN). While, the lowest gross realization (₹ 3,78,049/ha), net realization (₹ 2,70,755/ha) and B:C ratio (2.62) was obtained under the treatment F1 (75% RDN).