Annals of Coloproctology

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Prognostic Significance of the Decreased Rate of Perioperative Serum Carcinoembryonic Antigen Level in the Patients With Colon Cancer After a Curative Resection: Tae Doo Jung, Jong Han Yoo, Min Jae Lee, Ha Kyung Park, Jae Ho Shin, Min Sung An, Tae Kwun Ha, Kwang Hee Kim, Ki Beom Bae, Tae Hyeon Kim, Chang Soo Choi, Min Kyung Oh, Kwan Hee Hong; Ann Coloproctol. 2013;29(3):115-122. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.115

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Purpose

The serum level of carcinoembryonic antigen (CEA) is a clinical prognostic factor in the follow-up evaluation of patients with colon cancer. We aimed to evaluate the prognostic significance of the rate of decrease of the perioperative serum CEA level in patients with colon cancer after a curative resection.

Methods

A total of 605 patients who underwent a curative resection for colon cancer between January 2000 and December 2007 were enrolled retrospectively. The rate of decrease was calculated using the following equation: ([preoperative CEA - postoperative CEA]/[preoperative CEA] ×100).

Results

In the group with a preoperative serum CEA level of >5 ng/mL, the normalized group with a postoperative serum CEA level of ≤5 ng/mL showed a better overall survival (OS) rate and disease-free survival (DFS) rate than those of the non-normalized group (P ≤ 0.0001). The "cutoff values" of the rate of decrease in the perioperative serum CEA that determined the OS and the DFS were 48.9% and 50.8%, respectively. In the multivariate analysis of preoperative serum CEA levels >5 ng/mL, the prognostic factors for the OS and the DFS were the cutoff value (P < 0.0001) and the pN stage (P < 0.0001).

Conclusion

A rate of decrease of more than 50% in the perioperative serum CEA level, as well as the normalization of the postoperative serum CEA level, may be useful factors for determining a prognosis for colon cancer patients with high preoperative CEA levels.

Citations

Citations to this article as recorded by

Patients with T4N0 and T1‑3N1 colon cancer and a high preoperative carcinoembryonic antigen level benefit from adjuvant chemotherapy with oxaliplatin for 6 months
Hiroyuki Inoue, Hiroki Shimizu, Yoshiaki Kuriu, Tomohiro Arita, Kenji Nanishi, Jun Kiuchi, Takuma Ohashi, Yusuke Yamamoto, Hirotaka Konishi, Ryo Morimura, Atsushi Shiozaki, Hisashi Ikoma, Takeshi Kubota, Hitoshi Fujiwara, Eigo Otsuji
Oncology Letters.2024;[Epub] CrossRef
Metastasis of colorectal adenocarcinoma to the mandible
Kushal CHATTERJEE, Aritra CHATTERJEE, Debarati BHOWMICK, Hrishikesh KUMAR, Arif HOSSAIN, Debabrata GAYEN
European Journal of Oral and Maxillofacial Surgery.2021;[Epub] CrossRef
Perioperative Serum Carcinoembryonic Antigen Ratio Is a Prognostic Indicator in Patients With Stage II Colorectal Cancer
Jinsun Woo, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keun Ho Yang, Byung-Noe Bae, Ki Hwan Kim
Annals of Coloproctology.2018; 34(1): 4. CrossRef
Clinicopathologic features and oncologic outcomes of colorectal cancer patients with extremely high carcinoembryonic antigen
Soo Young Lee, Jeong Seon Jo, Hun Jin Kim, Chang Hyun Kim, Jae-Kyun Ju, Young Jin Kim, Hyeong Rok Kim
International Journal of Colorectal Disease.2015; 30(1): 63. CrossRef

Adipose-tissue-derived Stem Cells Enhance the Healing of Ischemic Colonic Anastomoses: An Experimental Study in Rats: Jong Han Yoo, Jae Ho Shin, Min Sung An, Tae Kwun Ha, Kwang Hee Kim, Ki Beom Bae, Tae Hyeon Kim, Chang Soo Choi, Kwan Hee Hong, Jeong Kim, Soo Jin Jung, Sun Hee Kim, Kuk Hwan Rho, Jong Tae Kim, Young Il Yang; J Korean Soc Coloproctol. 2012;28(3):132-139. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.132

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19 Citations

Abstract PDF

Purpose

This experimental study verified the effect of adipose-tissue-derived stem cells (ASCs) on the healing of ischemic colonic anastomoses in rats.

Methods

ASCs were isolated from the subcutaneous fat tissue of rats and identified as mesenchymal stem cells by identification of different potentials. An animal model of colonic ischemic anastomosis was induced by modifying Nagahata's method. Sixty male Sprague-Dawley rats (10-week-old, 370 ± 50 g) were divided into two groups (n = 30 each): a control group in which the anastomosis was sutured in a single layer with 6-0 polypropylene without any treatment and an ASCtreated group (ASC group) in which the anastomosis was sutured as in the control group, but then ASCs were locally transplanted into the bowel wall around the anastomosis. The rats were sacrificed on postoperative day 7. Healing of the anastomoses was assessed by measuring loss of body weight, wound infection, anastomotic leakage, mortality, adhesion formation, ileus, anastomotic stricture, anastomotic bursting pressure, histopathological features, and microvascular density.

Results

No differences in wound infection, anastomotic leakage, or mortality between the two groups were observed. The ASC group had significantly more favorable anastomotic healing, including less body weight lost, less ileus, and fewer ulcers and strictures, than the control group. ASCs augmented bursting pressure and collagen deposition. The histopathological features were significantly more favorable in the ASC group, and microvascular density was significantly higher than it was in the control group.

Conclusion

Locally-transplanted ASCs enhanced healing of ischemic colonic anastomoses by increasing angiogenesis. ASCs could be a novel strategy for accelerating healing of colonic ischemic risk anastomoses.

Citations

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Experimental models of high-risk bowel anastomosis in rats: A systematic review
Georgios Ntampakis, Manousos-Georgios Pramateftakis, Elissavet Anestiadou, Stefanos Bitsianis, Orestis Ioannidis, Chryssa Bekiari, George Koliakos, Maria Karakota, Anastasia Tsakona, Angeliki Cheva, Stamatios Angelopoulos
World Journal of Experimental Medicine.2024;[Epub] CrossRef
The Role of Adipose Tissue Mesenchymal Stem Cells in Colonic Anastomosis Healing in Inflammatory Bowel Disease: Experimental Study in Rats
Georgios Ntampakis, Manousos-Georgios Pramateftakis, Orestis Ioannidis, Stefanos Bitsianis, Panagiotis Christidis, Savvas Symeonidis, Georgios Koliakos, Maria Karakota, Chrysanthi Bekiari, Anastasia Tsakona, Angeliki Cheva, Stamatios Aggelopoulos
Journal of Clinical Medicine.2023; 12(19): 6336. CrossRef
The application of regenerative medicine in colorectal surgery
Ilan Kent, Michael R. Freund, Samir Agarwal, Steven D. Wexner
Surgery.2022; 171(4): 867. CrossRef
Stem cell therapy applied for digestive anastomosis: Current state and future perspectives
Jacobo Trébol, Tihomir Georgiev-Hristov, Isabel Pascual-Miguelañez, Hector Guadalajara, Mariano García-Arranz, Damian García-Olmo
World Journal of Stem Cells.2022; 14(1): 117. CrossRef
Stem Cell Therapies for Gastrointestinal Anastomotic Healing: A Systematic Review and Meta-Analysis on Results from Animal Studies
Apostolos Gaitanidis, Leonidas Kandilogiannakis, Eirini Filidou, Alexandra Tsaroucha, George Kolios, Michail Pitiakoudis
European Surgical Research.2022; 63(4): 173. CrossRef
Effect of Adipose-Derived Stem Cells on Colonic Anastomosis in Rats Immunosuppressed With Everolimus: An Experimental Study
Emre Karakaya, Aydincan Akdur, Alev Ok Atilgan, Ahmet Cagri Uysal, Huriye Eda Ozturan Ozer, Sedat Yildirim, Mehmet Haberal
Experimental and Clinical Transplantation.2021; 19(9): 970. CrossRef
The use of mesenchymal stem cells in animal models for gastrointestinal anastomotic leak: A systematic review
Joshua Richard Burke, Jack Helliwell, Jason Wong, Aaron Quyn, Sarah Herrick, David Jayne
Colorectal Disease.2021; 23(12): 3123. CrossRef
Human Oral Mucosal Stem Cells Reduce Anastomotic Leak in an Animal Model of Colonic Surgery
Ilan Kent, Cyrus Jahansouz, Amandeep Ghuman, Baruch Shpitz, Debora Kidron, Victoria Yaffe, Imad Abu El-Naaj, Shareef Araidy, Luciana Reina, Sandu Pitaru, Steven David Wexner, Shmuel Avital
European Surgical Research.2021; 62(1): 32. CrossRef
Anastomotic leak in colorectal cancer patients: New insights and perspectives
Caterina Foppa, Siew Chien Ng, Marco Montorsi, Antonino Spinelli
European Journal of Surgical Oncology.2020; 46(6): 943. CrossRef
Locally Transplanted Adipose Stem Cells Reduce Anastomotic Leaks in Ischemic Colorectal Anastomoses: A Rat Model
Andrew Morgan, Andrew Zheng, Kimberly M. Linden, Ping Zhang, Spencer A. Brown, Jeffrey P. Carpenter, Francis R. Spitz, Michael E. Kwiatt
Diseases of the Colon & Rectum.2020; 63(7): 955. CrossRef
The Proliferation and Differentiation of Adipose-Derived Stem Cells in Neovascularization and Angiogenesis
Greg Hutchings, Krzysztof Janowicz, Lisa Moncrieff, Claudia Dompe, Ewa Strauss, Ievgeniia Kocherova, Mariusz J. Nawrocki, Łukasz Kruszyna, Grzegorz Wąsiatycz, Paweł Antosik, Jamil A. Shibli, Paul Mozdziak, Bartłomiej Perek, Zbigniew Krasiński, Bartosz Kem
International Journal of Molecular Sciences.2020; 21(11): 3790. CrossRef
Wound healing and fibrosis: current stem cell therapies
Ruth Ellen Jones, Deshka S. Foster, Michael S. Hu, Michael T. Longaker
Transfusion.2019; 59(S1): 884. CrossRef
Protective effect of adipose tissue–derived mesenchymal stromal cells in an experimental model of high-risk colonic anastomosis
Valter Alvarenga, Pedro Teixeira da Silva, Natália Deoclécio Bonfá, Beatriz Pêgo, Hayandra Nanini, Cláudio Bernardazzi, Kalil Madi, Wagner Baetas da Cruz, Morgana Teixeira Castelo-Branco, Heitor Siffert Pereira de Souza, Alberto Schanaider
Surgery.2019; 166(5): 914. CrossRef
Adipose Tissue-Derived Stem Cell Sheet Application for Tissue Healing In Vivo: A Systematic Review
Panithi Sukho, Abigael Cohen, Jan Willem Hesselink, Jolle Kirpensteijn, Femke Verseijden, Yvonne M. Bastiaansen-Jenniskens
Tissue Engineering Part B: Reviews.2018; 24(1): 37. CrossRef
Adipose-Derived Mesenchymal Stromal Cells Improve the Healing of Colonic Anastomoses Following High Dose of Irradiation Through Anti-Inflammatory and Angiogenic Processes
Dirk Van de putte, Christelle Demarquay, Elke Van Daele, Lara Moussa, Christian Vanhove, Marc Benderitter, Wim Ceelen, Piet Pattyn, Noëlle Mathieu
Cell Transplantation.2017; 26(12): 1919. CrossRef
Autologous adipose-derived stem cell sheets enhance the strength of intestinal anastomosis
Yasuhiro Maruya, Nobuo Kanai, Shinichiro Kobayashi, Kurodo Koshino, Teruo Okano, Susumu Eguchi, Masayuki Yamato
Regenerative Therapy.2017; 7: 24. CrossRef
Effects of adipose stem cell sheets on colon anastomotic leakage in an experimental model: Proof of principle
Panithi Sukho, Geesien S.A. Boersema, Abigael Cohen, Nicole Kops, Johan F. Lange, Jolle Kirpensteijn, Jan Willem Hesselink, Yvonne M. Bastiaansen-Jenniskens, Femke Verseijden
Biomaterials.2017; 140: 69. CrossRef
Novel therapy for pancreatic fistula using adipose-derived stem cell sheets treated with mannose
Hirokazu Kaneko, Toshio Kokuryo, Yukihiro Yokoyama, Junpei Yamaguchi, Tokunori Yamamoto, Rei Shibata, Momokazu Gotoh, Toyoaki Murohara, Akira Ito, Masato Nagino
Surgery.2017; 161(6): 1561. CrossRef
Therapeutic angiogenesis of adipose-derived stem cells for ischemic diseases
Lina Zhao, Takerra Johnson, Dong Liu
Stem Cell Research & Therapy.2017;[Epub] CrossRef

Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases: Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong; J Korean Soc Coloproctol. 2012;28(2):100-107. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.100

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22 Download
11 Citations

Abstract PDF

Purpose

The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution.

Methods

A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence.

Results

The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016).

Conclusion

The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.

Citations

Citations to this article as recorded by

Short-term outcomes of robotic tumor-specific mesorectal resection of rectal cancer: surgical techniques in mesorectal division using rolling division of the mesorectum
Yushi Yamakawa, Nobuhiro Haruki, Nobuo Ochi, Reo Sato, Hiroyuki Asai, Tomohiro Kako, Takumi Kato, Mitsuki Nakazawa, Shuji Takiguchi
Surgical Endoscopy.2024; 38(6): 3478. CrossRef
Current Controversies in the Management of Locally Advanced Colon Cancer
Mishal Gillani, Seth Alan Rosen
The American Surgeon™.2023; 89(8): 3361. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
Locally Advanced Rectal Cancer Evaluation by Magnetic Resonance Imaging after Neoadjuvant Therapy on Decision Making: Cancer Center Experience and Literature Review
Alejandro Recio-Boiles, Hytham Hammad, Krisha Howell, Bobby T. Kalb, Valentine N. Nfonsam, Aaron J. Scott, Hani M. Babiker, Emad Elquza
Journal of Gastrointestinal Cancer.2020; 51(1): 254. CrossRef
The feasibility of laparoscopic TSME preserving the left colic artery and superior rectal artery for upper rectal cancer
Chi Zhang, Hao-tang Wei, Wenqing Hu, Yueming Sun, Qinyuan Zhang, Masanobu Abe, Zhuoran Du, Yingying Xu, Liang Zong, Xiang Hu
World Journal of Surgical Oncology.2020;[Epub] CrossRef
Recurrence in patients with stage I colorectal cancer
Patrick Ely Teloken, David Ransom, Ian Faragher, Ian Jones, Peter Gibbs, Cameron Platell
ANZ Journal of Surgery.2016; 86(1-2): 49. CrossRef
Current methods in the treatment of rectal cancer
L. Yu. Kazieva, E. G. Rybakov, S. I. Sevostianov
Endoskopicheskaya khirurgiya.2016; 22(4): 49. CrossRef
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Koloproktologia.2016; (2): 57. CrossRef
Anastomotic leakage after curative rectal cancer resection has no impact on long-term survival: a propensity score analysis
Sabrina M. Ebinger, René Warschkow, Ignazio Tarantino, Bruno M. Schmied, Lukas Marti
International Journal of Colorectal Disease.2015; 30(12): 1667. CrossRef
Determinants of recurrence after intended curative resection for colorectal cancer
Michael Wilhelmsen, Thomas Kring, Lars N. Jorgensen, Mogens Rørbæk Madsen, Per Jess, Orhan Bulut, Knud Thygesen Nielsen, Claus Lindbjerg Andersen, Hans Jørgen Nielsen
Scandinavian Journal of Gastroenterology.2014; 49(12): 1399. CrossRef
A Circumferential Resection Margin of 1 mm Is a Negative Prognostic Factor in Rectal Cancer Patients With and Without Neoadjuvant Chemoradiotherapy
Jong Seob Park, Jung Wook Huh, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun
Diseases of the Colon & Rectum.2014; 57(8): 933. CrossRef

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