Annals of Coloproctology

Original Articles

Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older: Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu; Received June 7, 2023 Accepted September 11, 2023 Published online August 5, 2024; DOI: https://doi.org/10.3393/ac.2023.00367.0052 [Epub ahead of print]

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Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

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Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization
Yakup Duzkopru, Özlem Doğan
Turkish Journal of Clinics and Laboratory.2025; 16(1): 118. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. CrossRef

Colorectal cancer

Evaluating prognostic significance of preoperative C-reactive protein to albumin ratio in older patients with pathological stage II or III colorectal cancer: Koji Numata, Yukari Ono, Mihwa Ju, Shizune Onuma, Ayano Tanaka, Taichi Kawabe, Sho Sawazaki, Akio Higuchi, Kazuki Yamanaka, Shinsuke Hatori, Hiroyuki Saeki, Hiroshi Matsukawa, Yasushi Rino, Kazuyuki Tani; Ann Coloproctol. 2024;40(2):161-168. Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00367.0052

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Abstract PDF

Purpose
This study was performed to evaluate the prognostic value of preoperative C-reactive protein to albumin ratio (CAR) in older patients with colorectal cancer (CRC) undergoing curative resection.
Methods
We retrospectively analyzed 244 older patients (aged 75 years or higher) with pathological stage II or III CRC who underwent curative surgery between 2008 and 2016. The optimal value of CAR was calculated and its correlation with the clinicopathological factors and prognosis was examined.
Results
The optimal cutoff value of the CAR was 0.085. High preoperative CAR was significantly associated with high carcinoembryonic antigen levels (P=0.001), larger tumor size (P<0.001), and pT factor (P=0.001). On multivariate analysis, high CAR was independent prognostic factor for relapse-free survival (P=0.042) and overall survival (P=0.001).
Conclusion
Preoperative elevated CAR could be considered as an adverse predictor of both relapse-free survival and overall survival in older patients with CRC undergoing curative surgery.

Citations

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C-Reactive Protein/Albumin Ratio Is an Independent Risk Factor for Recurrence and Survival Following Curative Resection of Stage I–III Colorectal Cancer in Older Patients
Tomoaki Bekki, Manabu Shimomura, Minoru Hattori, Saki Sato, Atsuhiro Watanabe, Sho Ishikawa, Kouki Imaoka, Kosuke Ono, Keiso Matsubara, Tetsuya Mochizuki, Shintaro Akabane, Takuya Yano, Hideki Ohdan
Annals of Surgical Oncology.2024; 31(7): 4812. CrossRef
Towards a Gradual Optimization of Oncologic Prognostic Factors in the Era of the Frail Patient: The Potential Role of Preoperative Inflammation and Nutritional Status
Giuseppe Zimmitti
Annals of Surgical Oncology.2024; 31(8): 4853. CrossRef
Prognostic role of C-reactive protein to albumin ratio in cancer patients treated with immune checkpoint inhibitors: a meta-analysis
Menglu Dai, Wei Wu
Frontiers in Oncology.2023;[Epub] CrossRef
The association of blood biomarkers with treatment response and adverse health outcomes in older patients with solid tumors: A systematic review
Yara van Holstein, P. Janne E. van den Berkmortel, Stella Trompet, Diana van Heemst, Frederiek van den Bos, Marieke Roemeling-van Rhijn, Nienke A. de Glas, Marian Beekman, P. Eline Slagboom, Johanneke E.A. Portielje, Simon P. Mooijaart, Barbara C. van Mun
Journal of Geriatric Oncology.2023; 14(7): 101567. CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. CrossRef

Colorectal cancer

Clinical impact of C-reactive protein to albumin ratio of the 7th postoperative day on prognosis after laparoscopic colorectal cancer surgery: Masahiro Kataoka, Kuniyuki Gomi, Ken Ichioka, Takuya Iguchi, Tomoki Shirota, Arano Makino, Ko Shimada, Kiyotomi Maruyama, Motohiro Mihara, Shoji Kajikawa; Ann Coloproctol. 2023;39(4):315-325. Published online June 13, 2022; DOI: https://doi.org/10.3393/ac.2022.00234.0033

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Graphical Abstract Abstract PDF

Purpose
C-reactive protein to albumin ratio (CAR) has been utilized as a prognostic factor in various carcinomas. We investigated the relationship between preoperative, postoperative day (POD) 1, and POD 7 CARs and the prognosis of patients with colorectal cancer (CRC).
Methods
Three hundred twenty patients with CRC who underwent laparoscopic radical resection between May 2011 and December 2016 were enrolled. Patients were selected into 2 groups, high CAR and low CAR (n=72/group), based on preoperative, POD 1, and POD 7 CARs. The relapse-free survival (RFS) and overall survival (OS) were compared between groups using propensity score matching.
Results
The high CAR group had a significantly worse RFS (P<0.001) and OS (P=0.002) at POD 7 than those in the low CAR group. However, in preoperative and POD 1 analysis, no differences were observed.
Conclusion
In patients with CRC, CAR of POD 7 was a significant prognostic factor.

Citations

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C-Reactive Protein/Albumin Ratio Is an Independent Risk Factor for Recurrence and Survival Following Curative Resection of Stage I–III Colorectal Cancer in Older Patients
Tomoaki Bekki, Manabu Shimomura, Minoru Hattori, Saki Sato, Atsuhiro Watanabe, Sho Ishikawa, Kouki Imaoka, Kosuke Ono, Keiso Matsubara, Tetsuya Mochizuki, Shintaro Akabane, Takuya Yano, Hideki Ohdan
Annals of Surgical Oncology.2024; 31(7): 4812. CrossRef
Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer
Sung Uk Bae
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Revisiting the diagnostic performance of exosomes: harnessing the feasibility of combinatorial exosomal miRNA profiles for colorectal cancer diagnosis
Jin Sung Park, Jin Ah Choi, Da Han Hyun, Chorok Byeon, Sang Gyu Kwak, Jun Seok Park, Seonki Hong
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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
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Colorecal cancer

Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients: Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2023;39(5):410-420. Published online April 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00143.0020

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Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the predictive value of lymph node yield (LNY) for survival outcomes according to tumor response after preoperative chemoradiotherapy (PCRT) in patients with rectal cancer.
Methods
This study was a retrospective study conducted in a tertiary center. A total of 1,240 patients with clinical stage II or III rectal cancer who underwent curative resection after PCRT between 2007 and 2016 were included. Patients were categorized into the good response group (tumor regression grade [TRG], 0–1) or poor response group (TRG, 2–3). Propensity score matching was performed for age, sex, and pathologic stage between LNY of ≥12 and LNY of <12 within tumor response group. The primary outcome was 5-year disease-free survival (DFS) and overall survival (OS).
Results
LNY and positive lymph nodes were inversely correlated with TRG. In good responders, 5-year DFS and 5-year OS of patients with LNY of <12 were better than those with LNY of ≥12, but there was no statistical significance. In poor responders, the LNY of <12 group had worse survival outcomes than the LNY of ≥12 group, but there was also no statistical significance. LNY of ≥12 was not associated with DFS and OS in multivariate analysis.
Conclusion
LNY of <12 showed contrasting outcomes between the good and poor responders in 5-year DFS and OS. LNY of 12 may not imply adequate oncologic surgery or proper staging in rectal cancer patients treated by PCRT. Furthermore, a decrease in LNY should be comprehended differently according to tumor response.

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Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
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Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef

Review

Malignant disease, Rectal cancer,Colorectal cancer,Prognosis,Biomarker & risk factor

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer: Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim; Ann Coloproctol. 2022;38(2):97-108. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.01004.0143

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Abstract PDF

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

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Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
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Ke-Jin Li, Zi-Yi Zhang, Kuan Wang, Subinur Sulayman, Xiang-Yue Zeng, Juan Liu, Yi Chen, Ze-Liang Zhao
World Journal of Gastroenterology.2025;[Epub] CrossRef
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Ali H. Abd-Allah, Haider A. Jabbar, Mazen J. Ibrahim
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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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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
Cancers.2022; 14(24): 6239. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Prognostic Factors Affecting Disease-Free Survival and Overall Survival in T4 Colon Cancer: Taeyeong Eom, Yujin Lee, Jungbin Kim, Inseok Park, Geumhee Gwak, Hyunjin Cho, Keunho Yang, Kiwhan Kim, Byung-Noe Bae; Ann Coloproctol. 2021;37(4):259-265. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2020.00759.0108; Correction in: Ann Coloproctol 2023;39(5):444

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18 Citations

Abstract PDF

Purpose
It is known that as the T stage of a carcinoma progresses, the prognosis becomes poorer. However, there are few studies about factors that affect the prognosis of T4 advanced colon cancer. This study aimed to identify the prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in T4 colon cancer.
Methods
Patients diagnosed with stage T4 on histopathology after undergoing curative surgery for colon cancer between March 2009 and March 2018 were retrospectively analyzed for factors related to postoperative survival. Primary outcomes were DFS and OS.
Results
Eighty-two patients were included in the study. DFS and OS of the pathologic (p) T4b group were not inferior to that of the pT4a group. Multivariate analysis showed that differentiation (hazard ratio [HR], 4.994; P = 0.005), and laparoscopic surgery (HR, 0.323; P = 0.008) were significant prognostic factors for DFS, while differentiation (HR, 7.904; P ≤ 0.001) and chemotherapy (HR, 0.344; P = 0.038) were significant prognostic factors for OS.
Conclusion
Tumor differentiation, laparoscopic surgery, and adjuvant chemotherapy were found to be significant prognostic factors in patients with T4 colon cancer. Adjuvant chemotherapy and curative resections by laparoscopy might improve the prognosis in these patients.

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Sebastián Jerí-McFarlane, Álvaro García-Granero, Marco Antonio Martínez-Ortega, Isabel Amengual-Antich, Ángela Rodríguez Robayo, Margarita Gamundí-Cuesta, Francisco Xavier González-Argenté
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Prognostic Factors of Postoperative Mortality in Patients with Complicated Right Colon Cancer
Raul Mihailov, Corina Dima, Bianca Georgiana Constantin, Florentin Dimofte, Mihaela Craescu, Lavinia Moroianu, Laura Iuliana Candussi, Virginia Lutenco, Oana Mariana Mihailov, Valerii Lutenco
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Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
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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
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Ji-Hyun Seo, In-Ja Park
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Erratum to “Prognostic factors affecting disease-free survival and overall survival in T4 colon cancer”

Annals of Coloproctology.2023; 39(5): 444. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
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
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Impact on inadequate lymph node harvest on survival in T4N0 colorectal cancer: A would-be medical center experience in Taiwan
Yi-Kai Kao, Hsin-Pao Chen, Kuang-Wen Liu, Ling-Chiao Song, Yi-Chieh Chen, Yu-Chun Lin, Chih-I Chen
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Tsutomu Kumamoto, Shigeki Yamaguchi, Ryosuke Nakagawa, Yoji Nagashima, Fumi Maeda, Kimitaka Tani, Hiroka Kondo, Kurodo Koshino, Yuka Kaneko, Yoshiko Bamba, Shimpei Ogawa, Yuji Inoue, Michio Itabashi
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Javier Fernández, Blanca Silván, Rodrigo Entrialgo-Cadierno, Claudio J. Villar, Raffaele Capasso, José Antonio Uranga, Felipe Lombó, Raquel Abalo
Biomedicine & Pharmacotherapy.2021; 143: 112241. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

The Impact of Primary Tumor Resection on Survival in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases: Ki Yoon Doah, Ui Sup Shin, Byong Ho Jeon, Sang Sik Cho, Sun Mi Moon; Ann Coloproctol. 2021;37(2):94-100. Published online April 30, 2021; DOI: https://doi.org/10.3393/ac.2020.09.15.1

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15 Citations

Abstract PDF

Purpose
This study was conducted to evaluate the effectiveness of primary tumor resection (PTR) in asymptomatic colorectal cancer (CRC) patients with unresectable metastases using the inverse probability of treatment weighting (IPTW) method to minimize selection bias.
Methods
We selected 146 patients diagnosed with stage IV CRC with unresectable metastasis between 2001 and 2018 from our institutional database. In a multivariate logistic regression model using the patients’ baseline covariates associated with PTR, we applied the IPTW method based on a propensity score and performed a weighted Cox proportional regression analysis to estimate survival according to PTR.
Results
Upfront PTR was performed in 98 patients, and no significant differences in baseline factors were detected. The upweighted median survival of the PTR group was 18 months and that of the non-PTR group was 15 months (P = 0.15). After applying the IPTW, the PTR was still insignificant in the univariate Cox regression (hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.5–1.21). However, in the multivariate weighted Cox regression with adjustment for other covariates, the PTR showed a significantly decreased risk of cancer-related death (HR, 0.61; 95% CI, 0.40–0.94).
Conclusion
In this study, we showed that asymptomatic CRC patients with unresectable metastases could gain a survival benefit from upfront PTR by analysis with the IPTW method. However, randomized controlled trials are mandatory.

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Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies
Jun Huang, Jiahao Zhou, Ping Zhang, Qingbin Wu, Ziqiang Wang
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Effect of primary tumor resection on survival in patients with asymptomatic unresectable metastatic colorectal cancer: a systematic review and meta-analysis
Chengren Zhang, Cong Cao, Lili Liu, Yaochun Lv, Jingjing Li, Jiyong Lu, Shuai Wang, Binbin Du, Xiongfei Yang
Expert Review of Anticancer Therapy.2023; 23(1): 107. CrossRef
The role of upfront primary tumor resection in asymptomatic patients with unresectable stage IV colorectal cancer: A systematic review and meta-analysis
Zongyu Liang, Zhiyuan Liu, Chengzhi Huang, Xin Chen, Zhaojun Zhang, Meijuan Xiang, Weixian Hu, Junjiang Wang, Xingyu Feng, Xueqing Yao
Frontiers in Surgery.2023;[Epub] CrossRef
Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview
Junge Bai, Ming Yang, Zheng Liu, Sergey Efetov, Cuneyt Kayaalp, Audrius Dulskas, Darcy Shaw, Xishan Wang
Frontiers in Oncology.2023;[Epub] CrossRef
Palliative primary tumor resection in minimally symptomatic (asymptomatic) patients with colorectal cancer and synchronous unresectable metastases versus chemotherapy alone: a metaanalysis
Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov, M. V. Alekseev
Koloproktologia.2023; 22(2): 126. CrossRef
The impact of primary tumor resection for asymptomatic colorectal cancer patients with unresectable metastases: a systematic review and meta-analysis
Shuyuan Li, Liqiang Ji, Jie Huang, Ye Wang, Peng Liu, Wei Zhang, Zheng Lou
International Journal of Colorectal Disease.2023;[Epub] CrossRef
The impact of palliative primary tumor resection on overall survival in minimally symptomatic (asymptomatic) colorectal cancer and synchronous unresectable metastases vs chemotherapy only: a comparative study of outcomes
Iu. V. Alimova, S. I. Achkasov, Yu. A. Shelygin, M. V. Alekseev, V. N. Kashnikov, M. Yu. Fedyanin, M. A. Danilov, E. G. Rybakov
Koloproktologia.2023; 22(4): 10. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Palliative primary tumor resection in minimally symptomatic patients with colorectal cancer and synchronous unresectable metastases: when is it necessary? (systematic review)
Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov
Koloproktologia.2022; 21(3): 99. CrossRef
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Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
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Eun Jung Park, Seung Hyuk Baik
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Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Primary Tumor Resection in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases: Can It Improve Survival?
Myong Hoon Ihn
Annals of Coloproctology.2021; 37(2): 71. CrossRef
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
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Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer: Mok-Won Lee, Jin-Su Kim, Ji-Yeon Kim, Kyung-ha Lee; Ann Coloproctol. 2021;37(1):35-43. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.03

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8 Citations

Abstract PDF

Purpose
There is no clear evidence of the benefit of adjuvant chemotherapy (AC) in stage IIA colon cancer. Therefore, we aimed to evaluate the prognostic factors and survival benefit of AC in this disease.
Methods
A retrospective data collection for patients who underwent radical surgery for colon cancer between January 2008 and December 2015 was undertaken. The cohort was divided into the no-AC and AC groups.
Results
We included 227 patients with stage IIA colon cancer in our study cohort, including 67 and 160 patients in the no-AC and AC groups, respectively. The number of retrieved lymph nodes and the presence of tumor complications as obstruction or perforation were independent risk factors for survival. In the no-AC group, there was a significant difference in survival according to the number of retrieved lymph nodes. In the AC group, there were significant differences in survival according to sidedness and preoperative carcinoembryonic antigen (CEA). There was no significant difference in survival between the no-AC and the AC groups.
Conclusion
The number of retrieved lymph nodes and the presence of tumor complications were prognostic factors for stage IIA colon cancer but lymphovascular and perineural invasion were not. Sidedness and preoperative CEA could be used as factors to predict the benefit of adjuvant chemotherapy. Currently, it is believed that there is no benefit of AC for stage IIA colon cancer. Further studies are needed to determine the survival benefit of adjuvant chemotherapy in stage IIA colon cancer.

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Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. 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
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis
Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han, Zhou Li
International Journal of Colorectal Disease.2022; 37(12): 2481. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. 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
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Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju
Annals of Coloproctology.2020; 36(3): 131. CrossRef

Case Report

Malignant disease

Nasal Cavity Metastasis From Colorectal Cancer Represents End-Stage Disease and Should Be Palliated: Stephen Hwang, Dedrick Kok Hong Chan, Fredrik Petersson, Ker-Kan Tan; Ann Coloproctol. 2020;36(2):119-121. Published online November 13, 2019; DOI: https://doi.org/10.3393/ac.2019.03.04

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6 Citations

Abstract PDF

Nasal metastases from colorectal cancer is rare. The presentation of nasal metastases is often very similar to primary nasal sinus adenocarcinoma. A high index of suspicion is required, especially in patients who have had a previous history of colorectal carcinoma. Histology is ultimately required for diagnosis. We describe 2 cases of nasal metastases from colorectal carcinoma, and discuss the presentation, diagnosis and management of the case. Such metastatic disease ultimately represents end-stage malignancy, and patients should be palliated.

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Andrew J. Rothka, David Goldrich, Jessyka G. Lighthall
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Eun Jung Park, Seung Hyuk Baik
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Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
A Very Rare Case of Metastases to the Nasal Cavity from Primary Rectal Adenocarcinoma
Nishant Lohia, Harish Sadashiva, Sankalp Singh, Samir Agarwal, Vikas Gupta, Manoj Prashar, Gaurav Trivedi
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Sannia Sjöstedt, Ane Yde Schmidt, Filipe Garrett Vieira, Gro Linno Willemoe, Tina Klitmøller Agander, Caroline Olsen, Finn Cilius Nielsen, Christian von Buchwald
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Rare case of metastatic adenocarcinoma to the maxillary sinus
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Original Articles

Neutrophil to Lymphocyte Ratio: A Predictive Marker for Treatment Outcomes in Patients With Rectal Cancer Who Underwent Neoadjuvant Chemoradiation Followed by Surgery: Byong Ho Jeon, Ui Sup Shin, Sun Mi Moon, Jung Il Choi, Mi-Sook Kim, Kie Hwan Kim, Se-Jin Sung; Ann Coloproctol. 2019;35(2):100-106. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2018.10.01

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16 Citations

Abstract PDF

Purpose
In this study, we investigated the role of neutrophil to lymphocyte ratio (NLR) as a predictor of tumor response and as a prognostic factor in patients with rectal cancer who had undergone curative surgery after neoadjuvant chemoradiation therapy (nCRT).
Methods
Between January 2009 and July 2016, we collected 140 consecutive patients who had undergone curative intent surgery after nCRT due to rectal adenocarcinoma. We obtained the pre- and post-nCRT NLR by dividing the neutrophil count by the lymphocyte count. The cutoff value was obtained using receiver operating characteristic analysis for tumor response and using maximally selected rank analysis for recurrence-free survival (RFS). The relationship among NLR, tumor response, and RFS was assessed by adjusting the possible clinico-pathological confounding factors.
Results
The possibility of pathologic complete response (pCR) was significantly decreased in high pre- (>2.77) and postnCRT NLR (>3.23) in univariate regression analysis. In multivariate analysis, high post-nCRT NLR was an independent negative predictive factor for pCR (adjusted odds ratio, 0.365; 95% confidence interval [CI], 0.145–0.918). The 5-year RFS of all patients was 74.6% during the median 37 months of follow-up. Patients with higher pre- (>2.66) and post-nCRT NLR (>5.21) showed lower 5-year RFS rates (53.1 vs. 83.3%, P = 0.006) (69.2 vs. 75.7%, P = 0.054). In multivariate Cox analysis, high pre-nCRT NLR was an independent poor prognostic factor for RFS (adjusted hazard ratio, 2.300; 95% CI, 1.061–4.985).
Conclusion
Elevated NLR was a negative predictive marker for pCR and was independently associated with decreased RFS. For confirmation, a large-scale study with appropriate controls is needed.

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Landscape of Biomarkers and Pathologic Response in Rectal Cancer: Where We Stand?
Abrahams Ocanto, Macarena Teja, Francesco Amorelli, Felipe Couñago, Ariel Gomez Palacios, Diego Alcaraz, Ramón Cantero
Cancers.2024; 16(23): 4047. CrossRef
Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis
Giuseppe Portale, Patrizia Bartolotta, Danila Azzolina, Dario Gregori, Valentino Fiscon
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
NEUTROPHIL-LYMPHOCYTE RATIO (NLR) AND LYMPHOPENIAAS PROGNOSTIC FACTORS OF OVERALL SURVIVAL IN LOCALADVANCED RECTAL CANCER
Ocanto A, Morera R, Rodríguez I, Cantero R
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2023; : 11. CrossRef
Neutrophil-to-lymphocyte ratio predicts survival of patients with rectal cancer receiving neo-adjuvant chemoradiation followed by radical resection: a meta-analysis
Giuseppe Colloca, Antonella Venturino, Domenico Guarneri
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Efficacy of concurrent radiotherapy in patients with locally advanced rectal cancer and synchronous metastasis receiving systemic therapy
Tzu-Chieh Yin, Po-Jung Chen, Yung-Sung Yeh, Ching-Chun Li, Yen-Cheng Chen, Wei-Chih Su, Tsung-Kun Chang, Ching-Wen Huang, Chun-Ming Huang, Hsiang-Lin Tsai, Jaw-Yuan Wang
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The Crying Need for a Better Response Assessment in Rectal Cancer
Samuel Amintas, Nicolas Giraud, Benjamin Fernandez, Charles Dupin, Quentin Denost, Aurelie Garant, Nora Frulio, Denis Smith, Anne Rullier, Eric Rullier, Te Vuong, Sandrine Dabernat, Véronique Vendrely
Current Treatment Options in Oncology.2023; 24(11): 1507. CrossRef
Prognostic Role of Peripheral Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) in Patients with Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy
Şefika Arzu Ergen, Ceren Barlas, Cumhur Yıldırım, Didem Çolpan Öksüz
Journal of Gastrointestinal Cancer.2022; 53(1): 151. CrossRef
Deep regional hyperthermia combined with modern concurrent chemoradiotherapy increases T-downstaging rate in locally advanced rectal cancer
Yuxia Wang, Siyi Lu, Yuxia Shao, Ran Peng, Xuemin Li, Junjie Wang, Hao Wang
International Journal of Hyperthermia.2022; 39(1): 431. CrossRef
High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates
Serdar Karakaya, İbrahim Karadağ, Mehmet Emin Yılmaz, Ömür Berna Çakmak Öksüzoğlu
Cureus.2022;[Epub] CrossRef
Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer
Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
Annals of Coloproctology.2022; 38(2): 97. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Histopathological and Haemogram Features Correlate with Prognosis in Rectal Cancer Patients Receiving Neoadjuvant Chemoradiation without Pathological Complete Response
Yu-Ming Huang, Hsi-Hsien Hsu, Chien-Kuo Liu, Ching-Kuo Yang, Po-Li Tsai, Tzu-Yin Tang, Shih-Ming Hsu, Yu-Jen Chen
Journal of Clinical Medicine.2022; 11(17): 4947. CrossRef
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Hytham K.S. Hamid, George N. Davis, Mario Trejo-Avila, Patrick O. Igwe, Andrés Garcia-Marín
Surgical Oncology.2021; 37: 101556. CrossRef
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Mate Naszai, Alina Kurjan, Timothy S. Maughan
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Chirag Pereira, Jiju Mohan, Shankar Gururaj, Prajwal Chandrashekhara
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Yanwu Sun, Zhekun Huang, Pan Chi
International Journal of Clinical Oncology.2020; 25(7): 1299. CrossRef

Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection: Jung Ho Park, Hyoung-Chul Park, Sung Chan Park, Jae Hwan Oh, Duck-Woo Kim, Sung-Bum Kang, Seung Chul Heo, Min Jung Kim, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park, for the Seoul Colorectal Group (SECOG); Ann Coloproctol. 2018;34(6):286-291. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.10.29

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1 Citations

Abstract PDF

Purpose
Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer.
Methods
From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS.
Results
The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1–134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19–1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29–2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08–2.15; P < 0.01) and a high (≥0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63–5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC.
Conclusion
Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

Citations

Citations to this article as recorded by

Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer
Shuanhu Wang, Yakui Liu, Yi Shi, Jiajia Guan, Mulin Liu, Wenbin Wang
Journal of International Medical Research.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; Ann Coloproctol. 2018;34(1):4-10. Published online February 28, 2018; DOI: https://doi.org/10.3393/ac.2018.34.1.4

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Abstract PDF

Purpose

The aim of this study was to evaluate whether the perioperative carcinoembryonic antigen (CEA) ratio could be used as a determinant for adjuvant therapy after curative surgery in stage II colorectal cancer.

Methods

Data for 119 patients with stage II colorectal cancer who underwent radical surgery between 2010 and 2013 were collected. The perioperative CEA ratio was defined as the postoperative/preoperative serum CEA level, and the patients were grouped according to their perioperative CEA ratios: high ratio (≥0.5) and low ratio (<0.5). Overall survival rates were calculated, and their prognostic significances were analyzed.

Results

The overall survival rates of the high and the low perioperative CEA groups were 68.2% and 86.8%, respectively (P = 0.033). In patients with normal preoperative CEA levels (<5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (71.7% vs. 100.0%, P = 0.007). In patients with high preoperative CEA levels (≥5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (33.3% vs. 75.0%, P = 0.036). In the multivariate analysis, perioperative CEA ratio (P = 0.046), age (P = 0.034), and venous invasion (P = 0.015) were independent prognostic factors for survival.

Conclusion

The perioperative CEA ratio is a prognostic indicator for stage II colorectal cancer. Patients with normal preoperative serum CEA levels might also be considered for adjuvant therapy if their perioperative CEA ratios are higher than 0.5.

Citations

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Tumor regression and immunity in combination therapy with anti-CEA chimeric antigen receptor T cells and anti-CEA-IL2 immunocytokine
Seung E. Cha, Maciej Kujawski, Paul J. Yazaki, Christine Brown, John E. Shively
OncoImmunology.2021;[Epub] CrossRef
Prognostic Impact of Pretreatment Elevated and Normalized Carcinoembryonic Antigen Levels After Neoadjuvant Chemoradiotherapy in Resected Locally Advanced Rectal Cancer Patients
Jianyuan Song, Zhuhong Chen, Daxin Huang, Benhua Xu
Cancer Management and Research.2021; Volume 13: 3713. CrossRef
Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer
Thomas A. Odeny, Nicole Farha, Hannah Hildebrandand, Jessica Allen, Wilfred Vazquez, Maximillian Martinez, Ravi Kumar Paluri, Anup Kasi
Journal of Clinical Medicine.2020; 9(12): 3848. CrossRef

Clinical Significance of Signet-Ring-Cell Colorectal Cancer as a Prognostic Factor: Sang-Oh Yun, Yong Beom Cho, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yoon Ah Park, Jung Wook Huh; Ann Coloproctol. 2017;33(6):232-238. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.232

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53 Download
28 Web of Science
27 Citations

Abstract PDF

Purpose

The aim of this study is to evaluate the prognosis for patients with a signet-ring-cell carcinoma (SRCC) who undergo curative surgery by comparing them to patients with an adenocarcinoma (ADC), excluding a mucinous ADC.

Methods

Between September 1994 and December 2013, 14,110 patients with colorectal cancer underwent surgery and among them, 12,631 patients were enrolled in this study. 71 patients with a SRCC and 12,570 patients with a ADC were identified. We analyzed the disease-free survival and the overall survival rates before and after a 1:2 propensity score matching and evaluated those rates after stage stratification.

Results

The median follow-up durations were 48.5 months for the SRC group and 48.6 months for the ADC group. The disease-free survival rates and the overall survival rates were significantly lower in the SRC group before and after propensity score matching (P < 0.001). After stratification by stage, no differences were observed between the SRC and the ADC groups for the disease-free survival (DFS) and the overall survival (OS) rates for patients with cancer in its early stages (P = 0.913 and P = 0.380 for the DFS and the OS, respectively, in stages 0 and I, and P = 0.223 and P = 0.991 for the DFS and the OS, respectively, in stage II), but those rates were significantly lower in the SRC group for cancer in its later stages (P < 0.001, respectively in stages III and IV).

Conclusion

For cancer in advanced stages, patients with a resectable colorectal SRCC had a poorer prognosis after propensity score matching than those with an ADC did. Therefore, more intensive surveillance and closer observation should be offered to such patients.

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