Perioperative XXXX to avoid surgically induced immune suppression in @entity14 @entity1 .

@entity1 @entity66 @entity5 @entity3 @entity14 @entity14434 @entity405 @entity3027
Surgical treatment of @entity14 is associated with postoperative immunosuppression, which might facilitate dissemination of @entity5 cells and outgrowth of minimal @entity66 /(micro) @entity3 . Minimal @entity66 has been shown to be of prognostic relevance in @entity14 . Therefore, stimulation of (anti- @entity5 ) immune responses may be beneficial in the prevention of @entity3 formation. Important anti- @entity5 effector cells, which serve this function, are natural killer (NK) cells, @entity405 + lymphocytes (CTL), dendritic cells (DC) and macrophages. In this review the immunomodulating properties of @entity3027 are discussed, with a particular focus on perioperative stimulation of immune function in @entity5 @entity1 . @entity3027 is known to enhance innate immune functions such as stimulation of NK cells, transition from innate to adaptive responses (activation of DC) and regulating of @entity405 + CTL activity and memory. Moreover, it exerts direct antitumor effects by regulating apoptosis and cell cycle. In several clinical trials, perioperative administration of @entity3027 has indeed been shown to improve T cell responsiveness, prevent @entity14434 and increase expression of activation markers on NK, T and NKT cells. In a clinical pilot study we showed in @entity14 @entity1 that received perioperative @entity3027 enhanced activation markers on T cells and NK cells, combined with better-preserved T cell function as indicated by phytohemaggluttinin skin tests. In the liver of these @entity1 significantly more @entity405 + T cells were found. In conclusion, @entity3027 provides an effective adjuvant in several forms of @entity5 and improves several postoperative immune functions in perioperative administration. However, larger clinical trials are necessary to investigate effects on disease-free and overall survival.
