Reyer T. Ottow's research while affiliated with National Cancer Institute (USA) and other places

Publications (18)

Article
Production of biological response modifiers through recombinant techniques has stimulated interest in immunotherapy of cancer. One of these, interleukin-2 (IL-2), will induce in vivo as well as in vitro proliferation of noncommitted T lymphocytes into lymphokine-activated killer (LAK) cells: cells cytolytic for a broad range of tumor cells. We have...
Article
Interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells were used in intraperitoneal and pulmonary tumor models in C57BL/6 mice. To maintain the immunotherapeutic effects of IL-2 plus LAK treatment but reduce its toxicity, ways were sought to augment IL-2 effects. The investigation showed that the adoptive transfer of LAK cells was a prere...
Article
Five patients with colorectal cancer widely metastatic to peritoneal surfaces have been treated i.p. with infusions of autologous blood monocytes made cytotoxic by in vitro incubation with human gamma-interferon. The monocytes were purified by a combination of cytapheresis and counter-current centrifugal elutriation procedures; each week approximat...
Article
In a significant proportion of patients with gastrointestinal and ovarian malignancy the peritoneal cavity is a prominent site at which surgical treatment fails. Adjuvant treatments directed at this site should be investigated in an attempt to improve survival in patients with these cancers. In the study reported here, a model of intraperitoneal tu...
Article
The control of malignancy disseminated within the peritoneal cavity is an important problem in the management of low-grade gastrointestinal and ovarian neoplasms. A model of peritoneal carcinomatosis in the mouse was used to investigate the potential of lymphokine-activated killer (LAK) cells and exogenous interleukin 2 (IL-2) to control intraperit...
Chapter
In reviewing the literature and in updating the experience at the National Cancer Institute, two conclusions become apparent: 1) liver resection offers the only significant chance of cure in patients with colorectal cancer metastases, and 2) 60–80% of patients who undergo liver resection are not cured. The multifactorial nature of the problem makes...
Article
The optimal method of transecting liver parenchyma has not been established and presently a variety of methods are in use. In a controlled study in pigs standard resections were performed with four different transection techniques: ultrasonic dissection, suction dissection, electrocautery, and sharp dissection. The blood loss, number of vessels ide...
Article
Proximal biliary tract cancer carries a dismal prognosis. Few patients have a curative option. However, worthwhile palliation can be achieved in many patients by relieving obstructive jaundice. An overview is presented to place in perspective the treatment methods described and the results obtained.
Article
Full-text available
This report analyzes an experience with 33 hepatic resections for metastatic colorectal cancer over a 7-year period and with intraperitoneal 5-FU administered as a postresection adjuvant in 21 of these patients. Particular emphasis is placed on the identification of clinical determinants of postresection survival. There was no operative mortality i...
Article
This report analyzes an experience with 33 hepatic resections for metastatic colorectal cancer over a 7-year period and with intraperitoneal 5-FU administered as a postresection adjuvant in 21 of these patients. Particular emphasis is placed on the identification of clinical determinants of postresection survival. There was no operative mortality i...
Chapter
Currently the only potentially curative therapy for the patient with a primary hepatic malignancy or with hepatic metastases is surgical resection of the cancer. Therefore, this option should always be evaluated before other treatment alternatives are pursued. In selected patients resection can be performed with a morbidity and mortality similar to...
Article
Death from colorectal cancer frequently results from manifestations of recurrent local or metastatic disease following initial 'curative' therapy. Presently, the attempted curative treatment of recurrent colorectal cancer lays in the hands of the surgeon. This paper reviews the natural history of surgically treated large bowel cancer and summarizes...
Chapter
Currently the only potentially curative therapy for the patient with hepatic metastases is surgical resection of the cancer. Therefore, this option should always be evaluated before other treatment alternatives are pursued. In selected patients resection can be performed with a morbidity and mortality similar to that of many surgical procedures tha...
Chapter
In previous chapters the indications and results of surgery for metastatic cancer have been presented. Authors have discussed at length the clinical and research problems associated with treating metastatic disease to the liver. From this discussion the following four concepts should be considered when one reviews a patient with hepatic metastases.

Citations

... Experimental peritoneal cancer index (ePCI) were used to evaluate the extent of tumor dissemination, based on the published studies by Shao 11 and Steller. 12 The abdominal-pelvic cavity was divided into four subareas ( Figure 1B), and lesion size score (LS) in each subarea is determined by the diameter of the largest tumor: LS-0, no visible tumor; LS-1, diameter ≤ 0.2 cm; LS-2, 0.2 cm < diameter ≤0.5 cm;LS-3, diameter > 0.5 cm; and Mucinous ascites, 1 point. The accumulative ePCI score ranges from 0 to 13. ePCI score was evaluated and checked by operator and recorder at the same time. ...
... Liver metastases evident at the time of primary surgery, or appearing at an interval, presented a frustrating obstacle to surgical cure [24] . There had been some surgery on these metastases from as early as the 1940s [25][26][27] and liver resection for metastases was included in Wangensteen et al [7] 's 1954 report but it was in the 1970s and 1980s that liver resection started to gather momentum [27][28][29][30][31][32][33][34][35][36][37][38][39] . Full mobilisation of the liver was included in the 1982 protocol of the CEA second-look trial [40] . ...
... Indeed, IL-13 has been shown to up-regulate mesothelial VCMA-1 (but not ICAM-1) expression (Sironi et al, 1994), although the effect of IL-4 and IL-7 on mesothelial function has not yet been reported. Interestingly, IL-2 has previously been investigated as a potential adjuvant in intraperitoneal immunotherapy and, in a murine model, the combined injection of lymphokine activated killer (LAK) cells and IL-2 produced a significant reduction in intraperitoneal tumour mass and prolonged survival (Ottow et al, 1987). However, when tumour inoculation was preceded by laparotomy, the therapeutic effects of IL-2 and LAK cell therapy were completely abrogated, with excessive tumour growth at sites of peritoneal trauma (Eggermont et al, 1988). ...
... Many studies have been performed to improve the results and/or reduce treatment-related toxicity. In both experimental tumour models and human cancer patients it has been shown that S.C. or regional IL-2 administration results in better tolerance of the treatment without apparent loss of therapeutic efficacy (Ottow et al., 1987;Steis et al., 1990;Vaage, 1991;Sleijfer et al., 1992;Ravaud et al., 1994;Sone and Ogura, 1994). Also, evidence is accumulating that doses of less than 10% of the maximum tolerated dose are therapeutically effective (Cortesina et al., 1988;Velotti et al., 1991;Huland et al., 1992;Lissoni et al., 1992;Mattijssen et al., 1992Mattijssen et al., , 1994Bruton and Koeller, 1994;Yang et al., 1994). ...
... Unilateral stenting with or without computed tomography (CT)/magnetic resonance cholangiopancreatography (MRCP) guidance with or without contrast has shown encouraging results (1)(2)(3). Radiation therapy has been tried in these patients (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). However, external beam irradiation is limited owing to tolerance of liver, bowel and kidneys. ...
... Macrophages have a great propensity to migrate to the TME. Therefore, the modi cation and adoptive transfer of macrophages may address this drug delivery challenge (20)(21)(22)(23). Genetically engineered macrophages (GEMs) have been developed to deliver therapeutic payloads to activate immune responses and have shown promise in preclinical studies and clinical trials (20,(24)(25)(26). ...
... The intraperitoneal tumor load was semiquantitatively evaluated at the site of surgery, parietal peritoneum, omentum, retroperitoneum, mesentery, liver, spleen, and pelvic fat. The amount and the size of tumors were determined and scored from 0e5 depending on the tumor diameter using the peritoneal cancer index described by [24] ( Table 1). The scoring was performed blinded to the treatment applied to each animal. ...
... Tumour remissions have been reported with systemic IL-2 treatment alone (Lotze et al., 1986;Louie et al., 1989;Oliver et al., 1989;Sosman et al., 1990). The anti-tumour effects of IL-2 are believed to be due to activation and proliferation of tumour-infiltrating lymphocytes (TIL) (Ettinghausen et al., 1985;Eggermont et al., 1987), although lymphocytes activated by IL-2 at distant sites may traffic to tumours as well. The tumour microenvironment differs markedly from that within non-neoplastic tissues, due primarily to insufficient vascular supply and decreased tumour blood flow (Vaupel et al., 1989). ...
... In the mid-1980s, the Colorectal Cancer Section of the Surgery Branch, National Cancer Institute, Bethesda, MD was negotiating heavily concerning a protocol to test the efficacy and safety of the resection of 1-3 liver metastases in patients with colon or rectal cancer. We eventually piloted an IRB-approved trial testing long-term intraperitoneal 5-fluorouracil as an adjuvant to complete resection [1]. For several logistical reasons, the final results of approximately 60 patients were never published. ...
... The intraoperative blood loss during hepatic parenchymal resection remains a major concern. Therefore, various devices for hepatic transection are available (1). The occlusion of hepatic inflow is another concern in controlling bleeding (2). ...