Annals of Coloproctology

Guideline

Colorectal cancer

Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment: Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Chang Hoon Song, Mi Sun Ahn, Jae Seon Eo, Young Chul Yoon, Joon-Kee Yoon, Kyung Ha Lee, Kyung Hee Lee, Kil-Yong Lee, Myung Su Lee, Sung Hak Lee, Jong Min Lee, Ji Eun Lee, Han Hee Lee, Myong Hoon Ihn, Je-Ho Jang, Sun Kyung Jeon, Kum Ju Chae, Jin-Ho Choi, Dae Hee Pyo, Gi Won Ha, Kyung Su Han, Young Ki Hong, Chang Won Hong, Jung-Myun Kwak, Korean Colon Cancer Multidisciplinary Committee; Ann Coloproctol. 2024;40(2):89-113. Published online April 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00059.0008

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Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

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Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
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Rıdvan Yavuz, Orhan Aras, Hüseyin Çiyiltepe, Onur İlkay Dinçer, Ahmet Şükrü Alparslan, Tebessüm Çakır
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2023 Korean Multidisciplinary Guidelines for Colon Cancer Management: Summary of Radiological Points
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Original Articles

Malignant disease,Colorectal cancer,Epidemiology & etiology

Clinicopathologic characteristics of early-onset colorectal cancer: Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2022;38(5):362-369. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00976.0139

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Abstract PDF

Purpose
The aim of this study was to analysis of the clinicopathological characteristics and prognosis of colorectal cancer (CRC) under the age of 50 years.
Methods
Between January 2009 and December 2018, 1,126 primary CRC patients were included from National Health Insurance Service Ilsan Hospital. The patients were divided into group 1 (n=111, ≤50 years) and group 2 (n=1,015, >50 years). The clinicopathologic features and prognostic outcomes were compared. In addition, to analyze whether there were any differences of those characteristics in 3 groups, patients aged under 50 years were divided into their 20s, 30s, and 40s.
Results
Group 1 had a slightly higher distribution in the left colon and rectum, lower T stage I and higher T stage IV rate, and a significantly higher distribution in stage N2 than group 2 (30.6%:16.3%, P<0.001). Poor histological differentiation of tumors was significantly high in group 1 (P=0.003). The 5-year survival rate for those in their 30s (69.2%) and 40s (91.6%) was higher than those in their 20s who died immediately after surgery (P<0.001). The 5-year disease-free survival rate was also confirmed to be meaningful for each age group, with 0% in their 20s, 53.8% in their 30s, 79.2% in their 40s (P<0.001).
Conclusion
Although the age was not an independent prognostic factor for overall survival in this study, the early onset group of CRCs is more advanced at the time of diagnosis and has a more aggressive histologic type.

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Prognostic Differences Between Early-Onset and Late-Onset Colorectal Cancer
Vlad Alexandru Ionescu, Gina Gheorghe, Ioana-Alexandra Baban, Alexandru Barbu, Teodor Florin Georgescu, Loredana-Crista Tiuca, Ninel Antonie Iacobus, Camelia Cristina Diaconu
Medicina.2025; 61(3): 390. CrossRef
Multiethnic Trends in Early Onset Colorectal Cancer
Michelle Nagata, Kohei Miyagi, Brenda Y. Hernandez, Scott K. Kuwada
Cancers.2024; 16(2): 398. CrossRef
Surgical and survival outcomes of early‐onset colorectal cancer patients: a single‐centre descriptive Australian study
Celine Garrett, Daniel Steffens, Michael Solomon, Cherry Koh
ANZ Journal of Surgery.2024; 94(9): 1584. CrossRef
Global epidemiology of early‐onset upper gastrointestinal cancer: trend from the Global Burden of Disease Study 2019
Pojsakorn Danpanichkul, Thanida Auttapracha, Siwanart Kongarin, Ben Ponvilawan, Daniel M. Simadibrata, Kwanjit Duangsonk, Supitchaya Jaruvattanadilok, Sakditad Saowapa, Kanokphong Suparan, Rashid N. Lui, Suthat Liangpunsakul, Michael B. Wallace, Karn Wija
Journal of Gastroenterology and Hepatology.2024; 39(9): 1856. CrossRef
Early onset metastatic colorectal cancer in Australia
A. Jalali, S. Smith, G. Kim, H. Wong, M. Lee, J. Yeung, M. Loft, R. Wong, J.D. Shapiro, S. Kosmider, J. Tie, S. Ananda, B. Ma, M. Burge, R. Jennens, B. Lee, J. Johns, L. Lim, A. Dean, L. Nott, P. Gibbs
Cancer Treatment and Research Communications.2024; 40: 100827. CrossRef
Five-year overall survival of early- and late-onset colorectal cancer in Medellín, Colombia: a comparative study
Álvaro Esteban Ruiz-Grajales, Juan Camilo Correa-Cote, Miguel Ángel Sánchez-Zapata, Manuela María Orozco-Puerta, Juan Felipe Baena-García, Esteban Castrillón-Martínez
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
The prognostic significance of clinicopathological characteristics in early-onset versus late-onset colorectal cancer liver metastases
Yi-Tong Li, Xiang-Yu Wang, Bo Zhang, Bao-Rui Tao, Zhen-Mei Chen, Xiao-Chen Ma, Jia-Hao Han, Chong Zhang, Rui Zhang, Jin-Hong Chen
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Patients younger than 40 years with colorectal cancer have a similar prognosis to older patients
Tomoki Abe, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Takashi Kato, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Taro Oshikiri, Yoshihiro Kakeji
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical and pathological characteristics of early-onset colorectal cancer in South Korea
Su Bee Park, Jin Young Yoon, Min Seob Kwak, Jae Myung Cha
Saudi Journal of Gastroenterology.2023; 29(6): 358. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: A collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2023;[Epub] CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients
Caterina Foppa, Annalisa Maroli, Sara Lauricella, Antonio Luberto, Carlotta La Raja, Francesca Bunino, Michele Carvello, Matteo Sacchi, Francesca De Lucia, Giuseppe Clerico, Marco Montorsi, Antonino Spinelli
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Benign GI diease

Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis: Tae Gyeong Lee, Soomin Nam, Hyung Soon Lee, Jin Ho Lee, Young Ki Hong, Jung Gu Kang; Ann Coloproctol. 2020;36(1):30-34. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.06.25

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Abstract PDF

Purpose
To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.
Methods
Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.
Results
A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.
Conclusion
There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Citations

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Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
Dezhao Liu, Yuchi Wang, Liyun Sun, Lijia Pan, Junkui Wang, Ying Lu, Zhao Cui, Jingying Li, Hui Geng
BMC Pediatrics.2024;[Epub] CrossRef
Management of appendicitis: appendicectomy, antibiotic therapy, or both?
Elroy P. Weledji, Anutebeh V. Zisuh, Eleanore Ngounou
Annals of Medicine & Surgery.2023; 85(4): 897. CrossRef
Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy
Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee
Frontiers in Surgery.2022;[Epub] CrossRef
To Reduce the Incidence of Postoperative Intraabdominal Abscess, the Application of Nonoperative Management Should be Circumspect Considering Patient Factors and the Nature of Acute Appendicitis
You Jin Lee, Kwang Hyun Yoon
Journal of Acute Care Surgery.2022; 12(3): 111. CrossRef
Effect and safety of peritoneal lavage for appendectomy: A meta-analysis
Yi-Ting Yen, El-Wui Loh, Ka-Wai Tam
The Surgeon.2021; 19(6): e430. CrossRef
A Novel Suction-and-Irrigation Laparoscopic Surgical Instrument: Internal Design and Preclinical Performance Evaluation
Sang Wook Yi
Journal of Medical Devices.2021;[Epub] CrossRef
Aspiration versus peritoneal lavage in appendicitis: a meta-analysis
Gloria Burini, Maria Chiara Cianci, Marco Coccetta, Alessandro Spizzirri, Salomone Di Saverio, Riccardo Coletta, Paolo Sapienza, Andrea Mingoli, Roberto Cirocchi, Antonino Morabito
World Journal of Emergency Surgery.2021;[Epub] CrossRef

Malignant disease, Rectal cancer

Clinicopathologic Analysis of Lateral Margin Measured by Whole-Mount Section in T3 Rectal Cancer: Soomin Nam, Youngki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2020;36(3):172-177. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.19.1

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Abstract PDF

Purpose
Total mesorectal excision is a standard technique for rectal cancer. The whole-mount section can encompass the entire specimen, so it is a more appropriate for measuring circumferential margin than conventional section. We analyzed the clinical characteristics and prognosis based on lateral margins measured by whole-mount sections. Materials and Methods: Medical records of patients who were operated on for T3 rectal cancer from 2005 to 2015 were reviewed retrospectively. A total of 154 patients were included. The slides of the whole-mount sections were re-reviewed by a single pathologist.
Results
We divided the groups according to the length of the lateral margin (LM: 1mm, 1.5mm and 2mm). There was significantly frequent lymphovascular invasion and N state was higher when LM was short in all groups. There were more micrometastasis in group LM

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Risk factors of positive resection margin differ in pancreaticoduodenectomy and distal pancreatosplenectomy for pancreatic ductal adenocarcinoma undergoing upfront surgery
Bo Li, Shiwei Guo, Xiaoyi Yin, Chenming Ni, Suizhi Gao, Gang Li, Canrong Ni, Hui Jiang, Wan Yee Lau, Gang Jin
Asian Journal of Surgery.2023; 46(4): 1541. CrossRef
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Is Whole-Mount Section in Rectal Cancer Effective for Measuring Lateral Margin?
Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju
Annals of Coloproctology.2020; 36(3): 131. CrossRef

The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection: Youngki Hong, Soomin Nam, Jung Gu Kang; Ann Coloproctol. 2017;33(3):106-111. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.106

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Abstract PDF

Purpose

The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate.

Methods

This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes.

Results

Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8–39 days).

Conclusion

Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.

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Emergency Colon and Rectal Surgery, What Every Surgeon Needs to Know
Brian Williams, Abhinav Gupta, Sarah D. Koller, Tanya JT Starr, Maximillian J.H. Star, Darcy D. Shaw, Ali H. Hakim, Jennifer Leinicke, Michael Visenio, Kenneth H. Perrone, Zachary H. Torgerson, Austin D. Person, Charles A. Ternent, Kevin A. Chen, Muneera
Current Problems in Surgery.2024; 61(1): 101427. CrossRef
Safety profile of a multimodal fail-safe model to minimize postoperative complications in oncologic colorectal resections—a cohort study
Shahram Khadem, Jonas Herzberg, Human Honarpisheh, Robert Maximilian Jenner, Salman Yousuf Guraya, Tim Strate
Perioperative Medicine.2023;[Epub] CrossRef
Intraoperative Colonic Irrigation for Low Rectal Resections With Primary Anastomosis: A Fail-Safe Surgical Model
Jonas Herzberg, Shahram Khadem, Salman Yousuf Guraya, Tim Strate, Human Honarpisheh
Frontiers in Surgery.2022;[Epub] CrossRef
Malignant Large Bowel Obstruction
Roberta L. Muldoon
Clinics in Colon and Rectal Surgery.2021; 34(04): 251. CrossRef
Mechanical Bowel Preparation, Do It or Not: When Crossing a River, What Do People Do?
Hungdai Kim
Annals of Coloproctology.2017; 33(3): 84. CrossRef

Correlation of Histopathology With Anorectal Manometry Following Stapled Hemorrhoidopexy: Young Ki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2013;29(5):198-204. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.198

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Abstract PDF

Purpose

The removal of smooth muscle during stapled hemorrhoidopexy raises concerns regarding its effects on postoperative anorectal function. The purpose of this study was to evaluate the correlation between the amount of muscle removed and changes in anorectal manometry following stapled hemorrhoidopexy.

Methods

Patients with symptomatic II, III, or IV degree hemorrhoids that underwent stapled hemorrhoidopexy between January 2008 and May 2011 were included in this study. Anorectal manometry was performed preoperatively and at three months postoperatively. The resected doughnuts were examined histologically, and the thicknesses of muscle fibers were evaluated.

Results

Eighty-five patients (34 males) with a median age of 47 years were included. Muscularis propria fibers were identified in 63 of 85 pathologic specimens (74.1%). The median thickness of the muscle fibers was 1.58 ± 1.21 mm (0 to 4.5 mm). The mean resting pressure decreased by approximately 7 mmHg after operation in the 85 patients (P = 0.019). In patients with muscle incorporation, there was a significant difference in mean resting pressure (P = 0.041). In the analysis of the correlation of the difference in anorectal manometry results ([the result of postsurgical anorectal manometry] - [the result of presurgical anorectal manometry]) to the thickness of muscle fibers, no significant differences were seen. No patients presented with fecal incontinence.

Conclusion

Although the incidence of fecal incontinence is very low, muscle incorporation in the resected doughnuts following stapled hemorrhoidopexy may affect anorectal pressure. Therefore, surgeons should endeavor to minimize internal sphincter injury during stapled hemorrhoidopexy.

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The prevalence of incontinence after excisional hemorrhoidectomy and stapled hemorrhoidopexy: A systematic review and meta-analysis
James Z. Jin, Velia Men, Praharsh Bahl, Harshitha Penneru, Robin Yang, Niket Shah, Andrew G. Hill
Surgery.2025; 180: 109139. CrossRef
Anatomical Anal Stenosis after PPH: Insights from a Retrospective Study and Rat Model
Chia-Cheng Wen, Shih-Ming Huang, Yi-Wen Wang
International Journal of Molecular Sciences.2024; 25(6): 3543. CrossRef
Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
Association of Muscle Fibers with Histopathology in Doughnut Specimens Following Stapled Hemorrhoidopexy and Their Impacts on Postoperative Outcomes
Chetty Y. V. Narayanaswamy, M. R. Sreevathsa, G. Akhil Chowdari, Koteshwara Rao
The Surgery Journal.2022; 08(03): e199. CrossRef
Anorectal Functional Outcomes Following Doppler-Guided Transanal Hemorrhoidal Dearterialization: Evidence from Vietnam
Le Manh Cuong, Vu Nam, Tran Thai Ha, Tran Thu Ha, Tran Quang Hung, Do Van Loi, Tran Manh Hung, Nguyen Van Son, Vu Duy Kien
Advances in Therapy.2020; 37(3): 1136. CrossRef
Post-surgical fecal incontinence
Filippo Pucciani
Updates in Surgery.2018; 70(4): 477. CrossRef
Magnetic resonance imaging and endorectal ultrasound for diagnosis of rectal lesions
Franciszek Burdan, Iwona Sudol-Szopinska, Elzbieta Staroslawska, Malgorzata Kolodziejczak, Robert Klepacz, Agnieszka Mocarska, Marek Caban, Iwonna Zelazowska-Cieslinska, Justyna Szumilo
European Journal of Medical Research.2015;[Epub] CrossRef
Histopathology and Physiological Alterations After Procedure for Prolapsed Hemorrhoids
Do Sun Kim
Annals of Coloproctology.2013; 29(5): 179. CrossRef

Case Report

Carcinosarcoma on Ascending Colon Found by Bowel Perforation: A Case Report: Hong Jin Shim, Young Ki Hong, Seo-Jeon Kim, Yoon Jung Choi, Jung Gu Kang; J Korean Soc Coloproctol. 2010;26(5):368-372. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.368

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Abstract PDF

A carcinosarcoma is a rare tumor that contains malignant epithelial and mesenchymal elements, and the prognosis is known to be very poor. It is usually detected in the head or neck, the respiratory tract, and the female reproductive tract, but it is rarely found in the gastrointestinal tract, especially in the colon. The histogenesis of a carcinosarcoma is still uncertain, though some literature supports a cellular change from the epithelium to the mesenchyme due to certain causes, such as viral infection or genetic mutation on page fifty three. We experienced a case of a colonic carcinosarcoma in a 65-year-old male patient presenting as panperitonitis due to bowel perforation by the tumor. A right hemicolectomy with lymph node dissection was performed. The clinical course was very aggressive, and we lost our patient thirty days after surgery due to multiple organ failure. Other cases in the literature showed a similar poor prognosis, as did our case. Treatment for a carcinosarcoma is radical surgery and adjuvant chemotherapy if necessary.

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Sarcomatoid Carcinoma of the Anorectal Junction: Struggling with an Extremely Rare Tumor
Dimitrios Keramidaris, Ilias Koukoutsis, Stavros Gourgiotis, Emmanuel Lagoudianakis, Dimitrios Sampaziotis, Christos Gakis, George Gemenentzis, John Lahanas, Μaria Varela, Charalampos Seretis, George Dimitrakopoulos
Journal of Gastrointestinal Cancer.2012; 43(S1): 93. CrossRef

Original Article

Relation of the Expression of Cyclooxygenase-2 in Colorectal Adenomas and Adenocarcinomas to Angiogenesis and Prognosis: Yoon Dae Han, Young Ki Hong, Jung Gu Kang, Yoon Jung Choi, Chan Heun Park; J Korean Soc Coloproctol. 2010;26(5):339-346. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.339

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Abstract PDF

Purpose

Recent studies have shown that cyclooxygenase (COX)-2 may be involved in tumor growth, invasion and apoptosis in various carcinomas. Vascular endothelial growth factor (VEGF) has a potent angiogenic activity, and COX-2 promotes angiogenesis by modulating angiogenic factors, including VEGF. Endothelial growth factor receptor (EGFR) is considered as a factor of cell growth, maturation and cell death. The current study was designed to investigate the possible roles of COX-2 in colorectal tumor progression and angiogenesis.

Methods

Fifty colorectal adenomas and forty adenocarcinomas were investigated by using immunohistochemical staining for COX-2, VEGF and EGFR. The correlations of COX-2, VEGF and EGFR with the grade of dysplasia, the size of the adenoma, and various clinicopathologic factors were studied.

Results

The expressions of COX-2, VEGF and EGFR were each significantly correlated with carcinomatous transformation, and the expressions of COX-2 and VEGF were significantly correlated. COX-2 and EGFR showed correlations with adenomas rather than adenocarcinomas. However, no correlations of COX-2, VEGF and EGFR expression to other clinicopathologic factors, except tumor size in EGFR expression, were detected.

Conclusion

These results suggest that COX-2 may play an important role in carcinogenesis through interaction with VEGF and EGFR in human colorectal cancer.

Citations

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