Annals of Coloproctology

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

Prognostic Impact of Carcinoembryonic Antigen Levels in Rectal Cancer Patients Who Had Received Neoadjuvant Chemoradiotherapy: Jung Il Joo, Sang Woo Lim, Bo Young Oh; Ann Coloproctol. 2021;37(3):179-185. Published online May 11, 2021; DOI: https://doi.org/10.3393/ac.2020.11.27

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Purpose
Carcinoembryonic antigen (CEA) is a useful marker for rectal cancer. The aim of this study was to investigate the prognostic impact of CEA level according to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients who underwent radical surgery.
Methods
A total of 245 patients with rectal cancer who underwent radical surgery were retrospectively evaluated. Serum CEA level was measured preoperatively and postoperatively. We compared survival outcomes based on CEA level before and after surgery according to nCRT.
Results
Of the 245 patients, elevation of CEA level was observed preoperatively in 79 and postoperatively in 30, respectively. Eighty-seven (35.5%) patients received nCRT, and elevated CEA level was a significant prognostic factor both before and after surgery. In patients who had not received nCRT, an elevated CEA level was a significant prognostic factor before surgery but was not significant after surgery. In a multivariate analysis for prognostic factors, elevation of preoperative CEA level was an independent prognostic factor of disease-free survival (DFS) regardless of nCRT. Postoperative CEA level was an independent prognostic factor of DFS in patients who had received nCRT but was not a factor in patients who had not received nCRT.
Conclusion
Serum CEA level was an independent prognostic factor both preoperatively and postoperatively in rectal cancer patients who had received nCRT.

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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
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
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer
Soledad Iseas, Juan M. Sendoya, Juan Robbio, Mariana Coraglio, Mirta Kujaruk, Vanesa Mikolaitis, Mariana Rizzolo, Ana Cabanne, Gonzalo Ruiz, Rubén Salanova, Ubaldo Gualdrini, Guillermo Méndez, Marina Antelo, Marcela Carballido, Cecilia Rotondaro, Julieta
Frontiers in Oncology.2022;[Epub] CrossRef
Carcinoembryonic Antigen, the Most Accessible Test for Predicting Colorectal Cancer Prognosis: Exploring Alternative Roles
Sanghee Kang
Annals of Coloproctology.2021; 37(3): 129. CrossRef

Clinical Outcomes of Patients With Locally Advanced Rectal Cancer With Persistent Circumferential Resection Margin Invasion After Preoperative Chemoradiotherapy: Chang Hyun Kim, Seung-Seop Yeom, Hand-Duk Kwak, Soo Young Lee, Jae Kyun Ju, Young Jin Kim, Hyeong Rok Kim; Ann Coloproctol. 2019;35(2):72-82. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2019.04.22

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Abstract PDF

Purpose
Treatment after failure of circumferential resection margin (CRM) conversion after preoperative chemoradiotherapy (pCRT) for locally advanced rectal cancer (LARC) has not been evaluated well. We conducted a single‐center, retrospective analysis to fill this information gap.
Methods
From 2008 to 2016, we included 112 patients who had predictive CRM involvement on baseline magnetic resonance imaging (MRI) and who underwent surgery following pCRT for LARC. Baseline and posttreatment radiologic and clinical factors were analyzed.
Results
Of 493 patients with LARC, 112 had CRM involvement by baseline MRI (mrCRM). In 40 patients (35.7%), mrCRM involvement was converted as negative posttreatment CRM (ymrCRM−). Multivariate analysis showed the risk factors for persistent CRM involvement (ymrCRM+) after pCRT were extramural venous invasion (mrEMVI+) (P = 0.030) and lower tumor location (P = 0.007). In addition, persistent CRM involvement after pCRT was an independent risk factor for predicting pathologic CRM involvement. The Cox proportional hazard model showed baseline positive mrEMVI remained significant for disease-free survival (DFS) (P < 0.001). On posttreatment MRI, abdominoperineal resection (P = 0.031), intersphincteric resection (P = 0.006), and persistent CRM involvement (P = 0.001) remained significant for local recurrence-free survival. With regard to DFS, persistent CRM involvement (P = 0.048) and positive EMVI on posttreatment MRI (ymrEMVI) (P = 0.014) were significant. In the patient subgroup with persistent CRM involvement, 5-year DFS in patients with mrEMVI and ymrEMVI was 29.8% and 21.2%, respectively.
Conclusion
Patients who fail to convert to negative CRM have extremely poor oncologic outcomes. Lower tumor height and negative mrEMVI status were good responders to ymrCRM conversion. Our results suggest that these patients require a more intensive treatment modality.

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Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis
Nerea Becerra‐Tomás, Georgios Markozannes, Margarita Cariolou, Katia Balducci, Rita Vieira, Sonia Kiss, Dagfinn Aune, Darren C. Greenwood, Laure Dossus, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark‐Wahnefried, Melissa M. Hudson, Anne M. Ma
International Journal of Cancer.2024; 155(3): 400. CrossRef
A Review of Neoadjuvant Therapy and the Watch-and-Wait Protocol in Rectal Cancer: Current Evidence and Future Directions
Iulian M Slavu, Octavian Munteanu, Florin Filipoiu, Raluca Tulin, Anca Monica Macovei Oprescu , Ileana Dima, Iulian A Dogaru, Adrian Tulin
Cureus.2024;[Epub] CrossRef
A Predictive Model to Evaluate Pathologic Complete Response in Rectal Adenocarcinoma
Shuiwang Qing, Lei Gu, Tingting Du, Xiaolan Yin, Ke-jia Zhang, Huo-jun Zhang
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Oncologic Outcomes Associated With MRI-detected Extramural Venous Invasion (mrEMVI) in Rectal Cancer
François Rouleau Fournier, Mohammad Ali K. Motamedi, Carl J. Brown, Terry Phang, Manoj J. Raval, Cameron J. Hague, Ahmer A. Karimuddin
Annals of Surgery.2022; 275(2): 303. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Are oncological long-term outcomes equal after laproscopic completed and converted laparoscopic converted rectal resection for cancer?
M. Finochi, B. Menahem, G. Lebreton, J. Lubrano, Y. Eid, A. Alves
Techniques in Coloproctology.2021; 25(1): 91. CrossRef
Sphincter‐saving surgery for ultra‐low rectal carcinoma initially indicated for abdominoperineal resection: Is it safe on a long‐term follow‐up?
Philippe Rouanet, Michel Rivoire, Sophie Gourgou, Bernard Lelong, Eric Rullier, Merhdad Jafari, Laurent Mineur, Marc Pocard, Jean Luc Faucheron, François Dravet, Denis Pezet, Jean Michel Fabre, Laurent Bresler, Jacques Balosso, Christophe Taoum, Claire Le
Journal of Surgical Oncology.2021; 123(1): 299. CrossRef
The prognostic value of MRI-detected extramural vascular invasion (mrEMVI) for rectal cancer patients treated with neoadjuvant therapy: a meta-analysis
Silin Chen, Ning Li, Yuan Tang, Jinming Shi, Ying Zhao, Huiying Ma, Shulian Wang, Ye-xiong Li, Jing Jin
European Radiology.2021; 31(12): 8827. CrossRef
Predictors of Positive Circumferential Resection Margin in Rectal Cancer: A Current Audit of the National Cancer Database
Hillary L. Simon, Thais Reif de Paula, Magda M. Profeta da Luz, Ravi P. Kiran, Deborah S. Keller
Diseases of the Colon & Rectum.2021; 64(9): 1096. CrossRef
MRI-detected extramural venous invasion of rectal cancer: Multimodality performance and implications at baseline imaging and after neoadjuvant therapy
Akitoshi Inoue, Shannon P. Sheedy, Jay P. Heiken, Payam Mohammadinejad, Rondell P. Graham, Hee Eun Lee, Scott R. Kelley, Stephanie L. Hansel, David H. Bruining, Jeff L. Fidler, Joel G. Fletcher
Insights into Imaging.2021;[Epub] CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. 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
Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer
Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim
Annals of Coloproctology.2019; 35(5): 229. CrossRef

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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Abstract PDF

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

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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

Stromal-cell-derived Factor 1-α Promotes Tumor Progression in Colorectal Cancer: Se Jun Park, Tae Sung Ahn, Sung Woo Cho, Chang Jin Kim, Dong Jun Jung, Myung Won Son, Sang Ho Bae, Eung Jin Shin, Moon Soo Lee, Chang Ho Kim, Moo Jun Baek; J Korean Soc Coloproctol. 2012;28(1):27-34. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.27

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Abstract PDF

Purpose

Although stromal-cell-derived factor (SDF)-1α is suggested to be involved in tumorigenicity and tumor angiogenesis, the clinicopathological significance of its expression in colorectal cancers is not fully understood. We examined SDF-1α expression in colorectal cancers and investigated its relationship to clinicopathological features such as tumor staging, lymph-node metastasis, vascular invasion (VI), lymphatic invasion (LI) and neural invasion (NI).

Methods

Specimens of 83 primary colorectal cancers were examined immunohistochemically, and the relationships between clinicopathological features and SDF-1α expression were analyzed. To compare the expressions between the normal colon tissue and colorectal cancer tissues, we performed Western blot analyses.

Results

According to the Western blot analyses, SDF-1α was more highly expressed in colorectal carcinoma tissues than in normal colonic mucosa (20/21). According to the immunohistochemical stain, SDF-1α was associated with nodal status, distant metastasis, tumor staging, VI and LI. SDF-1α expression had a significant prognostic value for overall survival. Kaplan-Meier plots of survival in patients with high SDF-1α showed that high SDF-1α expression was associated with a shorter overall survival. However, no association was found between SDF-1α expression and other pathologic or clinical variables, including age, gender, degree of differentiation, and presence of perineural invasion.

Conclusion

The expression of SDF-1α might be associated with tumor progression in colorectal cancer. Inhibition of SDF-1α could be a therapeutic option in colorectal cancer patients.

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Human CD133-positive hematopoietic progenitor cells initiate growth and metastasis of colorectal cancer cells
Chao Zhang, Chang Zhou, Xiao-Jin Wu, Min Yang, Zhao-hui Yang, Han-zhen Xiong, Chun-ping Zhou, Yan-xia Lu, Yuan Li, Xue-nong Li
Carcinogenesis.2014; 35(12): 2771. CrossRef

Clinical Significance of Lymph Node Ratio in Stage III Colorectal Cancer: Yo Han Park, Jae Im Lee, Jong Kyung Park, Hang Ju Jo, Won Kyung Kang, Chang Hyeok An; J Korean Soc Coloproctol. 2011;27(5):260-265. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.260

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Abstract PDF

Purpose

Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer.

Methods

We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR.

Results

There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR ≤ 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 ≥ LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor.

Conclusions

LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.

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The prognostic performance of the log odds of positive lymph nodes in patients with esophageal squamous cell carcinoma: A population study of the US SEER database and a Chinese single‐institution cohort
Hongdian Zhang, Wanyi Xiao, Peng Ren, Kai Zhu, Ran Jia, Yueyang Yang, Lei Gong, Zhentao Yu, Peng Tang
Cancer Medicine.2021; 10(17): 6149. CrossRef
Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer
Giovanni Li Destri, Giuseppe Privitera, Gaetano La Greca, Roberto Scilletta, Antonio Pesce, Teresa Rosanna Portale, Erminia Conti, Stefano Puleo
International Surgery.2021; 105(1-3): 122. CrossRef
Rectal cancers with microscopic circumferential resection margin involvement (R1 resections): Survivals, patterns of recurrence, and prognostic factors
Gianpiero Gravante, David Hemingway, James Andrew Stephenson, David Sharpe, Ahmed Osman, Melissa Haines, Vafa Pirjamali, Roberto Sorge, Justin Ming Yeung, Michael Norwood, Andrew Miller, Kirsten Boyle
Journal of Surgical Oncology.2016; 114(5): 642. CrossRef
Prognostic Impact of the Metastatic Lymph Node Ratio on Survival in Rectal Cancer
Wafi Attaallah, Omer Gunal, Manuk Manukyan, Gulden Ozden, Cumhur Yegen
Annals of Coloproctology.2013; 29(3): 100. CrossRef
Prognostic Value of Total Lymph Node Identified and Ratio of Lymph Nodes in Resected Colorectal Cancer
Leila Ghahramani, Leila Moaddabshoar, Samira Razzaghi, Sayed Hasan Hamedi, Saeedeh Pourahmad, Mohammad Mohammadianpanah
Annals of Colorectal Research.2013; 1(3): 81. CrossRef
Prognostic Value of Lymph Node Ratios in Node Positive Rectal Cancer Treated with Preoperative Chemoradiation
Jamal Jafari Nadoshan, Ramesh Omranipour, Omid Beiki, Kazem Zendedel, Abbas Alibakhshi, Habibollah Mahmoodzadeh
Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3769. CrossRef
Proposal of a New Classification for Stage III Colorectal Cancer Based on the Number and Ratio of Metastatic Lymph Nodes
Li‐Ping Wang, Hong‐Yan Wang, Rui Cao, Cong Zhu, Xiong‐Zhi Wu
World Journal of Surgery.2013; 37(5): 1094. CrossRef
An appraisal of lymph node ratio in colon and rectal cancer: not one size fits all
M. Medani, Niall Kelly, George Samaha, G. Duff, Vourneen Healy, Elizabeth Mulcahy, Eoghan Condon, David Waldron, Jean Saunders, J. Calvin Coffey
International Journal of Colorectal Disease.2013; 28(10): 1377. CrossRef

Clinical Applications of Radio-Frequency Ablation in Liver Metastasis of Colorectal Cancer: Ji Hun Gwak, Bo-Young Oh, Ryung Ah Lee, Soon Sup Chung, Kwang Ho Kim; J Korean Soc Coloproctol. 2011;27(4):202-210. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.202

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Abstract PDF

Purpose

The aim of this study is to evaluate long-term survival and prognostic factors for radio-frequency ablation (RFA) in colorectal liver metastases.

Methods

We retrospectively reviewed 35 colorectal liver metastases patients who underwent RFA between 2004 and 2008. We analyzed survival after RFA and prognostic factors for survival.

Results

Of the 35 patients, 23 patients were male and 12 were female. Their mean age was 62.40 ± 12.52 years. Mean overall survival was 38.8 ± 4.6 months, and mean progression free survival was 19.9 ± 3.4 months. Three- and 5-year overall survival rates were 42.7 ± 0.1% and 26.0 ± 0.1%, respectively. Three- and 5-year progression-free survival rates were 19.6 ± 0.1% and 4.9 ± 0.04%, respectively. Overall survival and progression-free survival were significantly improved in male and in patients with carcinoembryonic antigen (CEA) ≤ 100 ng/mL, carbohydrate antigen (CA) 19-9 ≤ 100 ng/mL, absence of extrahepatic disease, and a unilobar hepatic lesion. In addition, progression-free survival was improved in patients with a solitary hepatic lesion. On the multivariate analysis, significant survival factors were the absence of extrahepatic disease and the presence of a unilobar hepatic lesion.

Conclusion

RFA for colorectal liver metastases is an effective treatment option in male patients and in patients with CEA or CA19-9 ≤ 100, absence of extrahepatic disease, a solitary hepatic lesion, and a unilobar hepatic lesion.

Citations

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The combined detection of carcinoembryonic antigen, carcinogenic antigen 125, and carcinogenic antigen 19-9 in colorectal cancer patients
Ling-Zhen Gong, Qian-Wen Wang, Jie-Wen Zhu
World Journal of Gastrointestinal Surgery.2024; 16(7): 2073. CrossRef
Microwave Ablation, Radiofrequency Ablation, Irreversible Electroporation, and Stereotactic Ablative Body Radiotherapy for Intermediate Size (3–5 cm) Unresectable Colorectal Liver Metastases: a Systematic Review and Meta-analysis
Sanne Nieuwenhuizen, Madelon Dijkstra, Robbert S. Puijk, Bart Geboers, Alette H. Ruarus, Evelien A. Schouten, Karin Nielsen, Jan J. J. de Vries, Anna M. E. Bruynzeel, Hester J. Scheffer, M. Petrousjka van den Tol, Cornelis J. A. Haasbeek, Martijn R. Meije
Current Oncology Reports.2022; 24(6): 793. CrossRef
Optimizing Loco Regional Management of Oligometastatic Colorectal Cancer: Technical Aspects and Biomarkers, Two Sides of the Same Coin
Giovanni Mauri, Lorenzo Monfardini, Andrea Garnero, Maria Giulia Zampino, Franco Orsi, Paolo Della Vigna, Guido Bonomo, Gianluca Maria Varano, Marco Busso, Carlo Gazzera, Paolo Fonio, Andrea Veltri, Marco Calandri
Cancers.2021; 13(11): 2617. CrossRef
Combined CT-guided radiofrequency ablation with systemic chemotherapy improves the survival for nasopharyngeal carcinoma with oligometastasis in liver: Propensity score matching analysis
Wang Li, Yutong Bai, Ming Wu, Lujun Shen, Feng Shi, Xuqi Sun, Caijin Lin, Boyang Chang, Changchuan Pan, Zhiwen Li, Peihong Wu
Oncotarget.2017; 8(32): 52132. CrossRef
Radiofrequency ablation in combined treatment of metastatic colorectal liver cancer
O. G. Skipenko, K. N. Petrenko, N. N. Bagmet, A. L. Bedzhanyan, L. O. Polishchuk, N. K. Chardarov, G. A. Shatveryan
Khirurgiya. Zhurnal im. N.I. Pirogova.2016; (12): 4. CrossRef
Systematic review of 12 years of thermal ablative therapies of non-resectable colorectal cancer liver metastases
Sameh Saif, Ania Z, Kielar, Matthew McInnes
International Journal of Gastrointestinal Intervention.2016; 5(1): 27. CrossRef
Evaluation of YO-PRO-1 as an early marker of apoptosis following radiofrequency ablation of colon cancer liver metastases
Sho Fujisawa, Yevgeniy Romin, Afsar Barlas, Lydia M. Petrovic, Mesruh Turkekul, Ning Fan, Ke Xu, Alessandra R. Garcia, Sebastien Monette, David S. Klimstra, Joseph P. Erinjeri, Stephen B. Solomon, Katia Manova-Todorova, Constantinos T. Sofocleous
Cytotechnology.2014; 66(2): 259. CrossRef
Clinical outcome of ultrasound-guided percutaneous microwave ablation on colorectal liver metastases
JIANBIN WANG, PING LIANG, JIE YU, MING-AN YU, FANGYI LIU, ZHIGANG CHENG, XIAOLING YU
Oncology Letters.2014; 8(1): 323. CrossRef
Efficacy and safety of thermal ablation in patients with liver metastases
Yingjun Liu, Shengping Li, Xiangbin Wan, Yi Li, Binkui Li, Yaqi Zhang, Yunfei Yuan, Yun Zheng
European Journal of Gastroenterology & Hepatology.2013; 25(4): 442. CrossRef
Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer
Matthew J. Furman, Giles F. Whalen, Shimul A. Shah, Sidney P. Kadish
Practical Radiation Oncology.2013; 3(1): 40. CrossRef

The Prognostic Factors and Severity Index in Fournier's Gangrene.: Kim, Kwang Min , Seong, Seung Hoon , Won, Dal Yeon , Ryu, Hoon , Kim, Ik Yong; J Korean Soc Coloproctol. 2010;26(1):29-33.; DOI: https://doi.org/10.3393/jksc.2010.26.1.29

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Abstract PDF

PURPOSE
Fournier's disease is polymicrobial necrotizing fasciitis of the perineal, perianal, or genital areas. The objective of this study was to investigate patients with Fournier's gangrene and to determine risk factors that affect mortality.
METHODS
This study was a retrospective clinical study. Clinical presentations and outcomes of surgical treatments were evaluated in 27 patients with Fournier's gangrene that were treated in a single institution from January 2000 to March 2009.
RESULTS
The mean age of patients was 52.8+/-14.4 yr, and the male-to-female ratio was 25:2. Among the predisposing factors, diabetes mellitus was the most common (n=8, 29.6%). The most common infection source was anorectal (n=16, 59.3%). Sepsis on admission was detected in 16 cases (59.3%). Four patients died during treatment, for an overall mortality of 14.8%. A logistic regression test showed a Fournier's gangrene severity index greater than 9 and sepsis on admission to be prognostic factors.
CONCLUSION
The mortality rate was higher in patients with sepsis on admission and with a Fournier's gangrene severity index greater than nine.

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Usefulness of Noninvasive Ventilation with Negative-Pressure Wound Therapy in the Intensive Care Unit: A Case Report
Dongbeen Choi, Ji Young Jang, Kwanhoon Park, Kang Yoon Lee, Hangil Yun, Sungho Lee
Journal of Acute Care Surgery.2024; 14(3): 113. CrossRef
Effect of Sarcopenia on Mortality and Morbidity in Patients With Fournier’s Gangrene
Deniz Tazeoglu, Sami Benli, Ahmet Cem Esmer, Tahsin Colak, Feramuz Demir Apaydin
The American Surgeon™.2023; 89(12): 5527. CrossRef
Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea
In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
Acute and Critical Care.2023; 38(4): 452. CrossRef
Delta neutrophil index as a prognostic factor for mortality in patients with Fournier's gangrene
In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
International Journal of Urology.2022; 29(11): 1287. CrossRef
Intérêt de l’index de sévérité de la gangrène de Fournier dans la prédiction des facteurs pronostiques de la mortalité
S.M. Moudouni, S. Arza, A. Benhaddou, K.H. Baka, M.A. Lakmichi, Z. Dahami, I. Sarf
African Journal of Urology.2017; 23(4): 347. CrossRef
Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study
Kyung Sook Hong, Hee Jung Yi, Ryung‐Ah Lee, Kwang Ho Kim, Soon Sup Chung
International Wound Journal.2017; 14(6): 1352. CrossRef
Clinical Practice Guidelines for Soft Tissue Infections

Infection & Chemotherapy.2012; 44(4): 213. CrossRef

Prognostic Factors for Complication and Mortality of Colonic Perforation.: Park, Keon Hwan , Choi, Pyong Wha , Kim, Jae Il , Noh, Tae Ho , Heo, Tae Gil , Park, Je Hoon , Lee, Myung Soo , Kim, Chul Nam , Chang, Surk Hyo; J Korean Soc Coloproctol. 2009;25(3):143-149.; DOI: https://doi.org/10.3393/jksc.2009.25.3.143

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Abstract PDF

PURPOSE
The present study was performed to assess the outcomes in patients with colonic perforation and to determine the prognostic factors for mortality.
METHODS
The cases of 42 patients who underwent surgery for colonic perforation between March 1999 and September 2008 were retrospectively reviewed. Age, sex, American Society of Anesthesiologists (ASA) classification, presence of preoperative shock, duration of symptoms, cause of perforation, location of perforation, degree of peritonitis, and the Mannheim Peritonitis Index (MPI) score were analyzed for their association with early outcome by using univariate and multivariate analyses.
RESULTS
Diverticulitis (46%, 19 patients) and colorectal cancer (36%, 15 patients) were the most common causes of noniatrogenic colonic perforation, and the sigmoid colon was the most common site of perforation (60%, 25 patients). The postoperative mortality was 21.4% (9 patients). The mortality in patients with preoperative shock, with a MPI score of more than 25, and with Hinchey stage III or IV peritonitis were 70.0%, 57.1%, and 53.3%, respectively (P<0.001). No statistical difference was observed in postoperative mortality with regard to age, sex, ASA classification, duration of symptoms, cause of perforation, and location of perforation. According to the multivariate analysis, preoperative shock proved to be the only significant prognostic factor for mortality (P=0.027) (odds ratio: 19.8, 95% confidence interval: 1.4-276.9).
CONCLUSION
Preoperative shock, a MPI score of more than 25, and Hinchey stage III or IV peritonitis were associated with high postoperative mortality in patients with colonic perforation. Especially, more intensive management and interest are required for patient s with preoperative shock due to colonic perforation.

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Ostomy in Nontraumatic Conditions: Our Experience and Review of the Literature
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
Indian Journal of Surgery.2016; 78(6): 471. CrossRef
EVALUATION OF MANNHEIM PERITONITIS INDEX (MPI) SCORING SYSTEM IN PROGNOSIS OF PATIENTS WITH PERITONITIS DUE TO HOLLOW VISCOUS PERFORATION
Mahammad Ali Sutar, Ramakrishna Yaradhimmaiah, Nikhath Ingva Arshi
Journal of Evolution of Medical and Dental Sciences.2016; 5(31): 1626. CrossRef

The Relatioships Between Tumor-related Gene Expression and Tumor Budding, Tumor Nodule and Lymph Node Extracapsular Extension in Colorectal Cancer.: Kang, Hyun Jong , Cho, Hang Joo , Kang, Gi Chang , Kim, Kee Hwan , Kang, Won Kyung , Kim, Ji Il , Park, Jong Kyung , Oh, Seungtack , Kim, Jeong Soo , An, Chang Hyeok; J Korean Soc Coloproctol. 2009;25(1):1-7.; DOI: https://doi.org/10.3393/jksc.2009.25.1.1

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Abstract PDF: PURPOSE
Despite the similar lymph node metastasis observed in patients with advanced colorectal cancer (CRC), there was a different clinical outcome. The relationships between tumor-related gene expression and prognostic factors such as tumor budding, tumor nodule and extracapsular extension (ECE) of lymph nodes in patients with CRC remain unclear yet. The purpose of this study was to evaluate the relationship between expression of molecular markers such as vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), matrix metalloproteinases (MMPs) and E-cadherin and the tumor budding, tumor nodule and ECE of lymph nodes in patients with stage III CRC.
METHODS
The tissue of 87 patients with stage III CRC were investigated for expressions of molecular markers using immunohistochemical methods.
RESULTS
VEGF and MMP-9 expression in tumor tissue were positively associated with the colorectal cancer prognostic factors such as tumor budding, tumor nodule and extracapsular lymph node extension (P<0.05). But, MMP-2, EGF and E-cadherin expression were of no value with regard to them.
CONCLUSION
Our results suggest that molecular markers, in particular VEGF and MMP-9, may provide additional prognostic information regarding tumor budding, ECE and tumor nodule.

Colorectal Cancer Presenting as an Early Recurrence Within 1 Year after a Curative Resection.: Jung, Sang Hun , Kim, Hee Cheol , Kim, Ah Young , Choi, Pyong Wha , Park, In Ja , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(4):265-272.; DOI: https://doi.org/10.3393/jksc.2008.24.4.265

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Abstract PDF

PURPOSE
An individualized surveillance protocol based on stratified prognostic factors is needed for the early detection of recurrent disease. The aim of this study was to determine both the clinicopathological characteristics for early-recurring colorectal cancer and the impact on survival.
METHODS
From January 1996 to September 2000, 1,504 patients with curatively resected colorectal cancer were recruited. The primary goal of this study was to evaluate the time interval until first loco-regional or distant recurrence, and the secondary goal was the last survival status. Early recurrence was defined as recurrence within the first 12 months postoperatively. Clinicopathologic data and preoperative CT records were reviewed. The follow-up period was over 48 months.
RESULTS
The 5-year recurrence rate was 25.4%, and 39.5% of these were detected within the first 12 months postoperatively. In the multivariate analysis, the independent prognostic factors for early recurrence were cell differentiation (PD/MUC/SRC), lymphovascular invasion, and absence of adjuvant chemotherapy in stage III and curatively resected colorectal cancer in stage IV. Inaccurate interpretation by a low-quality CT scan resulted in a stage III cancer being understaged preoperatively. The 5-year overall survival rate according to the recurrent time interval was significantly different (early recurrence: 7.4% vs. late recurrence: 23.6%, P<0.05). The resection rate was similar in both groups (early recurrence: 22.7% vs. late recurrence: 27.6%, P=0.392).
CONCLUSIONS
Colorectal cancer that recurred within 12 months showed more aggressive biologic behaviors and poor survival. Understaging caused by incomplete preoperative evaluation for disease extension may cause treatment failure.

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Predictive factors and the prognosis of recurrence of colorectal cancer within 2 years after curative resection
Jong Pil Ryuk, Gyu-Seog Choi, Jun Seok Park, Hye Jin Kim, Soo Yeun Park, Ghil Suk Yoon, Soo Han Jun, Yong Chul Kwon
Annals of Surgical Treatment and Research.2014; 86(3): 143. CrossRef
Advanced Neoplasm Detection and Its Associated Factors in Colonoscopic Surveillance of Endoscopically Resected Early Colorectal Cancer
Soon Ha Kwon, Jin Woo Choo, Hyun Gun Kim, Seong Ran Jeon, Byung Hoo Lee, Tae Hee Lee, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joo Young Cho, Joon Seong Lee, Moon Sung Lee
The Korean Journal of Gastroenterology.2013; 62(4): 219. CrossRef

The Prognostic Significance of Tumor Budding, Tumor Nodules, and Lymph Node Extracapsular Extension in Stage III Colorectal Cancer Patients.: Kim, Seong Ah , Shin, Ok Ran , Kim, Hyong Ran , Cho, Hang Ju , Seo, Hak Jun , Kim, Kee Hwan , Kim, Ji Il , An, Chang Hyeok , Oh, Seung Tack , Kim, Jeong Soo; J Korean Soc Coloproctol. 2007;23(6):460-476.; DOI: https://doi.org/10.3393/jksc.2007.23.6.460

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Abstract PDF

PURPOSE
The prognosis of advanced colorectal cancer patients may be different even for the same TNM staging. The characteristic features of tumors, such as tumor budding, tumor nodules, and extracapsular extension (ECE) of lymph nodes, can influence the disease progression and the outcome for patients. Tumor budding occurs what at the invasion front of colorectal adenocarcinomas, tumor cells, singly or in small aggregates, become detached from the neoplastic glands, and it can be divided it into two groups, low grade (0~16 foci in a field) and high grade (17 or more foci in a field). A tumor nodule is histologically identified within the fatty tissue or the detached fatty tissue around the dissected lymph nodes, or is a place picked up as lymph nodes from resected specimens which contain no lymph node components. ECE is defined as a tumor extension beyond the node capsule. The aims of this study were to evaluate the clinical significance of tumor budding, tumor nodules, and ECE of lymph nodes as prognostic factors in Stage III colorectal cancer patients.
METHODS
We analyzed the disease-free and overall 5-year survival rates and recurrence rates in 94 Stage-III colorectal cancer patients according to tumor the budding intensity, the tumor nodules, and the lymph node ECE status.
RESULTS
Of the entire group, the 5-year disease-free and overall survival rates were 49%, and 50%, respectively. The 5-year disease-free and overall survival rates were higher in the low-grade tumor budding group than in the high-grade group (58% vs 33%, P=0.045, 61% vs 39%, P=0.003). The 5-year disease-free and overall survival rates in patients with tumor nodules were lower than those in patients without one (44% vs 69%, P=0.086, 47% vs 77%, P=0.018). The recurrence rate was also higher in the group with tumor nodules than without one (80% vs 52%, P=0.045). The 5-year disease-free and overall survival rates were higher in the ECE negative group than in the positive one (68% vs 37%, P=0.018, 75% vs 42%, P=0.001). The recurrence rate was also higher in the ECE positive group than in the negative group (78% vs 46%, P=0.008). The existence of ECE and tumor nodule were strongly related to systemic recurrence (P=0.006, P=0.033), but not to the local recurrence (P=0.777, P=0.611). Considering the analysis of the recurrence pattern by N stage classification, there is no statistical difference in the N2 patient group, but there was in the existence of ECE and tumor nodule were strongly related to the systemic recurrence in N1 group (P=0.019, P=0.028). These three factors were scored according to the existence, and the score range was divided into two prognostic groups, high risk group (> or =2) and low risk group (<2). The high risk group was significantly associated with systemic recurrence (P= 0.004) rather than recurrence (P=0.865), and these score value were only significant in the N1 patient group (P=0.007) rather than in the N2 group (P=0.927). The high risk group also showed poor overall survival rate compared with the low risk one in only the N1 group (P=0.002), but nof in the N2 group (P=0.193). On multivariate analysis, UICC stage and ECE were two significant factors for tumor recurrence and the 5-year disease-free survival rate.
CONCLUSIONS
These data showed that even if similar lymph node metastasis existed in advanced colorectal cancer patients, there was a different 5-year disease-free survival rate and overall survival rate according to the tumor budding, tumor nodule, and ECE status. On multivariate analysis, UICC stage and ECE were two significant factors for the tumor recurrence and the 5-year disease-free survival rate. Our results suggest that tumor budding, tumor nodule, and ECE of lymph node are excellent parameters to provide a confident prediction of clinical outcome.

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Tumor Budding and Survival After Potentially Curative Resection of Node-Positive Colon Cancer
Joanne Sy, Caroline L.-S. Fung, Owen F. Dent, Pierre H. Chapuis, Les Bokey, Charles Chan
Diseases of the Colon & Rectum.2010; 53(3): 301. CrossRef
The Relatioships Between Tumor-related Gene Expression and Tumor Budding, Tumor Nodule and Lymph Node Extracapsular Extension in Colorectal Cancer
Hyun Jong Kang, Hang Joo Cho, Gi Chang Kang, Kee Hwan Kim, Won Kyung Kang, Ji Il Kim, Jong Kyung Park, Seungtack Oh, Jeong Soo Kim, Chang Hyeok An
Journal of the Korean Society of Coloproctology.2009; 25(1): 1. CrossRef

Multicenter Study

Long-term Follow-up of Patients with Curatively Resected Colorectal Cancer; May Long-term Follow-up of More than 5 Years be Warranted?.: Moon, Sun Mi , Park, Jae Woo , Hwang, Dae Yong; J Korean Soc Coloproctol. 2007;23(4):262-269.; DOI: https://doi.org/10.3393/jksc.2007.23.4.262

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Abstract PDF

PURPOSE
The data and the recommendations for the postoperative follow-up period after curative surgery for colorectal cancer are unclear, although postoperative follow-up for at least 5 years is generally recommended. The Department of Surgery, Korea Cancer Center Hospital, has a policy of lifetime follow-up. The aim of this study is to investigate the long-term outcome of patients with colorectal cancer with curative treatment and the significance of long-term follow-up.
METHODS
Between January 1993 and December 2002, 1,100 consecutive patients underwent curative surgery for a colorectal adenocarcinoma in the Department of Surgery, Korea Cancer Center Hospital. They were followed, and local or systemic recurrence was recorded. The analysis was performed on 962 of the 1,100 (87%) patients who had undergone curative surgery.
RESULTS
With a median follow-up of 143 months, the 10-year overall survival (OS) was 67% and the 10-year recurrence-free survival (RFS) was 72%. The 5-year OS was 78%, and the 5-year RFS was 78%. Two hundred ninety-nine (31.5%) patients had recurrences. Of the recurrences, 278 (93.0%) became evident within 5 years and 21 (7.0%) presented after 5 years. Twenty-four (2.5%) patients had local recurrences alone, 17 had (1.8%) local plus systemic recurrences, and 258 (26.8%) had systemic recurrences alone. Of the local recurrences, 33 (80%) became evident within 5 years, and 8 (20%) presented after 5 years. Of the systemic recurrences, 258 (94%) became evident within 5 years and 17 (6%) presented after 5 years.
CONCLUSIONS
The long-term surveillance of patients undergoing a curative resection for colorectal cancer demonstrates that most local recurrences and distant metastases occur within 5 years after a 5-year follow-up, most local and systemic recurrences following curative surgery had occurred. However, our data suggest that the postoperative follow-up of more than 5 years may be warranted. Large, multicenter trials are required to define the patterns of disease recurrence after 5 years of follow-up.

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Advantages of 3d laparoscopic surgery for colorectal cancers
Thanh Xuân Nguyễn
Vietnam Journal of Endolaparoscopic Surgey.2024;[Epub] CrossRef
Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer
Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim
Journal of the Korean Society of Coloproctology.2011; 27(2): 64. CrossRef

Original Articles

Lung Metastasis of Colorectal Cancer.: Kim, Pyong Su , Moon, Sun Mi , Hwang, Dae Yong; J Korean Soc Coloproctol. 2006;22(6):380-386.

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Abstract PDF: PURPOSE
The lung is the second most common site of metastasis of colorectal cancer. Pulmonary resection of lung metastasis of colorectal cancer has been reported a 5-year survival rate of 9~57% variably. Therefore we have tried to assess the clinical patterns of lung metastasis from colorectal cancer and to evaluate prognostic factors.
METHODS
A retrospective study was performed on 76 patients who presented with colorectal cancer with pulmonary metastasis between Jan. 1993 and Dec. 2001. Follow up period was 2~92 months.
RESULTS
53 patients had developed pulmonary metastasis after curative resection of colorectal cancer, 27 patients of these cases showed isolated lung metastasis and 12 patients underwent pulmonary resection. The number of patients with single pulmonary nodule was 7 and they showed higher survival rate than those of multiple nodules (2-year survival rate: 80% vs. 33.3%, P=0.0325). The patients with normal serum CEA level showed higher survival rate than those with elevated serum CEA level (median survival-71 months vs. 32 months, P=0.0123) in 53 patients who had developed pulmonary metastasis after curative resection of primary tumor. The number of patients of TNM stage IV with synchronous lung metastasis was 23. And serum CEA level and the number of metastatic site had affected the survival in these cases.
CONCLUSIONS
The serum CEA level could be prognostic factors in pulmonary metastasis of colorectal cancer. And pulmonary resection for selected patients may improve the survival rate especially in the case which the number of metastatic nodule was only one.

Prognostic Factors Associated with Surgical Mortality Conferred by Emergency Operation in Colorectal Cancer.: Lee, Ho Jin , Oh, Jae Hwan , Lee, Jung Nam , Baek, Jeong Heum , Chung, Min , Lee, Woon Kee , Kim, Keon Kuk , Park, Heung Kyu , Min, Seung Kee , Lee, Young Don , Lee, Tae Hun; J Korean Soc Coloproctol. 2006;22(5):301-307.

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Abstract PDF: PURPOSE
Compared with elective surgery, emergency surgery for colorectal cancer has been reported to be associated with high mortality, though little is known about the prognostic factors associated with surgical mortality. Above all, a distinction between patients with high and low mortalities might be helpful for perioperative management. The purpose of this study was to identify prognostic factors associated with surgical mortality due to an emergency operation.
METHODS
Ninety-five cases of emergency surgery for colorectal cancer were performed from 1998 through 2005. The genders and the ages of the patients, the duration of symptoms, the APACHE score, the cancer location, the presence of perforation, the operative type, and the disease stage were determined as prognostic factors. The patients were examined retrospectively to establish any relationships between the prognostic factors and surgical mortality.
RESULTS
In the univariate analysis, significantly higher surgical mortality rates were found in patients who were more than 75 years old, who had an APACHE II score above 10, and who had a perforation (P<0.05). Gender, duration of symptoms, cancer location, operation type, and disease stage were, however, not associated with a significantly higher surgical mortality (P>0.05). Multivariate analysis showed that age and APACHE II score were related to surgical mortality. The surgical mortality rate for colorectal cancer in an emergency situation was 8.4%.
CONCLUSIONS
Prognostic factors of significance associated with surgical mortality due to an emergency operation were age (> or = 75) and APACHE II score (>10). Careful attention is needed for appropriate perioperative management of patients with these risk factors.

Clinicopathological Correlation of hMLH1 and hMSH2 Protein Expressions in Stage III Colon Cancer.: Cho, Young Kyu , Yu, Chang Sik , Namgung, Hwan , Kim, Hee Chul , Kim, Jung Seon , Lee, Je Hwan , Kim, Tae Won , Kim, Jin C; J Korean Soc Coloproctol. 2004;20(4):218-224.

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Abstract PDF: PURPOSE
Functional loss of mismatch repair has been reported to be the reason for resistance to several chemotherapeutic drugs. The expressions of hMLH1 and hMSH2 were examined to assess whether they correlated with the biological behavior and the chemotherapeutic responsiveness in paflents with sporadic colon cancers.
METHODS
Ninety-one patients with stage III primary colon cancer were included from the tumor registry of the Asan Medical Center, Seoul, Korea. All patients underwent a curative operation and postoperative chemotherapy with 5- fluorouracil and leucovorin for 6 cycles between 1993 and 1997. Immunohistochemical staining for hMLH1 and hMSH2 was performed using archival paraffin blocks. A positive expression was determined when unequivocal nuclear staining was identified in more than 10% of the cancer cells. The survival and the clinicopathologic variables regarding hMLH1 and hMSH2 expressions were assessed using the log-rank test and the Cox proportional regression method.
RESULTS
Either hMLH1 or hMSH2 expression was lost in nine cases (9.9%). hMLH1 and hMSH2 expressions were significantly correlated with tumor invasion (P=0.012) and tumor differentiation (P=0.017). The disease-free survival did not differ with respect to hMLH1 and hMSH2 expressions. The number of metastatic lymph nodes and the preoperative serum CEA level were independent predictors of disease-free survival on a multivariate analysis.
CONCLUSIONS
The loss of hMLH1 or hMSH2 expresscon appears to be involved in the differentiation of and the invasion by colon cancer. However, nether hMLH1 nor hMSH2 expression was correlated withthe 5-fluorouracil responsiveness.

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