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Characteristics and Survival of Korean Patients With Colorectal Cancer Based on Data From the Korea Central Cancer Registry Data: Hyuk Hur, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim; Ann Coloproctol. 2018;34(4):212-221. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.08.02.1

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Purpose
The incidence of colorectal cancer (CRC) in Korea has increased remarkably during the past few decades. The present study investigated the characteristics and survival of patients with CRC in Korea as a function of time, tumor distribution, stage, sex, and age.
Methods
We retrieved clinical data on 326,712 CRC patients diagnosed between 1996 and 2015 from the Korea Central Cancer Registry. The incidence and the 5-year relative survival rates were compared across time period, tumor distribution, stage, sex, and age group.
Results
The percentage of patients with colon cancer increased from 49.5% in 1996–2000 to 66.4% in 2011–2015 while the percentage of patients with rectal cancer decreased from 50.5% to 33.6%. The 5-year relative survival rates for all CRCs improved from 58.7% in 1996–2000 to 75.0% in 2011–2015. For 1996–2000, survival rates were highest for patients with left-sided colon cancers, followed by those with right-sided, transverse, rectal, rectosigmoid cancers. For 2011–2015, the survival rates for patients with left-sided cancers were highest, followed by those with rectosigmoid, rectal, transverse, and right-sided colon cancers. Patients with local and regional, but not distant, SEER (Surveillance, Epidemiology, and End Results) stage tumors experienced significantly increased survival rates for 2006–2010 and 2011–2015. The proportion of CRC patients by age decreased in the order ≥70, 60–69, 50–59, 40–49, ≤39 years whereas survival rates decreased in the order 50–59, 60–69, 40–49, ≤39, ≥70 years.
Conclusion
Korean CRC has some distinct characteristics and survival patterns in terms of tumor distribution, stage, sex, and age. With time, survival outcomes have improved for both local and regional, but not distant, stage tumors.

Citations

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Primary tumor location is a risk factor for postoperative development of sarcopenia as a predictive marker for unfavorable outcomes in patients with colorectal cancer
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Anatomical Distribution of Colon Cancer: A Retrospective 10-Year Study to Evaluate Rightward Shift in Two Referral Hospitals in Iran
Ahmad R Mafi, Shima Azimi Oliaei, Ramin Heshmat, Hossein Yahyazadeh, Ali G Motlagh
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Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer: Sare Hosseini, Ali Mohammad Bananzadeh, Roham Salek, Mohammad Zare-Bandamiri, Ali Taghizadeh Kermani, Mohammad Mohammadianpanah; Ann Coloproctol. 2017;33(2):57-63. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.57

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14 Citations

Abstract PDF

Purpose

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

Methods

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

Results

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

Conclusion

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

Citations

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Association between lymphovascular invasion and lymph node metastases in colon cancer: A National Cancer Database analysis
Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Anjelli Wignakumar, Marylise Boutros, Steven D. Wexner
Colorectal Disease.2025;[Epub] CrossRef
Comprehensive Overview of Molecular, Imaging, and Therapeutic Challenges in Rectal Mucinous Adenocarcinoma
Mihaela Berar, Andra Ciocan, Emil Moiș, Luminița Furcea, Călin Popa, Răzvan Alexandru Ciocan, Florin Zaharie, Cosmin Puia, Nadim Al Hajjar, Cosmin Caraiani, Ioana Rusu, Florin Graur
International Journal of Molecular Sciences.2025; 26(2): 432. CrossRef
Clinicopathological and prognostic features of colorectal mucinous adenocarcinomas: a systematic review and meta-analysis
Xiao Wang, Haoran Wang, Haoqing He, Kai Lv, Wenguang Yuan, Jingbo Chen, Hui Yang
BMC Cancer.2024;[Epub] CrossRef
Multi gene mutation signatures in colorectal cancer patients: predict for the diagnosis, pathological classification, staging and prognosis
Yan Zhuang, Hailong Wang, Da Jiang, Ying Li, Lixia Feng, Caijuan Tian, Mingyu Pu, Xiaowei Wang, Jiangyan Zhang, Yuanjing Hu, Pengfei Liu
BMC Cancer.2021;[Epub] CrossRef
Clinicopathological Features and Survival of Signet-Ring Cell Carcinoma and Mucinous Adenocarcinoma of Right Colon, Left Colon, and Rectum
Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
Pathology and Oncology Research.2021;[Epub] CrossRef
Identification of Potential Biomarkers and Biological Pathways for Poor Clinical Outcome in Mucinous Colorectal Adenocarcinoma
Chang Woo Kim, Jae Myung Cha, Min Seob Kwak
Cancers.2021; 13(13): 3280. CrossRef
Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study
Chuanwang Yan, Hui Yang, Lili Chen, Ran Liu, Wei Shang, Wenguang Yuan, Fei Yang, Qing Sun, Lijian Xia
BMC Cancer.2021;[Epub] CrossRef
Incidence and prognosis of pulmonary metastasis in colorectal cancer: a population-based study
Yizhi Ge, Shijun Lei, Bo Cai, Xiang Gao, Guobin Wang, Lin Wang, Zheng Wang
International Journal of Colorectal Disease.2020; 35(2): 223. CrossRef
Association between aberrant dynein cytoplasmic�1 light intermediate chain�1 expression levels, mucins and chemosensitivity in colorectal cancer
Chun‑Chao Chang, Kuo‑Ching Chao, Chi‑Jung Huang, Chih‑Sheng Hung, Yen‑Chieh Wang
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Clinical impact of non-predominant histopathological subtypes on the long-term prognosis of colorectal cancer patients in Japan
Heita Ozawa, Shinichi Yamauchi, Hiroki Nakanishi, Junichi Sakamoto, Shin Fujita, Kenichi Sugihara
International Journal of Colorectal Disease.2020; 35(12): 2257. CrossRef
Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
SCF/c-KIT Signaling Increased Mucin2 Production by Maintaining Atoh1 Expression in Mucinous Colorectal Adenocarcinoma
Ping Shen, Shu Yang, Haimei Sun, Guilan Li, Bo Wu, Fengqing Ji, Tingyi Sun, Deshan Zhou
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Mucinous Subtype in Patients With Colorectal Cancer
Hyung Jin Kim
Annals of Coloproctology.2017; 33(2): 44. CrossRef

Prognostic Significance of Tissue Leptin Expression in Colorectal Cancer Patients: Woon Kyung Jeong, Seong Kyu Baek, Mi Kyung Kim, Sun Young Kwon, Hye Soon Kim; Ann Coloproctol. 2015;31(6):222-227. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.222

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48 Download
13 Web of Science
12 Citations

Abstract PDF

Purpose

Leptin is encoded by the ob gene and is involved in the control of food intake and energy expenditure. Recent studies have implicated leptin expression to be an indicator of tumor features and prognosis. The purpose of this study was to investigate the association of tissue expression of leptin with the clinicopathological characteristics and clinical outcomes in colorectal cancer patients.

Methods

Patients who had undergone a curative surgical resection for a colorectal adenocarcinoma from 2000 to 2004 were included in the study. Immunohistochemical analyses of leptin expression were performed, and clinicopathological parameters were evaluated.

Results

Clinical data and tumor tissues of 146 patients were evaluated. The mean age was 68.6 ± 11.3 years, and 61.0% were men. Immunohistochemically, the rates of negative, weak, moderate, and strong leptin expression were 2.7% (4 of 146), 5.5% (8 of 146), 43.2% (63 of 146), and 48.6% (71 of 146), respectively. We compared the negative, weak, and moderate expression group (group A) with the strong expression group (group B). Leptin expression was inversely associated with nodal stage (P = 0.007) between the two groups. Leptin expression was not significantly associated with differentiation (P = 0.37), T stage (P = 0.16), and American Joint Committee on Cancer stage (P = 0.49), and no significant differences in the disease-free and the overall survivals (P = 0.78 and P = 0.61) were observed.

Conclusion

Results demonstrated an inverse association of nodal stage with high leptin expression. Higher leptin expression level might predict better oncologic outcome. However, further studies are warranted to identify the exact role of leptin expression in colorectal cancer.

Citations

Citations to this article as recorded by

Leptin in colorectal cancer: literature review
Dhouha Bacha, Khouloud Ayed, Rahma Boughriba, Rym Akrout, Marwa Weslati, Asma Gati
Hormone Molecular Biology and Clinical Investigation.2025; 46(3): 103. CrossRef
CORRELATION OF LEPTIN AND ADIPONECTIN RECEPTOR EXPRESSION WITH CLINICOPATHOLOGICAL PARAMETERS IN COLORECTAL CARCINOMA - A CROSS-SECTIONAL PROSPECTIVE STUDY
Priyanka PARMESH, Udupi Shastri DINESH, Ajay S KHANDAGALE, Anil Bargale BAPU, Roshni SADASHIV, Pradnya REDDY
Arquivos de Gastroenterologia.2024;[Epub] CrossRef
The Effect of Serum Leptin Concentration and Leptin Receptor Expression on Colorectal Cancer
Sylwia Chludzińska-Kasperuk, Jolanta Lewko, Regina Sierżantowicz, Elżbieta Krajewska-Kułak, Joanna Reszeć-Giełażyn
International Journal of Environmental Research and Public Health.2023; 20(6): 4951. CrossRef
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Vanda Marques, Fabiola Arella, Marta B. Afonso, André A. Santos, Cecília M.P. Rodrigues
Clinical Science.2023; 137(15): 1095. CrossRef
Effects of conjugated linoleic acid supplementation on serum leptin levels, oxidative stress factors and tumor marker in rectal cancer patients undergoing preoperative chemoradiotherapy
Elnaz Faramarzi, Mohammad Mohammadzadeh, Sarvin Sanaie, Vibeke Andersen, Reza Mahdavi
Mediterranean Journal of Nutrition and Metabolism.2021; 14(3): 245. CrossRef
Leptin expression is substantially correlated with prognosis of urinary bladder carcinoma
Mohamad Nidal Khabaz, Imtiaz Ahmad Qureshi, Jaudah Ahmad Al-Maghrabi
Libyan Journal of Medicine.2021;[Epub] CrossRef
Leptin Overexpression as a Poor Prognostic Factor for Colorectal Cancer
Chunxiang Li, Jichuan Quan, Ran Wei, Zhixun Zhao, Xu Guan, Zheng Liu, Shuangmei Zou, Xishan Wang, Zheng Jiang, Jialiang Yang
BioMed Research International.2020;[Epub] CrossRef
Adipocytokines: Are they the Theory of Everything?
Pierre S. Maximus, Zeina Al Achkar, Pousette F. Hamid, Syeda S. Hasnain, Cesar A. Peralta
Cytokine.2020; 133: 155144. CrossRef
The prognostic and therapeutic role of hormones in colorectal cancer: a review
Stella Nikolaou, Shengyang Qiu, Francesca Fiorentino, Shahnawaz Rasheed, Paris Tekkis, Christos Kontovounisios
Molecular Biology Reports.2019; 46(1): 1477. CrossRef
Expression of leptin and leptin receptors in colorectal cancer—an immunohistochemical study
Saad M. Al-Shibli, Norra Harun, Abdelkader E. Ashour, Mohd Hanif B. Mohd Kasmuri, Shaikh Mizan
PeerJ.2019; 7: e7624. CrossRef
Expression of leptin in colorectal adenocarcinoma showed significant different survival patterns associated with tumor size, lymphovascular invasion, distant metastasis, local recurrence, and relapse of disease in the western province of Saudi Arabia
Jaudah Ahmed Al-Maghrabi, Imtiaz Ahmad Qureshi, Mohamad Nidal Khabaz
Medicine.2018; 97(34): e12052. CrossRef
Obesity-Related Colorectal Cancer: The Role of Leptin
Hyeong Rok Kim
Annals of Coloproctology.2015; 31(6): 209. CrossRef

Oncologic Outcomes of a Laparoscopic Right Hemicolectomy for Colon Cancer: Results of a 3-Year Follow-up: Jung Hoon Cho, Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim; J Korean Soc Coloproctol. 2012;28(1):42-48. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.42

7,641 View
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8 Citations

Abstract PDF

Purpose

The purpose of the study is to evaluate the oncologic outcomes of a laparoscopic-assisted right hemicolectomy for the treatment of colon cancer and compare the results with those of previous randomized trials.

Methods

From June 2006, to December 2008, 156 consecutive patients who underwent a laparoscopic right hemicolectomy with a curative intent for colon cancer were evaluated. The clinicopatholgic outcomes and the oncologic outcomes were evaluated retrospectively by using electronic medical records.

Results

There were 84 male patients and 72 female patients. The mean possible length of stay was 7.0 ± 1.5 days (range, 4 to 12 days). The conversion rate was 3.2%. The total number of complications was 30 (19.2%). Anastomotic leakage was not noted. There was no mortality within 30 days. The 3-year overall survival rate of all stages was 93.3%. The 3-year overall survival rates according to stages were 100% in stage I, 97.3% in stage II, and 84.8% in stage III. The 3-year disease-free survival rate of all stages was 86.1%. The 3-year disease-free survival rates according to stage were 96.2% in stage I, 90.3% in stage II, and 75.6% in stage III. The mean follow-up period was 36.3 (3 to 60) months.

Conclusion

A laparoscopic right hemicolectomy for the treatment of colon cancer is technically feasible and safe to perform in terms of oncologic outcomes. The present data support previously reported randomized trials.

Citations

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Short-term outcomes and the learning curve for laparoscopic right hemicolectomy using the ArtiSential: a multicenter pooled analysis
Seijong Kim, Jaeim Lee, Heung-Kwon Oh, Dae Hee Pyo, Yoon Suk Lee, Yong Sik Yoon, Dong Hwan Bae, Byung Soh Min, Chang Hyun Kim, Jung Wook Huh
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Nima Ahmadi, Isabella Mor, Ross Warner
Journal of Robotic Surgery.2022; 16(2): 429. CrossRef
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2021; 37(6): 434. CrossRef
Oncologic Outcomes of Self-Expandable Metallic Stent as a Bridge to Surgery and Safety and Feasibility of Minimally Invasive Surgery for Acute Malignant Colonic Obstruction
Seung Yoon Yang, Youn Young Park, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Annals of Surgical Oncology.2019; 26(9): 2787. CrossRef
Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy
Zhobin Moghadamyeghaneh, Mark H. Hanna, Joseph C. Carmichael, Alessio Pigazzi, Michael J. Stamos, Steven Mills
Surgical Endoscopy.2016; 30(7): 2792. CrossRef
Preoperative prediction of conversion from laparoscopic rectal resection to open surgery: a clinical study of conversion scoring of laparoscopic rectal resection to open surgery
Guang-Dong Zhang, Xu-Ting Zhi, Jian-Li Zhang, Guang-Bo Bu, Gang Ma, Kai-Lei Wang
International Journal of Colorectal Disease.2015; 30(9): 1209. CrossRef
Feasibility and safety of laparoscopic resection following stent insertion for obstructing left-sided colon cancer
Seoung Yoon Rho, Sung Uk Bae, Se Jin Baek, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
Journal of the Korean Surgical Society.2013; 85(6): 290. CrossRef
Totally Laparoscopic Right Hemicolectomy with Intracorporeal Anastomosis is a Technically and Oncologically Safe Procedure
V. N. N. Kornmann, J. Hagendoorn, S.van Koeverden, B.van Ramshorst, A. B. Smits
Acta Chirurgica Belgica.2013; 113(6): 439. CrossRef

The Prognostic Impact of Obstructed Colorectal Cancer.: Jung, Hwa Kyung , Jung, Sang Hun , Kim, Jae Hwang , Shim, Min Chul; J Korean Soc Coloproctol. 2008;24(6):479-486.; DOI: https://doi.org/10.3393/jksc.2008.24.6.479

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Abstract PDF: PURPOSE
An obstructed colorectal cancer (OB) has a poorer survival than a non-obstructed cancer (NOB). This study examined the prognostic impact of bowel obstruction on colorectal cancer.
METHODS
From December 1999 to December 2005, patients undergoing single stage operation for OB were examined prospectively. OB (n= 193) was compared with a NOB (n=444) used in a primary tumor resection during the same period. 637 colorectal cancers were examined in this study.
RESULTS
The overall operative mortality was 21 (3.3%) and the postoperative mortality was significantly higher in the OB (OB: 16, 8.3%) group than in the NOB (NOB: 5, 1.1%) group. The proportion of OB was higher in the left-colon (52.8%) than in the right colon (16.0%) and rectum (31.1%, P<0.001). However, OB was associated with an older age (P=0.013). The proportion of advanced tumor stage was higher in OB (II: 35.8%, III: 39.5%, IV: 24.7%) than in NOB (II: 53.2%, III: 35.8%, IV: 11.0%, P<0.001). The 5-year cancer-related survival for OB was worse than NOB (OB: 77.3%, NOB: 57.8%, P<0.05). However, in the cases of a colorectal cancer performed curative resection (stage II and III), the survival for OB was not worse than NOB: stage II (OB: 82.8%, NOB: 92.2%, P=0.24), stage III (OB: 65.2%, NOB: 56.9%, P=0.43).
CONCLUSIONS
OB has older and more advanced disease characteristics. However, if an oncologically curative resection is performed, the survival for OB is similar to that of a NOB.

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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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

Long-term Result for Rectal Cancer in Cases of a Curative Resection after Preoperative Chemoradiotherapy.: Lee, Dong Hyun , Jung, Sang Hun , Kim, Jae Hwang , Shim, Min Chul; J Korean Soc Coloproctol. 2007;23(6):503-510.; DOI: https://doi.org/10.3393/jksc.2007.23.6.503

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PURPOSE
Preoperative chemoradiation is the recommended standard therapy for locally advanced rectal cancer and is associated with sphincter preservation and improved survival. Our study was performed to determine the surgical outcomes and the prognostic factors for rectal cancer with preoperative chemoradiotherapy (PCRT) followed by a relative curative resection.
METHODS
We retrospectively reviewed the cases of 251 advanced rectal cancer patients who underwent a PCRT, between Jan 1995 and Dec 2002. All patients a received 25 days RTX (total dose: 4,500~5,040 cGy) and intravenous 5-FU (425 mg/m2/ day) plus leucovorin (20 mg/day) for 24 hrs. Surgery was performed about 4~6 weeks after completion of RTX. The median follow up was 79 months (range 1-142).
RESULTS
All patients were comfortable with PCRT. Postoperative mortality was 1.1%. After PCRT, 92.2% of the patients and, especially, 82.2% of the low rectal cancer patients had sphincter preserving surgery. Complete remission of the tumor was stenin 15.1% of the cases, but was not significantly associated with recurrence. The overall recurrence and the local recurrence rates were 15.1% and 4.4%, respectively. Cell differentiation, circumferential margin, and lymphovascular invasion were independent risk factors for local recurrence in the multivariate analysis. Prognostic factors for overall and disease-free survival were cell differentiation, circumferential margin, lymphovascular invasion, and lymph node metastasis in the multivariate analysis. The 5-year disease-free survival rates for stages I, II, and III, and for no-residual tumor were 96.1%, 83.4%, 69.0%, and 89.1%, respectively (P<0.05).
CONCLUSIONS
Advanced rectal cancer treated using preoperative chemoradiation resulted in excellent sphincter preservation. Our long-term follow-up results showed good local control and improved survival for rectal cancer.

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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

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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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

The Long-term Oncological Outcome of a Sphincter-saving Resection and an Abdominoperineal Resection for Lower Rectal Cancer.: Jung, Sang Hun , Yu, Chang Sik , Choi, Pyong Wha , Kim, Dae Dong , Hong, Dong Hyun , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(3):186-193.; DOI: https://doi.org/10.3393/jksc.2007.23.3.186

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Purpose
The oncological safety of a sphincter-saving resection (SSR) in lower rectal cancer is widely accepted, and both an abdominoperineal resection (APR) and a SSR are used in potentially curative surgery. This retrospective study was performed to compare the long-term oncological outcomes after an APR and a SSR in patients with lower rectal cancer (within 5 cm from the anal verge). Methods: We recruited 441 lower rectal cancer patients who underwent curative resections (APR: 305, SSR: 136) between 1995 and 2000. A total mesorectal excision and autonomic nerve preservation were routinely performed. The median follow- up period was 65 months. Results: Most demographic findings were comparable between the groups; however, the APR groups revealed more advanced pathological characteristics (tumor depth, size, cell differentiation, and metastatic LN number). The local recurrence rates after an APR and a SSR were 12.8% and 7.4%, respectively (P= 0.09). An independent risk factor of local recurrence was LN metastasis only. Distant recurrence was higher in the APR group (26.4%) than in the SSR group (13.2%), but on multivariate analysis the difference was not significant (P=0.17). The 5-year cancer-specific survival rates after an APR and a SSR were 73.2% and 87.6%, respectively (P<0.05). Particularly, there was a significant survival difference for stage III patients (APR: 59.0% vs. SSR: 83.0%, P<0.05). However, an APR was not an independent prognostic factor for cancer-specific survival in the multivariate analysis (P=0.07). Conclusions: An APR per se did not influence local recurrence after a curative resection for lower rectal cancer. The poor cancer-specific survival in the stage III APR group might be attributed to increased distant metastasis due to its more distal location.

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Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer
Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim
Annals of Coloproctology.2024; 40(4): 384. CrossRef
Long-term Result for Rectal Cancer in Cases of a Curative Resection after Preoperative Chemoradiotherapy
Dong Hyun Lee, Sang Hun Jung, Jae Hwang Kim, Min Chul Shim
Journal of the Korean Society of Coloproctology.2007; 23(6): 503. CrossRef

Mucinous Adenocarcinoma of the Colon and Rectum.: Kim, Kab Choong , Kim, Duck Woo , Park, Hyung Chul , Park, Jae Gahb; J Korean Soc Coloproctol. 2007;23(1):60-64.; DOI: https://doi.org/10.3393/jksc.2007.23.1.60

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PURPOSE
This study was to evaluate and compare the clinical characteristics of a mucinous adenocarcinoma with those of a non-mucinous adenocarcinoma in colorectal cancer patients.
METHODS
Data were retrospectively reviewed on 3,232 colorectal cancer patients, including 221 mucinous adenocarcinoma patients (6.1%), who received surgery between 1990 and 2003.
RESULTS
The mean tumor size (6.5 cm) of the mucinous adenocarcinomas was bigger than that (5.2 cm) of the non-mucinous adenocarcinomas. The locations of the mucinous adenocarcinomas were 95 (48.2%) in the proximal colon, 35 (17.8%) in the distal colon, and 67 (34.0%) in the rectum whereas those of the non-mucinous adenocarcinomas were 559 (18.9%) in the proximal colon, 861 (29.2%) in the distal colon, and 1,533 (51.9%) in the rectum. Stage distribution was as follows: In mucinous adenocarcinomas, 7 stage A (3.3%), 84 stage B (39.3%), 76 stage C (35.5%), and 47 stage D (21.9%). In non-mucinous adenocarcinomas, 447 stage A (15.2%), 1,036 stage B (35.1%), 997 stage C (33.8%), and 469 stage D (15.9%). In the univariate analysis, the overall 5-year survival rate of patients with a mucinous adenocarcinoma was lower than that of patients with a non-mucinous adenocarcinoma (60% vs. 65%, P=0.016), but survival rates for each stage were not significantly different. The difference in recurrence rates was not statistically significant (33.3% vs. 24.2%, P=0.258). A multivariate analysis showed that the mucinous histologic type was not useful as an independent prognostic factor.
CONCLUSIONS
Mucinous colorectal adenocarcinomas tend to be large, exist in a proximal location, have an advanced stage at diagnosis. The difference in survival rates for each stage was not statistically significant. A mucinous histologic type was not an independent prognostic factor.

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Analysis of Prognosis in Colorectal Mucinous Adenocarcinoma: A Retrospective Analysis with Peritoneal Fluid
Seung Bong Choi, In Kyu Lee, Dae Youn Won, Yoon Suk Lee, Yoon Si, Sang Chul Lee, Won Kyung Kang, Jong Kyung Park, Chang Hyeok Ahn, Jun-Gi Kim, Seong Taek Oh
Journal of the Korean Surgical Society.2010; 79(6): 474. CrossRef

Risk Factors and Oncologic Impact of Anastomotic Leakage after Rectal Cancer Surgery.: Jung, Sang Hun , Yu, Chang Sik , Choi, Pyong Wha , Kim, Dae Dong , Hong, Dong Hyun , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2006;22(6):371-379.

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Abstract PDF: PURPOSE
Anastomotic leakage (AL) is a serious and life-threatening complication following rectal cancer surgery. The impact on long-term oncologic outcome in patients with AL is not clear. The aim of this retrospective study was to evaluate the risk factors of AL and its impact on long-term prognosis after rectal cancer surgery.
METHODS
We investigated 1,391 patients who underwent primary resection and anastomosis for rectal cancer between January 1997 and August 2003. Operations were performed as follows: AR (n=164), LAR (n=898), uLAR (n=329). Standard procedures in our clinic were mesorectal excision according to tumor location and autonomic nerve preservation. Median follow-up period was 40.1 months (2~96 months).
RESULTS
AL rate was 2.5% (n=35). Gender (male), age (>60 years) and uLAR were independent risk factors in multivariate analysis (HR: 3.03, 95% CI: 1.18~7.22; HR: 2.42, 95% CI: 1.12~7.83; HR: 2.68, 95% CI: 1.08~7.09, respectively). Local recurrence in the AL group was significantly higher than that in the non-AL group (P<0.05), but there was no significant difference in multivariate analysis (P=0.14). Systemic recurrence between both groups was not statistically different. The 5-year overall survival rate was significantly lower in the AL group than in the non-AL group (55.1% vs 74.1%, P<0.05) and the cancer- specific survival rate was lower in the AL group than in the non-AL group (63.0% vs 78.3%, P=0.05).
CONCLUSIONS
Age, gender, and anastomotic level were risk factors for AL after rectal cancer surgery and anastomotic leakage was associated with a poor survival.

Survival after Curative Surgery for a Colorectal Mucinous Carcinoma.: Kim, Jun Ho , Baek, Jeong Heum , Lee, Jung Nam , Cho, Chung Yon , Min, Seung Kee , Lee, Woon Kee , Park, Heung Kyu , Chung, Min , Lee, Young Don , Oh, Jae Hwan; J Korean Soc Coloproctol. 2005;21(4):220-224.

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Abstract PDF: PURPOSE
The clinicopathological significance of a colorectal mucinous carcinoma remains controversial. Previous reports have suggested that mucinous carcinomas affect young patients, are more advanced at diagnosis, and have a worse prognosis than non-mucinous carcinomas, but more recent reports have refuted those results. The principal aim of this study was to evaluate whether colorectal mucinous carcinomas are associated with a worse prognosis than colorectal non-mucinous carcinomas for patients who undergo curative surgery.
METHODS
A total of 534 patients with colorectal carcinomas, including 42 cases of mucinous carcinomas, underwent surgery in the Department of Surgery of Gil Medical Center, Gachon Medical School, between March 1997 and February 2003. Of these, we retrospectively evaluated 33 patients with mucinous carcinomas and 407 patients with non-mucinous carcinomas who had undergone a curative resection. The age and the sex distributions, the primary location of the tumor, the stage at diagnosis, the curability, and the 3-year survival of mucinous- carcinoma patients were compared with those of non- mucinous-carcinoma patients. Thirteen patients were lost to follow-up, so we evaluated 427 patients for the overall survival rate by using the Kaplan-Meier method and the long-rank test for quality of curves.
RESULTS
The proportion of mucinous carcinomas was 7.8% (42/534). There were no significant differences in sex and curability, but the mucinous-carcinoma patients were found to be younger (P=0.014), to have a Right-side dominancy (P=0.038), and to have a more advanced stage at diagnosis (P=0.004). The 3-year survival rates in stage-B patients with mucinous carcinomas and non-mucinous carcinomas were 92.3% and 80.9%, respectively (P>0.05); in stage C, they were 62.2% and 73.8%, respectively (P>0.05). The difference of the survival rates for each stage was not statistically significant.
CONCLUSIONS
Many reports suggest that patients with colorectal mucinous carcinomas have worse survival than patients with non-mucinous carcinomas. However, there was no significant difference in the 3-year survival rates between patients with mucinous carcinomas and those with non-mucinous carcinomas in our study.

The Outcome of Preoperative Chemoradiation to Locally Advanced Rectal Cancer.: Park, Hyung Seok , Ahn, Byung Kwon , Lee, Seung Hyun , Baek, Sung Uhn; J Korean Soc Coloproctol. 2004;20(5):277-282.

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Abstract PDF: PURPOSE
Tumor downstaging after preoperative chemoradiation has been associated with an intent to improve anal sphincter preservation, resectability, local control, and possibly survival in locally advanced rectal cancer. We performed this study to evaluate the outcome of preoperative chemoradiation for locally advanced rectal cancer.
METHODS
We retrospectively reviewed the cases of 82 patients who had been treated by using preoperative chemoradiation combined with surgery for adenocarcinoma of the rectum between January, 1995, and December, 2002. All patients had fixed or locally advanced lesions, which had been detected by using digital rectal examination. No distant metastasis was proven before preoperative chemoradiation. All of the patients received the full scheduled dose of radiation (range, 3,000~5,400 cGy). Concurrent intravenous chemotherapy with 5-fluorouracil (450 mg/m2/day) and leucovorin (45 mg/day) was administered continuously on days 1~5 and 29~33. The mean interval between chemoradiation and surgery was 5.6 weeks (2.7~9.6 weeks). The survival rate was estimated by using the Kaplan-Meier method and the log-rank test. We compared the survival of locally advanced rectal cancers treated by using preoperative chemoradiation with surgery with that of 444 patients with resectable rectal cancers treated by using curative surgery alone during same period.
RESULTS
A curative resection could be performed on 64 of the 82 patients (78.2%). A sphincter-preserving surgery was performed on 42 patients (51.2%). A pathologic complete response (pCR) occurred in 6 patients (7.3%). The 5-year survival rates of patients with a pCR was 66.7%. In the comparison of the 5-year survival rates between patients with locally advanced rectal cancer treated by using preoperative chemoradiation with curative surgery and patients with rectal cancer treated by using curative surgery alone, those of stage I, stage II, and stage III cancers were 100% vs. 89.5%, 86.9% vs. 86.3%, and 52.9% vs. 63.3%, respectively (P>0.05).
CONCLUSIONS
The survival rates for patients with locally advanced rectal cancers, which are expected to be unresectable or non-curative, treated by using preoperative chemoradiation with surgery were similar to those for patients with resectable rectal cancers treated by using curative surgery alone. We think that preoperative chemoradiation with surgery improves the survival of patients with locally advanced rectal cancer. J Korean Soc Coloproctol 2004;20:277-282

nfluences of DNA Ploidy and Pre-operative CEA Level on the 5 Year Survival Rate in Colorectal Cancer.: Kang, Kyu Chul , Jung, Sung Teak , Yoon, Min Young , Choi, Sun Keun , Hur, Yoon Seok , Lee, Keon Young , Kim, Sei Joong , Cho, Young Up , Ahn, Seung Ik , Hong, Kee Chun , Shin, Seok Hwan , Kim, Kyoung Rae , Woo, Ze Hong; J Korean Soc Coloproctol. 2004;20(3):157-162.

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Abstract PDF: PURPOSE
The role of DNA ploidy in colon cancer as a prognostic factor and the correlation of DNA ploidy with the established prognostic factors have been studied for the past 20 years. The purpose of this study was to look into the correlation of DNA ploidy with the prognostic factors and to assess the influence of pre-operative CEA level and DNA ploidy on survival in colorectal cancer.
METHODS
A total of 319 patients with colorectal cancer received radical operations, and DNA flow cytometric analyses of DNA ploidy patterns were performed at the Department of Surgery, Inha University Hospital, from June 1996 to July 2002. The patients were divided into 2 groups according to the DNA ploidy patterns.
RESULTS
The DNA ploidies of the colorectal tumors were compared to various prognostic factors, the pre-operative CEA level and lymph-node metastasis. The latter two showed correlations to the DNA ploidy. The 5-year survival rate for patients with a normal pre-operative CEA level and DNA diploidy was 85.6% compared to 47.8% for patients with both high pre-operative CEA level and DNA aneuploidy, a statistically significant correlation (P= 0.0003).
CONCLUSIONS
This study suggests that DNA ploidy in patients with colon cancer has a significant correlation with pre-operative CEA level and lymph-node metastasis. Especially, the pre-operative CEA level and DNA ploidy in patients with colorectal cancer may play a role as useful prognostic factors.

Clinical Significance of Lymph Node Micrometastasis in Patients with Dukes' B Colorectal Cancer.: Lee, Hyo Won , Jang, Yong Seog; J Korean Soc Coloproctol. 2004;20(1):57-63.

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Abstract PDF: PURPOSE
This study aimed to provide immunohistochemical evidence of micrometastasis in patients with node-negative Dukes' B colorectal cancer and to evaluate the clinical implications, including prognostic significance, of lymphatic metastasis.
METHODS
A retrospective study of 90 patients who underwent a curative operation due to colorectal neoplasms from 1996 to 2001 was performed. Two consecutive sections of lymph nodes were prepared: one for ordinary hematoxylin-eosin staining, and the other for immunohistochemistry with pancytokeratine antibody. All clinical factors, including survival rate, were compared between patients with and without lymph-node metastasis. The mean follow- up period was 36.1 months.
RESULTS
Micrometastasis was confirmed in 115 nodes (7.9%) from 32 patients (35.6%). No correlations were observed between micrometastases and prognostic factors, including survival rate, except for lymphatic invasion and postoperative TNM staging. Twenty-six of the 32 (81.3%) patients with micrometastases belonged to stage T3N0M0 (P<0.003).
CONCLUSIONS
The immunohistochemical assay may be a useful way to identify micrometastasis in patients with Dukes' B colorectal neoplasms, but we were not able to demonstrate the prognostic significance of micrometastasis.

Characteristic Clinical Behaviors of and Prognosis for Mucinous Adenocarcinomas in the Colon and Rectum.: Yu, Yeun Sik , Kim, Hee Cheol , Park, Sang Jun , Yu, Jang Hak , Kim, Jung Sun , Lee, Gang Hong , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2003;19(6):379-385.

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Abstract PDF: PURPOSE
The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas.
METHODS
Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0~113) months for mucinous adenocarcinomas and 32 (0~130) months for non-mucinous adenocarcinoma.
RESULTS
Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P<0.001), frequent family history (P<0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P<0.001), and common peritoneal seeding at diagnosis (P<0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant.
CONCLUSIONS
Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed.

Surgical Treatment of Recurrent Colorectal Cancer.: Koo, Gwang Mo , Park, Sang Su , Yoon, Jin , Kim, Il Myoung , Yu, Byoung Uk , Yang, Dae Hyun , Cho, Ik Hang; J Korean Soc Coloproctol. 2003;19(5):314-321.

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Abstract PDF: PURPOSE
Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer.
METHODS
From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival.
RESULTS
Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3.
CONCLUSIONS
Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.

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