Annals of Coloproctology

Original Articles

Colorectal cancer

Recurrence following transanal total mesorectal excision for rectal cancer: a monocentric retrospective series of technically difficult cases: Jonathan Frigault, Geneviève Morin, Sébastien Drolet, Philippe Bouchard, Alexandre Bouchard, Thanh-Quan Philips Ngo, François Letarte; Ann Coloproctol. 2023;39(4):332-341. Published online November 14, 2022; DOI: https://doi.org/10.3393/ac.2022.00178.0025

2,849 View
59 Download

Abstract PDF: Purpose
Transanal total mesorectal excision (TaTME) has been proposed to overcome surgical difficulties encountered during rectal resection, especially for patients having high body mass index or low rectal cancer. The aim of this study was to evaluate oncologic outcomes following TaTME.
Methods
This retrospective study included all consecutive patients with rectal cancer who had a TaTME from 2013 to 2019. The main outcome was the incidence of locoregional recurrence by the end of the follow-up period.
Results
Among a total of 81 patients, 96.3% were male, and their mean age was 63±9 years. The mean body mass index was 30.3±5.7 kg/m2, and the median distance from tumor to anal verge was 5.0 cm (interquartile range [IQR], 4.0–6.0 cm). Most patients had a low anterior resection performed (n=80, 98.8%) with a diverting ileostomy (n=64, 79.0%). Distal and circumferential resection margins were positive in 2.5% and 6.2% of patients, respectively. Total mesorectal excision was complete or near complete in 95.1% of patients. A successful resection was achieved in 72 patients (88.9%). After a median follow-up of 27.5 months (IQR, 16.7–48.1 months), 4 patients (4.9%) experienced locoregional recurrence. Anastomotic leaks were observed in 21 patients (25.9%). At the end of the follow-up, 69 patients (85.2%) were stoma-free.
Conclusion
TaTME was associated with acceptable oncological outcomes, including low locoregional recurrence rates in selected patients with low rectal cancer. Although associated with a high incidence of postoperative morbidities, the use of TaTME enabled a high rate of successful sphincter-saving procedures in selected patients who posed a technical challenge.

Clinical Etiology of Hypermetabolic Pelvic Lesions in Postoperative Positron Emission Tomography/Computed Tomography for Patients With Rectal and Sigmoid Cancer: Yun Hee Kang, Eunji Han, Geon Park; Ann Coloproctol. 2018;34(2):78-82. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.21

5,044 View
75 Download
2 Web of Science
1 Citations

Purpose
The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer.
Methods
Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded. All PET findings were analyzed in comparison with contrast-enhanced CT.
Results
A total of 43 patients were classified into 2 groups: patients with a malignancy including local recurrence (n = 30) and patients with other benign lesions (n = 13). Malignant lesions such as a local recurrent tumor, peritoneal carcinomatosis, and incidental uterine malignancy, as well as various benign lesions such as an anastomotic sinus, fistula, abscess, reactive lymph node, and normal ovary, were observed.
Conclusion
PET/CT performed during postoperative surveillance of rectal and sigmoid colon cancer showed increased fluorodeoxyglucose uptake not only in local recurrence, but also in benign pelvic etiologies. Therefore, physicians need to be cautious about the broad clinical spectrum of hypermetabolic pelvic lesions when interpreting images.

Citations

Citations to this article as recorded by

Variants and Pitfalls in PET/CT Imaging of Gastrointestinal Cancers
Vetri Sudar Jayaprakasam, Viktoriya Paroder, Heiko Schöder
Seminars in Nuclear Medicine.2021; 51(5): 485. CrossRef

Case Report

Intramural Recurrence Without Mucosal Lesions After an Endoscopic Mucosal Resection for Early Colorectal Cancer: Min Sung Kim, Nam Kyu Kim, Ji Hye Park; Ann Coloproctol. 2013;29(3):126-129. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.126

3,454 View
30 Download
7 Citations

Abstract PDF

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.

Citations

Citations to this article as recorded by

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
Growth-inhibition of S180 residual-tumor by combination of cyclophosphamide and chitosan oligosaccharides in vivo
Xingchen Zhai, Shoujun Yuan, Xin Yang, Pan Zou, Yong Shao, A.M. Abd El-Aty, Ahmet Hacımüftüoğlu, Jing Wang
Life Sciences.2018; 202: 21. CrossRef
Handling and Pathology Reporting of Gastrointestinal Endoscopic Mucosal Resection
Bita Geramizadeh, David A. Owen
Middle East Journal of Digestive Diseases.2017; 9(1): 5. CrossRef
Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI
Young Chul Kim, Jai Keun Kim, Myeong-Jin Kim, Jei Hee Lee, Young Bae Kim, Sung Jae Shin
European Radiology.2016; 26(2): 297. CrossRef
Antitumor Effects of Orally and Intraperitoneally Administered Chitosan Oligosaccharides (COSs) on S180‐Bearing/Residual Mouse
Pan Zou, Xin Yang, Yanxin Zhang, Pengfei Du, Shoujun Yuan, Dexuan Yang, Jing Wang
Journal of Food Science.2016;[Epub] CrossRef
Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review
S. Cai, Y. Zhong, P. Zhou, J. Xu, L. Yao
Gastroenterology Report.2014; 2(1): 27. CrossRef
Anticancer activity of tuftsin-derived T peptide in postoperative residual tumors
Yinghong An, Linna Li, Dexuan Yang, Na Jia, Chengwang Xu, Qiong Wang, Shanshan Wang, Shoujun Yuan
Anti-Cancer Drugs.2014; 25(8): 857. CrossRef

Original Article

Analysis of Clinicopathological Factors Affecting Local Recurrence of Colorectal Cancer after Curative Resection.: Park, Chan Ho , Lee, Ho Kil , Yun, Min Young , Choi, Sun Keun , Hur, Yun Suk , Lee, Kun Young , Kim, Sei Joong , Cho, Young Up , Ahn, Seung Ick , Hong, Kee Chun , Shin, Suk Hwan , Kim, Kyung Rae , Woo, Ze Hong; J Korean Soc Coloproctol. 2005;21(5):320-324.

981 View
5 Download

Abstract PDF: PURPOSE
Local recurrence after curative resection of colorectal cancer has an important influence on both survival and quality of life. The ability to predict local recurrence after a curative resection of colorectal cancer may be useful for an intensive follow-up program and for a decision on adjuvant radiation or chemotherapy. The aim of this study was to analyze the factors affecting the incidence of local recurrence after a curative resection of colorectal cancer.
METHODS
A retrospective review of 390 patients who had a curative resection for a primary colorectal cancer by a single surgeon at the Department of Surgery, Inha University Hospital, between June 1996 and July 2002 was done. The medical records of patients diagnosed with a local recurrence were reviewed. Local recurrence was defined as any recurrence within the field of resection, regardless of the presence or absence of distant metastasis, that was diagnosed by using colonoscopy with biopsy and/or radiologic imaging.
RESULTS
Local recurrences were detected in 40 patients (10.3%). The gender distribution of patients with local recurrence was 24 males and 16 females with a mean age of 59.8 years. The median time to local recurrence was 15 months. The most common site of local recurrence was the anastomosis site, followed by a regional lymph node, the pelvicoperineal area, and the presacral area. Local recurrence was related to the depth of the primary tumor (P=0.027), lymphatics or vascular invasion (P=0.003), perineural invasion (P= 0.000), nodal status (P=0.000), and distant metastasis (P= 0.002). However, there was no statistically significant relation between local recurrence and primary tumor location (P=0.053), primary tumor size (P=0.982), tumor differentiation (0.256), and preoperative CEA level (P=0.481).
CONCLUSIONS
The depth of the primary tumor, lymphatics or vascular invasion, and perineural invasion were significant clinicopathologic factors of local recurrence, but tumor location, tumor size, tumor differentiation, and preoperative serum CEA level were not.

First
Prev
Page of 1
Next
Last

Search