Dental clinicians and researchers have recently recommended oral microbial examinations to more accurately diagnose and treat oral diseases, including periodontitis and dental caries. Theoretical and experimental evidence suggests that oral microbiota may also be associated with non-oral diseases, such as gastrointestinal and extra-gastrointestinal diseases. This review highlights studies demonstrating microbial alterations in the oral cavity associated with malignant tumors including gastric, colorectal, esophageal, and lung cancers, implying that these alterations may serve as early indicators for non-invasive diagnosis and risk assessment of cancer development. Furthermore, we addressed the implications of oral microbial co-occurrence with malignant tumors, such as Streptococcus anginosus, Fusobacterium nucleatum, and Veillonella parvula, which are recognized as tumor-enriched oral pathogens involved in the development and progression of cancers in the stomach, colon, and lungs, respectively. Notably, we explored the immune and inflammatory mechanisms underlying reciprocal interactions between oral microbiota and tumors, underscoring that targeting these mechanistic pathways can contribute to preventing cancer development.

Dental clinicians and researchers have recently recommended oral microbial examinations to more accurately diagnose and treat oral diseases, including periodontitis and dental caries. Theoretical and experimental evidence suggests that oral microbiota may also be associated with non-oral diseases, such as gastrointestinal and extra-gastrointestinal diseases. This review highlights studies demonstrating microbial alterations in the oral cavity associated with malignant tumors including gastric, colorectal, esophageal, and lung cancers, implying that these alterations may serve as early indicators for non-invasive diagnosis and risk assessment of cancer development. Furthermore, we addressed the implications of oral microbial co-occurrence with malignant tumors, such as Streptococcus anginosus, Fusobacterium nucleatum, and Veillonella parvula, which are recognized as tumor-enriched oral pathogens involved in the development and progression of cancers in the stomach, colon, and lungs, respectively. Notably, we explored the immune and inflammatory mechanisms underlying reciprocal interactions between oral microbiota and tumors, underscoring that targeting these mechanistic pathways can contribute to preventing cancer development.

Background: In patients with metastatic renal cell carcinoma (mRCC), sites of metastatic involvement have been reported to be associated with a difference in survival. However, the frequency and survival according to different sites of metastases in Korean patients with mRCC remain unclear. Therefore, this study aimed to assess the frequency of metastatic site involvement and the association between sites of metastatic involvement and survival in Korean patients with mRCC. Methods: This retrospective study used the multicenter cohort of the Korean Renal Cancer Study Group mRCC database to identify patients who started targeted therapy between December 2005 and March 2018. Data on the frequency of metastatic organ involvement at the time of mRCC diagnosis and oncologic outcomes according to different sites of metastasis were analyzed. Results: A total of 1,761 patients were eligible for analysis. Of the 1,761 patients, 1,564 (88.8%) had clear cell RCC, and 1,040 (59.1%) had synchronous metastasis. The median number of metastasis sites was 2 (interquartile range [IQR], 1–6). The median age at the initiation of systemic therapy was 60 years (IQR, 29–88), 1,380 (78.4%) were men, and 1,341 (76.1%) underwent nephrectomy. Based on the International Metastatic Renal Cell Carcinoma Database Consortium model, patients were stratified into favorable-, intermediate-, and poor-risk groups with 359 (20.4%), 1,092 (62.0%), and 310 (17.6%) patients, respectively. The lung (70.9%), lymph nodes (37.9%), bone (30.7%), liver (12.7%), adrenal gland (9.8%), and brain (8.2%) were the most common sites of metastasis, followed by the pancreas, pleura, peritoneum, spleen, thyroid, and bowel. Among the most common sites of metastasis (> 5%), the median cancer-specific survival (CSS) ranged from 13.9 (liver) to 29.1 months (lung). An association was observed between liver, bone, and pleural metastases and the shortest median CSS (< 19 months). Conclusion In Korean patients with mRCC, metastases to the lung, lymph nodes, bone, liver, adrenal gland, and brain were more frequent than those to other organs. Metastases to the liver, bone, and pleura were associated with poor CSS. The findings of this study may be valuable for patient counseling and guiding future study designs.

Background: In patients with metastatic renal cell carcinoma (mRCC), sites of metastatic involvement have been reported to be associated with a difference in survival. However, the frequency and survival according to different sites of metastases in Korean patients with mRCC remain unclear. Therefore, this study aimed to assess the frequency of metastatic site involvement and the association between sites of metastatic involvement and survival in Korean patients with mRCC. Methods: This retrospective study used the multicenter cohort of the Korean Renal Cancer Study Group mRCC database to identify patients who started targeted therapy between December 2005 and March 2018. Data on the frequency of metastatic organ involvement at the time of mRCC diagnosis and oncologic outcomes according to different sites of metastasis were analyzed. Results: A total of 1,761 patients were eligible for analysis. Of the 1,761 patients, 1,564 (88.8%) had clear cell RCC, and 1,040 (59.1%) had synchronous metastasis. The median number of metastasis sites was 2 (interquartile range [IQR], 1–6). The median age at the initiation of systemic therapy was 60 years (IQR, 29–88), 1,380 (78.4%) were men, and 1,341 (76.1%) underwent nephrectomy. Based on the International Metastatic Renal Cell Carcinoma Database Consortium model, patients were stratified into favorable-, intermediate-, and poor-risk groups with 359 (20.4%), 1,092 (62.0%), and 310 (17.6%) patients, respectively. The lung (70.9%), lymph nodes (37.9%), bone (30.7%), liver (12.7%), adrenal gland (9.8%), and brain (8.2%) were the most common sites of metastasis, followed by the pancreas, pleura, peritoneum, spleen, thyroid, and bowel. Among the most common sites of metastasis (> 5%), the median cancer-specific survival (CSS) ranged from 13.9 (liver) to 29.1 months (lung). An association was observed between liver, bone, and pleural metastases and the shortest median CSS (< 19 months). Conclusion In Korean patients with mRCC, metastases to the lung, lymph nodes, bone, liver, adrenal gland, and brain were more frequent than those to other organs. Metastases to the liver, bone, and pleura were associated with poor CSS. The findings of this study may be valuable for patient counseling and guiding future study designs.

Purpose: We conducted a randomized prospective trial (KLASS-07 trial) to compare laparoscopy-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. In this interim report, we describe short-term results in terms of morbidity and mortality. Methods: and Methods: The sample size was 442 participants. At the time of the interim analysis, 314 patients were enrolled and randomized. After excluding patients who did not undergo planned surgeries, we performed a modified per-protocol analysis of 151 and 145 patients in the LADG and TLDG groups, respectively. Results: The baseline characteristics, including comorbidity status, did not differ between the LADG and TLDG groups. Blood loss was somewhat higher in the LADG group, but statistical significance was not attained (76.76±72.63 vs. 62.91±65.68 mL; P=0.087). Neither the required transfusion level nor the operation or reconstruction time differed between the 2 groups. The mini-laparotomy incision in the LADG group was significantly longer than the extended umbilical incision required for specimen removal in the TLDG group (4.79±0.82 vs. 3.89±0.83 cm; P<0.001). There were no between-group differences in the time to solid food intake, hospital stay, pain score, or complications within 30 days postoperatively. No mortality was observed in either group. Conclusions Short-term morbidity and mortality rates did not differ between the LADG and TLDG groups. The KLASS-07 trial is currently underway.

Background: We sought to identify prognostic risk factors for one year recurrence in patient with renal cell carcinoma (RCC) after partial or radical nephrectomy. Methods: We performed a retrospective study of 1,269 patients with RCC after partial or radical nephrectomy and diagnosed recurrence using Korean Renal Cancer Study Group (KRoCS) database between January 1991 and March 2017. Recurrence-free survival (RFS), and overall survival (OS) were calculated using the Kaplan–Meier method and multivariate Cox regression analysis were performed to evaluate independent prognostic factors for recurrence. Results: The median patient age was 56 years and median follow-up period was 67 months.Multivariable analysis demonstrated BMI greater than or equal to 23 and less than 30 (vs. BMI less than 23, hazard ratio [HR]: 0.707, P = 0.020) reduced recurrence one year postoperatively. Eastern Cooperative Oncology Group performance status (ECOG PS) greater than or equal to 1 (vs. ECOG PS 0, HR: 1.548, P = 0.007), high pathological T stage (pT2 vs.pT1, HR: 2.622, P < 0.001; pT3 vs. pT1, HR: 4.256, P < 0.001; pT4 vs. pT1, HR: 4.558, P < 0.001), and tumor necrosis (vs. no tumor necrosis, HR: 2.822, P < 0.001) were independent predictive factors for early recurrence within one year in patients with RCC. Statistically significant differences on RFS and OS were found among pathological T stages (pT2 vs. pT1; pT3 vs. pT1; pT4 vs. pT1, all P < 0.001). Conclusion This large multicenter study demonstrated ECOG PS greater than or equal to 1, high pathological T stage, tumor necrosis and BMI less than 23 were significant prognostic risk factors of early recurrence within one year in patients with RCC who underwent nephrectomy.

Background: In patients with metastatic renal cell carcinoma (mRCC), sites of metastatic involvement have been reported to be associated with a difference in survival. However, the frequency and survival according to different sites of metastases in Korean patients with mRCC remain unclear. Therefore, this study aimed to assess the frequency of metastatic site involvement and the association between sites of metastatic involvement and survival in Korean patients with mRCC. Methods: This retrospective study used the multicenter cohort of the Korean Renal Cancer Study Group mRCC database to identify patients who started targeted therapy between December 2005 and March 2018. Data on the frequency of metastatic organ involvement at the time of mRCC diagnosis and oncologic outcomes according to different sites of metastasis were analyzed. Results: A total of 1,761 patients were eligible for analysis. Of the 1,761 patients, 1,564 (88.8%) had clear cell RCC, and 1,040 (59.1%) had synchronous metastasis. The median number of metastasis sites was 2 (interquartile range [IQR], 1–6). The median age at the initiation of systemic therapy was 60 years (IQR, 29–88), 1,380 (78.4%) were men, and 1,341 (76.1%) underwent nephrectomy. Based on the International Metastatic Renal Cell Carcinoma Database Consortium model, patients were stratified into favorable-, intermediate-, and poor-risk groups with 359 (20.4%), 1,092 (62.0%), and 310 (17.6%) patients, respectively. The lung (70.9%), lymph nodes (37.9%), bone (30.7%), liver (12.7%), adrenal gland (9.8%), and brain (8.2%) were the most common sites of metastasis, followed by the pancreas, pleura, peritoneum, spleen, thyroid, and bowel. Among the most common sites of metastasis (> 5%), the median cancer-specific survival (CSS) ranged from 13.9 (liver) to 29.1 months (lung). An association was observed between liver, bone, and pleural metastases and the shortest median CSS (< 19 months). Conclusion In Korean patients with mRCC, metastases to the lung, lymph nodes, bone, liver, adrenal gland, and brain were more frequent than those to other organs. Metastases to the liver, bone, and pleura were associated with poor CSS. The findings of this study may be valuable for patient counseling and guiding future study designs.

Dental clinicians and researchers have recently recommended oral microbial examinations to more accurately diagnose and treat oral diseases, including periodontitis and dental caries. Theoretical and experimental evidence suggests that oral microbiota may also be associated with non-oral diseases, such as gastrointestinal and extra-gastrointestinal diseases. This review highlights studies demonstrating microbial alterations in the oral cavity associated with malignant tumors including gastric, colorectal, esophageal, and lung cancers, implying that these alterations may serve as early indicators for non-invasive diagnosis and risk assessment of cancer development. Furthermore, we addressed the implications of oral microbial co-occurrence with malignant tumors, such as Streptococcus anginosus, Fusobacterium nucleatum, and Veillonella parvula, which are recognized as tumor-enriched oral pathogens involved in the development and progression of cancers in the stomach, colon, and lungs, respectively. Notably, we explored the immune and inflammatory mechanisms underlying reciprocal interactions between oral microbiota and tumors, underscoring that targeting these mechanistic pathways can contribute to preventing cancer development.

Dental clinicians and researchers have recently recommended oral microbial examinations to more accurately diagnose and treat oral diseases, including periodontitis and dental caries. Theoretical and experimental evidence suggests that oral microbiota may also be associated with non-oral diseases, such as gastrointestinal and extra-gastrointestinal diseases. This review highlights studies demonstrating microbial alterations in the oral cavity associated with malignant tumors including gastric, colorectal, esophageal, and lung cancers, implying that these alterations may serve as early indicators for non-invasive diagnosis and risk assessment of cancer development. Furthermore, we addressed the implications of oral microbial co-occurrence with malignant tumors, such as Streptococcus anginosus, Fusobacterium nucleatum, and Veillonella parvula, which are recognized as tumor-enriched oral pathogens involved in the development and progression of cancers in the stomach, colon, and lungs, respectively. Notably, we explored the immune and inflammatory mechanisms underlying reciprocal interactions between oral microbiota and tumors, underscoring that targeting these mechanistic pathways can contribute to preventing cancer development.

Dental clinicians and researchers have recently recommended oral microbial examinations to more accurately diagnose and treat oral diseases, including periodontitis and dental caries. Theoretical and experimental evidence suggests that oral microbiota may also be associated with non-oral diseases, such as gastrointestinal and extra-gastrointestinal diseases. This review highlights studies demonstrating microbial alterations in the oral cavity associated with malignant tumors including gastric, colorectal, esophageal, and lung cancers, implying that these alterations may serve as early indicators for non-invasive diagnosis and risk assessment of cancer development. Furthermore, we addressed the implications of oral microbial co-occurrence with malignant tumors, such as Streptococcus anginosus, Fusobacterium nucleatum, and Veillonella parvula, which are recognized as tumor-enriched oral pathogens involved in the development and progression of cancers in the stomach, colon, and lungs, respectively. Notably, we explored the immune and inflammatory mechanisms underlying reciprocal interactions between oral microbiota and tumors, underscoring that targeting these mechanistic pathways can contribute to preventing cancer development.