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Original Article
Anorectal benign disease
Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids
Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan
Ann Coloproctol. 2025;41(6):537-544.   Published online December 24, 2025
DOI: https://doi.org/10.3393/ac.2025.00549.0078
  • 893 View
  • 52 Download
AbstractAbstract PDFSupplementary Material
Purpose
We aimed to determine whether intra-anal cryotherapy reduces postoperative pain in patients undergoing hemorrhoidectomy.
Methods
This randomized controlled trial was conducted from January 2023 to August 2024. Patients with symptomatic grade III hemorrhoids were randomized 1:1 to receive either 1 minute of intra-anal cryotherapy or standard postoperative care. Because cryotherapy was applied before reversal of general anesthesia, patients were blinded to treatment allocation. The primary outcome was pain at rest on postoperative day (POD) 1. Secondary outcomes included pain after defecation, time to return to work or non-work activities, 30-day complications, and compliance with analgesia. Pain was measured using the visual analog scale.
Results
A total of 50 patients were randomized (25 per group). All 50 were included in the analysis. Baseline clinicodemographic characteristics were comparable between groups. The primary outcome, POD 1 pain at rest, did not demonstrate superiority of cryotherapy compared with standard care (median 3.0 vs. 4.0, P=0.062). However, the POD 1 pain score after defecation was significantly lower with cryotherapy than without (3.0 vs. 4.0, P=0.046). On POD 2, median pain scores at rest and after defecation were both significantly lower in the cryotherapy cohort (at rest: 2.0 vs. 4.0, P=0.043; after defecation: 2.0 vs. 5.0, P=0.001).
Conclusion
Intra-anal cryotherapy significantly reduces pain after defecation in the early postoperative period following surgery for grade III hemorrhoids. Its therapeutic efficacy, ease of application, and safety support consideration for routine use. Trial registration ClinicalTrials.gov identifier: NCT06005727
Review
Anorectal benign disease
Pharmacotherapy for fecal incontinence: potential treatment with a traditional Japanese medicine Kampo
Kotaro Maeda, Toshinobu Sasaki, Tomohisa Hattori
Ann Coloproctol. 2025;41(5):369-378.   Published online October 23, 2025
DOI: https://doi.org/10.3393/ac.2025.00283.0040
  • 2,324 View
  • 68 Download
AbstractAbstract PDF
Fecal incontinence (FI) significantly impairs patient quality of life and creates substantial distress not only for affected individuals but also for nurses and caregivers. The prevalence of FI among older adults is estimated at up to 20%, although the sensitive nature of the condition often prevents active reporting by patients. This article reviews risk factors and pharmacotherapies for FI, emphasizing the therapeutic potential of Daikenchuto (DKT). The etiology of FI is multifactorial and lacks a singular definition. Currently, no prescription drugs specifically approved for FI are available, leaving treatment options limited. Nonetheless, major clinical guidelines have identified several viable pharmacological approaches. Strongly recommended treatments include the antidiarrheal agent loperamide and stool bulking or solidifying agents, such as dietary fiber and polycarbophil. Other therapeutic options include ramosetron, a 5-HT3 receptor antagonist; amitriptyline, a tricyclic antidepressant; and sodium valproate and diazepam, which are GABAergic neuromodulators. Recently, research has explored the efficacy and mechanism of action of DKT, a traditional Japanese medicine Kampo. Historically used for abdominal symptoms like bloating and known for promoting intestinal motility, emerging evidence suggests DKT may also effectively manage FI.
Original Articles
Metastasis or chemotherapy
Short-term surgical outcomes following neoadjuvant immunotherapy in mismatch repair-deficient colorectal cancer: initial experience from a tertiary referral center
Ejaz Ahmed Latif, Ayman Abdelhafiz Ahmed, Mahmood Saad Al-Dhaheri, Ammar Aleter, Ali Toffaha, Mohamed Kurer, Tausief Fatima, Amjad Parvaiz, Mohmmad Hosni Abunada
Ann Coloproctol. 2025;41(4):338-345.   Published online August 28, 2025
DOI: https://doi.org/10.3393/ac.2025.00381.0054
  • 1,413 View
  • 45 Download
AbstractAbstract PDF
Purpose
Immunotherapy has demonstrated remarkable efficacy in mismatch repair-deficient (MMR-D) colorectal cancer (CRC). Due to their significant response rates, immune checkpoint inhibitors have emerged as a promising neoadjuvant therapy. However, data regarding short-term surgical outcomes following immunotherapy remain limited. The aim of this study is to evaluate the safety and feasibility of surgical resection after immunotherapy, as well as its short-term clinical outcomes.
Methods
A retrospective review of prospectively collected data was performed at a tertiary referral center from January 2020 to July 2024. Fifteen consecutive patients with MMR-D CRC treated with pembrolizumab were analyzed. The patients’ demographics, tumor characteristics, clinical outcomes, and histopathological responses were assessed.
Results
In total, 15 patients diagnosed with MMR-D locally advanced or metastatic colorectal cancers received neoadjuvant immunotherapy followed by surgery. Of the 15 patients, 11 (73.3%) were male, 12 (80.0%) presented with T3/T4 tumors, and 3 (20.0%) had metastatic disease at diagnosis. The median number of immunotherapy cycles was 5 (range, 3–13). Surgery was performed without any anastomotic leaks or 30-day mortality. The median length of hospital stay was 5 days (range, 3–14 days). All surgical specimens had negative resection margins. Major pathological response was observed in 11 patients (73.3%), including complete response in 8 (53.3%) and near-complete response in 3 (20.0%). The median follow-up was 14 months (range, 1–56 months). One patient developed liver metastasis, which was successfully resected.
Conclusion
Surgical resection of MMR-D CRC following neoadjuvant immunotherapy is safe and associated with low morbidity. Neoadjuvant immunotherapy in MMR-D CRC facilitates high rates of major pathological response.
Colorectal cancer
Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
Ann Coloproctol. 2025;41(5):473-482.   Published online July 10, 2025
DOI: https://doi.org/10.3393/ac.2024.00276.0039
  • 1,464 View
  • 32 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The decision for treatment after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer is intricately linked to tumor response and clinical parameters. This study was designed to elucidate determinants influencing treatment decisions for good responders to nCRT, while concurrently evaluating the ramifications of modifications in magnetic resonance imaging (MRI) tumor response evaluation protocols.
Methods
A survey was constructed with 5 cases of good responder after nCRT based on the magnetic resonance–based tumor regression grade (mrTRG) criteria. A total of 35 colorectal surgeons in Korea participated in the survey via email, and they were introduced to 2 discrete MRI-based tumor response evaluation methodologies: the conventional mrTRG and an emergent complete response (CR)/non-CR classification system. Surgeons were directed to select between total mesorectal excision, local excision, or a watch and wait strategy.
Results
Treatment decisions varied significantly (P<0.01), as gradually more clinical information was provided with mrTRG. The paradigm shift from mrTRG to CR/non-CR evaluation criterion instigated the highest alteration in decision (P<0.01). Even comparing with other sets of information, decision change with different tumor response assessment (i.e., mrTRG vs. CR/non-CR) was statistically significant (P<0.01). Three particular cases consistently displayed a declining predilection for total mesorectal excision, favoring a more pronounced inclination towards watch and wait strategy or local excision. Nonetheless, the magnitude of these decisional shifts oscillated depending on the specific endoscopic imagery present.
Conclusion
Our current findings underscore the significant role of tumor response assessment methods in shaping treatment decisions for rectal cancer patients who respond well to nCRT. This highlights the need for clear and accurate tools to interpret MRI results.

Citations

Citations to this article as recorded by  
  • Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
    Gyung Mo Son
    Annals of Coloproctology.2025; 41(6): 489.     CrossRef
Review
Inflammatory/benign bowel disease
Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review
Hyun Gu Lee, In Ja Park
Ann Coloproctol. 2025;41(2):107-118.   Published online April 16, 2025
DOI: https://doi.org/10.3393/ac.2023.00192.0027
  • 32,411 View
  • 471 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Appendectomy as the standard treatment for acute appendicitis has been challenged by accumulating evidence supporting nonoperative management with antibiotics as a potential primary treatment. This review aimed to summarize the clinical outcomes and the optimal indications for nonoperative management of acute appendicitis in adults. Current evidence suggests that uncomplicated and complicated appendicitis have different pathophysiologies and should be treated differently. Nonoperative management for uncomplicated appendicitis was not inferior to appendectomy in terms of complications and length of stay, with less than a 30% failure rate at 1 year. The risk of perforation and postoperative complications did not increase even if nonoperative management failed. Complicated appendicitis with localized abscess or phlegmon could also be treated conservatively, with a success rate of more than 80%. An interval appendectomy following successful nonoperative management is recommended only for patients over the age of 40 years to exclude appendiceal malignancy. The presence of appendicoliths increased the risk of treatment failure and complications; thus, it may be an indication for appendectomy. Nonoperative management is a safe and feasible option for both uncomplicated and complicated appendicitis. Patients should be informed that nonoperative management may be a safe alternative to surgery, with the possibility of treatment failure.

Citations

Citations to this article as recorded by  
  • Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
    Ju Tian
    World Journal of Clinical Cases.2025;[Epub]     CrossRef
Original Articles
Colorectal cancer
Is clinical complete response as accurate as pathological complete response in patients with mid-low locally advanced rectal cancer?
Niyaz Shadmanov, Vusal Aliyev, Guglielmo Niccolò Piozzi, Barıs Bakır, Suha Goksel, Oktar Asoglu
Ann Coloproctol. 2025;41(1):57-67.   Published online February 28, 2025
DOI: https://doi.org/10.3393/ac.2024.00339.0048
  • 9,898 View
  • 306 Download
  • 3 Web of Science
  • 4 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
The standard treatment for locally advanced rectal cancer involves neoadjuvant chemoradiation followed by total mesorectal excision surgery. A subset of patients achieves pathologic complete response (pCR), representing the optimal treatment outcome. This study compares the long-term oncological outcomes of patients who achieved pCR with those who attained clinical complete response (cCR) after total neoadjuvant therapy, managed using a watch-and-wait approach.
Methods
This study retrospectively evaluated patients with mid-low locally advanced rectal cancer who underwent neoadjuvant treatment from January 1, 2005, to May 1, 2023. The pCR and cCR groups were compared based on demographic, clinical, histopathological, and long-term survival outcomes.
Results
The median follow-up times were 54 months (range, 7–83 months) for the cCR group (n=73), 96 months (range, 7–215 months) for the pCR group (n=63), and 72 months (range, 4–212 months) for the pathological incomplete clinical response (pICR) group (n=627). In the cCR group, 15 patients (20.5%) experienced local regrowth, and 5 (6.8%) developed distant metastasis (DM). The pCR group had no cases of local recurrence, but 3 patients (4.8%) developed DM. Among the pICR patients, 58 (9.2%) experienced local recurrence, and 92 (14.6%) had DM. Five-year disease-free survival rates were 90.0% for cCR, 92.0% for pCR, and 69.5% for pICR (P=0.022). Five-year overall survival rates were 93.1% for cCR, 92.0% for pCR, and 78.1% for pICR. There were no significant differences in outcomes between the cCR and pCR groups (P=0.810); however, the pICR group exhibited poorer outcomes (P=0.002).
Conclusion
This study shows no significant long-term oncological differences between patients who exhibited cCR and those who experienced pCR.

Citations

Citations to this article as recorded by  
  • Total neoadjuvant therapy in rectal cancer: The FOREST protocol, a patient‐centered approach that clusters two cohorts with different outcomes
    Hector Guadalajara, Jose Luis Domínguez‐Tristancho, Raquel Fuentes Mateo, Miguel Leon‐Arellano, Raquel Sanz‐Baro, Eleonora Geraldi, Ana Isabel Hormigo‐Sanchez, Víctor Manuel Castellano Megías, Marta Pérez Cobos, Patricia Mellado Miras, Begoña Lopez‐Botet
    International Journal of Cancer.2026; 158(3): 697.     CrossRef
  • The Shifting and Evolving Neoadjuvant Treatments and Surgical Platforms on Oncological Outcomes and Sphincter Preservation in Distal Rectal Cancer: A 23-Year Retrospective Experience
    Niyaz Shadmanov, Vusal Aliyev, Barıs Bakır, Suha Goksel, Oktar Asoglu
    Journal of Gastrointestinal Cancer.2025;[Epub]     CrossRef
  • Organ preservation in rectal cancer: Clinical basis of the watch-and-wait strategy
    Rosa M. Jimenez-Rodriguez, Fátima Aguilar-del-Castillo, Felipe Quezada-Diaz, Julio García-Aguilar
    Cirugía Española (English Edition).2025; : 800248.     CrossRef
  • Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
    Gyung Mo Son
    Annals of Coloproctology.2025; 41(6): 489.     CrossRef
Translational/basic research
Preclinical testing of a new radiofrequency ablation device in a porcine perianal fistula model
Sunseok Yoon, Jung-Woo Choi, Yongtaik Son, Hyun Soon Lee, Kwang Dae Hong
Ann Coloproctol. 2025;41(1):84-92.   Published online February 26, 2025
DOI: https://doi.org/10.3393/ac.2024.00626.0089
  • 3,337 View
  • 133 Download
AbstractAbstract PDF
Purpose
Anorectal fistulas present a treatment challenge, with conventional surgical methods potentially resulting in complications such as fecal incontinence. To improve patient outcomes, more effective and minimally invasive therapies are critically needed. In this study, an optimal porcine model for the creation of anorectal fistulas was developed and used to evaluate the efficacy of radiofrequency ablation (RFA) therapy.
Methods
Two distinct but related experiments were conducted. In the first experiment, a reliable and standardized porcine anorectal fistula model was developed. In the second, the healing process was assessed, and outcomes were compared between the RFA-treated group and the control group using the established porcine model.
Results
The results indicated that a 3.5-cm fistula tract length and a 14-day evaluation period following seton removal are optimal for the porcine anorectal fistula model. In the second experiment, the RFA group tended to exhibit better outcomes regarding fistula closure, although the differences were not statistically significant. Histopathologically, no significant difference in inflammation grade was observed between groups; however, scar tissue was more predominant in the RFA group.
Conclusion
The findings suggest that RFA therapy may offer potential benefits in the treatment of anorectal fistulas, as demonstrated using a porcine model. To validate these results and explore the mechanisms of action underlying RFA therapy for anorectal fistulas, further research involving larger sample sizes and a more robust study design is required.
Review
Colorectal cancer
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Ann Coloproctol. 2024;40(6):527-537.   Published online December 20, 2024
DOI: https://doi.org/10.3393/ac.2024.00745.0106
  • 8,472 View
  • 171 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract PDF
Rectal cancer is one of the most common carcinomas and a leading cause of cancer-related mortality. Although significant advancements have been made in the treatment of rectal cancer, the deterioration of quality of life (QoL) remains a challenging issue. Various tools have been developed to assess QoL, including the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale, the QLQ-C30 and QLQ-CR29 by the European Organization for Research and Treatment of Cancer (EORTC), and the 36-Item Short Form Health Survey (SF-36). Factors such as the lower location of the tumor, radiation therapy, chemoradiotherapy, and chemotherapy are associated with a decline in QoL. Furthermore, anastomotic leakage following rectal cancer resection is an important risk factor affecting QoL. With the development of novel treatment approaches, including neoadjuvant therapies such as chemoradiotherapy and total neoadjuvant therapy, the rate of clinical complete remission has increased, leading to the emergence of organ-preserving strategies. Both local excision and the “watch-and-wait” approach following neoadjuvant therapy improved functional outcomes and QoL. Efforts to improve QoL after rectal cancer surgery are ongoing in surgical techniques for rectal cancer. Since QoL is determined by a complex interplay of factors, including the patient's physical condition, surgical techniques, and psychological and social elements, a comprehensive approach is necessary to understand and enhance it. This review aims to describe the methods for measuring QoL in rectal cancer patients after surgery, the key risk factors involved, and various strategies and efforts to improve QoL outcomes.

Citations

Citations to this article as recorded by  
  • Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
    Eun Jung Park
    Science Editing.2025; 12(1): 66.     CrossRef
  • Editorial: Organ preservation for rectal cancer patients
    Ionut Negoi, John R. T. Monson, Leonardo Bustamante-Lopez, Zoe Garoufalia, Vito D'Andrea, Sameh Hany Emile
    Frontiers in Surgery.2025;[Epub]     CrossRef
  • Sphincter-preserving surgical techniques in low rectal cancer management: A systematic review of contemporary evidence
    Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review
    In Ja Park
    Ewha Medical Journal.2025; 48(3): e40.     CrossRef
  • Strategies to reduce intestinal toxicity in neoadjuvant management of locally advanced rectal cancer
    Hoda Mahdavi, Sahar Dashti, Shima Jafari
    Discover Oncology.2025;[Epub]     CrossRef
Original Articles
Colorectal cancer
Preventive efficacy of hydrocortisone enema for radiation proctitis in rectal cancer patients undergoing short-course radiotherapy: a phase II randomized placebo-controlled clinical trial
Mohammad Mohammadianpanah, Maryam Tazang, Nam Phong Nguyen, Niloofar Ahmadloo, Shapour Omidvari, Ahmad Mosalaei, Mansour Ansari, Hamid Nasrollahi, Behnam Kadkhodaei, Nezhat Khanjani, Seyed Vahid Hosseini
Ann Coloproctol. 2024;40(5):506-514.   Published online October 22, 2024
DOI: https://doi.org/10.3393/ac.2024.00192.0027
  • 5,930 View
  • 104 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
This study aimed to investigate the efficacy of hydrocortisone enema in preventing radiation proctitis in patients with rectal cancer undergoing short-course radiotherapy (SCRT).
Methods
This phase II randomized controlled trial enrolled patients with newly diagnosed locally advanced rectal cancer (clinically staged T3–4 and/or N1–2M0). Participants received a median of 4 cycles of neoadjuvant chemotherapy (capecitabine plus oxaliplatin) followed by 3-dimensional conformal SCRT (25 Gy in 5 fractions). Patients were randomly assigned to receive either a hydrocortisone enema (n=50) or a placebo (n=51) once daily for 5 consecutive days during SCRT. The primary endpoint was the incidence and severity of acute proctitis.
Results
Of the 111 eligible patients, 101 were included in the study. Baseline characteristics, including sex, age, performance status, and tumor location, were comparable across the treatment arms. None of the patients experienced grade 4 acute gastrointestinal toxicity or had to discontinue treatment due to treatment-related adverse effects. Patients in the hydrocortisone arm experienced significantly less severe proctitis (P<0.001), diarrhea (P=0.023), and rectal pain (P<0.001) than those in the placebo arm. Additionally, the duration of acute gastrointestinal toxicity following SCRT was significantly shorter in patients receiving hydrocortisone (P<0.001).
Conclusion
Hydrocortisone enema was associated with a significant reduction in the severity of proctitis, diarrhea, and rectal pain compared to placebo. Additionally, patients treated with hydrocortisone experienced shorter durations of gastrointestinal toxicity following SCRT. This study highlights the potential benefits of hydrocortisone enema in managing radiation-induced toxicity in rectal cancer patients undergoing radiotherapy.

Citations

Citations to this article as recorded by  
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
Colorectal cancer
The impact of short-course total neoadjuvant therapy, long-course chemoradiotherapy, and upfront surgery on the technical difficulty of total mesorectal excision: an observational study with an intraoperative perspective
Cheryl Xi-Zi Chong, Frederick H. Koh, Hui-Lin Tan, Sharmini Su Sivarajah, Jia-Lin Ng, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Wen-Hsin Koo, Shuting Han, Si-Lin Koo, Connie Siew-Poh Yip, Fu-Qiang Wang, Fung-Joon Foo, Winson Jianhong Tan
Ann Coloproctol. 2024;40(5):451-458.   Published online September 19, 2024
DOI: https://doi.org/10.3393/ac.2023.00899.0128
  • 4,801 View
  • 102 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDFSupplementary Material
Purpose
Total neoadjuvant therapy (TNT) is becoming the standard of care for locally advanced rectal cancer. However, surgery is deferred for months after completion, which may lead to fibrosis and increased surgical difficulty. The aim of this study was to assess whether TNT (TNT-RAPIDO) is associated with increased difficulty of total mesorectal excision (TME) compared with long-course chemoradiotherapy (LCRT) and upfront surgery.
Methods
Twelve laparoscopic videos of low anterior resection with TME for rectal cancer were prospectively collected from January 2020 to October 2021, with 4 videos in each arm. Seven colorectal surgeons assessed the videos independently, graded the difficulty of TME using a visual analog scale and attempted to identify which category the videos belonged to.
Results
The median age was 67 years, and 10 patients were male. The median interval to surgery from radiotherapy was 13 weeks in the LCRT group and 24 weeks in the TNT-RAPIDO group. There was no significant difference in the visual analog scale for difficulty in TME between the 3 groups (LCRT, 3.2; TNT-RAPIDO, 4.6; upfront, 4.1; P=0.12). A subgroup analysis showed similar difficulty between groups (LCRT 3.2 vs. TNT-RAPIDO 4.6, P=0.05; TNT-RAPIDO 4.6 vs. upfront 4.1, P=0.54). During video assessments, surgeons correctly identified the prior treatment modality in 42% of the cases. TNT-RAPIDO videos had the highest recognition rate (71%), significantly outperforming both LCRT (29%) and upfront surgery (25%, P=0.01).
Conclusion
TNT does not appear to increase the surgical difficulty of TME.

Citations

Citations to this article as recorded by  
  • Left colic artery–preserving radical rectal cancer surgery: a literature review
    Xiyin Yang, Yuanshui Sun, Qiang Hu
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review
    In Ja Park
    Ewha Medical Journal.2025; 48(3): e40.     CrossRef
  • Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
    Gyung Mo Son
    Annals of Coloproctology.2025; 41(6): 489.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
Review
Colorectal cancer
The role of lateral pelvic lymph node dissection in advanced rectal cancer: a review of current evidence and outcomes
Gyu-Seog Choi, Hye Jin Kim
Ann Coloproctol. 2024;40(4):363-374.   Published online August 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00521.0074
  • 17,298 View
  • 762 Download
  • 11 Web of Science
  • 13 Citations
AbstractAbstract PDF
Metastatic lateral pelvic lymph nodes (LPNs) in rectal cancer significantly impact the prognosis and treatment strategies. Western practices emphasize neoadjuvant chemoradiotherapy (CRT), whereas Eastern approaches often rely on LPN dissection (LPND). This review examines the evolving role of LPND in the context of modern treatments, including total neoadjuvant therapy (TNT), and the impact of CRT on the management of clinically suspicious LPNs. We comprehensively reviewed the key literature comparing the outcomes of LPND versus preoperative CRT for rectal cancer, focusing on recent advancements and ongoing debates. Key studies, including the JCOG0212 trial and recent multicenter trials, were analyzed to assess the efficacy of LPND, particularly in conjunction with preoperative CRT or TNT. Current evidence indicates that LPND can reduce local recurrence rates compared to total mesorectal excision alone in patients not receiving radiation therapy. However, the benefit of LPND in the context of neoadjuvant CRT is influenced by the size and pretreatment characteristics of LPNs. While CRT can effectively control smaller metastatic LPNs, larger or clinically suspicious LPNs may require LPND for optimal outcomes. Advances in surgical techniques, such as robotic-assisted LPND, offer potential benefits but also present challenges and complications. The role of TNT in controlling metastatic LPNs and improving patient outcomes is emerging but remains underexplored. The decision to perform LPND should be individualized based on patient-specific factors, including LPN size, response to neoadjuvant treatment, and surgeon expertise. Future research should focus on optimizing treatment protocols and further evaluating the role of TNT in managing metastatic LPNs.

Citations

Citations to this article as recorded by  
  • Who is a candidate at the initial presentation? Prediction of positive lateral lymph node and survival after dissection
    Y. Lee
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • The oncologic benefits of lateral lymph node dissection after neoadjuvant therapy – local control or survival?
    T. Sammour
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Laparoscopic Versus Robotic Lateral Pelvic Lymph Node Dissection in Locally‐Advanced Rectal Cancer: A Cohort Study Comparing Perioperative Morbidity and Short‐Term Oncological Outcomes
    Joseph Mathew, Yogesh Kisan Bansod, Nishant Yadav, Janesh Murugan, Kovvuru Bhaskar Reddy, Mufaddal Kazi, Ashwin DeSouza, Avanish Saklani
    Cancer Reports.2025;[Epub]     CrossRef
  • Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
    Engeng Chen, Li Chen, Wei Zhang
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Cirugía por cáncer de recto más allá del mesorrecto: indicaciones, preparación límites y resultados
    Blas Flor-Lorente, Mario Javier de Miguel Valencia
    Cirugía Española.2025; 103(9): 800202.     CrossRef
  • Surgery for rectal cancer beyond the mesorectum: Indications, preparation, limits, and results
    Blas Flor-Lorente, Mario J. de Miguel-Valencia
    Cirugía Española (English Edition).2025; 103(9): 800202.     CrossRef
  • Cancer-associated fibroblasts enhance colorectal cancer lymphatic metastasis via CLEC11A/LGR5-mediated WNT pathway activation
    Chuhan Zhang, Teng Pan, Yuyuan Zhang, Yushuai Wu, Anning Zuo, Shutong Liu, Yuhao Ba, Benyu Liu, Shuaixi Yang, Yukang Chen, Hui Xu, Peng Luo, Quan Cheng, Siyuan Weng, Long Liu, Xing Zhou, Jingyuan Ning, Xinwei Han, Jinhai Deng, Zaoqu Liu
    Journal of Clinical Investigation.2025;[Epub]     CrossRef
  • Robotic lateral pelvic lymphadenectomy for rectal cancer—A video vignette
    D. Castrodá, M. Paniagua, L. Pérez Corbal, L. Otalora, R. Oubiña, A. Parajó
    Colorectal Disease.2025;[Epub]     CrossRef
  • Learning curve for lateral lymph node dissection in rectal cancer – a systematic review of literature
    D. Kehagias, L. Baldari, E. Cassinotti, L. Boni, C. Lampropoulos, I. Kehagias
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Pelvic Neuroanatomy in Colorectal Surgery: Advances in Nerve Preservation for Optimized Functional Outcomes
    Asim M. Almughamsi, Yasir Hassan Elhassan
    Surgeries.2025; 6(4): 94.     CrossRef
  • Targeting lateral pelvic lymph nodes in rectal cancer: response to neoadjuvant therapy and artificial intelligence driven clinical decision support
    Ruiqing Liu, Yun Lu, Luca Stocchi
    Intelligent Medicine.2025;[Epub]     CrossRef
  • Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
    Gyung Mo Son
    Annals of Coloproctology.2025; 41(6): 489.     CrossRef
  • From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
    In Ja Park
    Annals of Coloproctology.2024; 40(4): 285.     CrossRef
Original Articles
Colorectal cancer
Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older
Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
Ann Coloproctol. 2025;41(3):198-206.   Published online August 5, 2024
DOI: https://doi.org/10.3393/ac.2023.00367.0052
  • 7,595 View
  • 90 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

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  • Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
    Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
    Journal of Geriatric Oncology.2025; 16(3): 102200.     CrossRef
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    Yakup Duzkopru, Özlem Doğan
    Turkish Journal of Clinics and Laboratory.2025; 16(1): 118.     CrossRef
  • Does Oxaliplatin-based Adjuvant Therapy Benefit Older Colorectal Cancer Patients?
    Peter Hofland
    Onco Zine - The International Oncology Network.2025;[Epub]     CrossRef
  • Disease-Free Survival of Patients with Stage II Stroma-Rich Colorectal Adenocarcinomas with Microsatellite Stability
    Ángel Romo-Navarro, Juan Ruiz Martín, Irene García-Camacha Gutiérrez, Mariano Amo-Salas, María Recuero Pradillo, César Sánchez-Muñoz, Cristina María Murillo Lázaro, Esperanza Carabias López, Raquel Sánchez Simón, Carlos Quimbayo-Arcila, Yasmina Hernández
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    Gyung Mo Son
    Annals of Coloproctology.2024; 40(5): 415.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
Colorectal cancer
Lymphovascular invasion in colorectal cancers: can we predict it preoperatively?
Elbrus Zarbaliyev, Nihan Turhan, Sebahattin Çelik, Mehmet Çağlıkülekçi
Ann Coloproctol. 2024;40(3):245-252.   Published online June 25, 2024
DOI: https://doi.org/10.3393/ac.2023.00458.0065
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  • 1 Citations
AbstractAbstract PDF
Purpose
This study aimed to investigate preoperative predictors of lymphovascular invasion (LVI), which is a poor prognostic factor usually detected postoperatively in patients with colorectal cancer.
Methods
Results for all patients operated on for colorectal cancer between January 1, 2006, and December 31, 2021, were retrospectively analyzed. Potential preoperative factors and postoperative pathology results were recorded. The patients were categorized as those with LVI and those without LVI. Potential factors that may be associated with LVI were compared between the 2 groups.
Results
The study included 335 patients. The incidence of LVI was 3.11 times higher in patients with ascending colon tumors (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.34–7.23; P=0.008) and 4.28 times higher in those with metastatic tumors (OR, 4.28; 95% CI, 2.18–8.39; P<0.001). Diabetes mellitus was inversely related to LVI in colorectal cancer patients; specifically, LVI was 56% less common in colorectal cancer patients with diabetes mellitus, irrespective of its duration (OR, 0.44; 95% CI, 0.25–0.76; P<0.001).
Conclusion
The presence of preoperative LVI in colorectal cancer patients is difficult to predict. In particular, the effect of the effect of factors such as chronic disease accompanied by microvascular pathologies on LVI is still unclear. Advances in the neoadjuvant treatment of colorectal cancer patients, who are becoming more widespread every day, will encourage the investigation of different methods of preoperatively predicting LVI as a poor prognostic factor in these patients.

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  • Immunohistochemical Expression of MLH1, PMS2 and P53 in Colorectal Carcinoma with Clinicopathologic Correlation
    Saif Raghad Saleem Alhamadani, Zainab Khalid Shehab Almukhtar
    Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2025; 9(1): 222.     CrossRef
Guideline
Colorectal cancer
Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Chang Hoon Song, Mi Sun Ahn, Jae Seon Eo, Young Chul Yoon, Joon-Kee Yoon, Kyung Ha Lee, Kyung Hee Lee, Kil-Yong Lee, Myung Su Lee, Sung Hak Lee, Jong Min Lee, Ji Eun Lee, Han Hee Lee, Myong Hoon Ihn, Je-Ho Jang, Sun Kyung Jeon, Kum Ju Chae, Jin-Ho Choi, Dae Hee Pyo, Gi Won Ha, Kyung Su Han, Young Ki Hong, Chang Won Hong, Jung-Myun Kwak, Korean Colon Cancer Multidisciplinary Committee
Ann Coloproctol. 2024;40(2):89-113.   Published online April 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00059.0008
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  • 12 Citations
AbstractAbstract PDFSupplementary Material
Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

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Original Articles
Colorectal cancer
Comparing the efficacy of combined versus single immune cell adaptive therapy targeting colorectal cancer
Denis Nchang Che, NaHye Lee, Hyo-Jung Lee, Yea-Won Kim, Solongo Battulga, Ha Na Lee, Won-Kook Ham, Hyunah Lee, Mi Young Lee, Dawoon Kim, Haengji Kang, Subin Yun, Jinju Park, Daeyoun David Won, Jong Kyun Lee
Ann Coloproctol. 2024;40(2):121-135.   Published online April 22, 2024
DOI: https://doi.org/10.3393/ac.2023.00402.0057
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  • 1 Web of Science
AbstractAbstract PDFSupplementary Material
Purpose
Colorectal cancer (CRC) is the most frequent cancer with limited therapeutic achievements. Recently, adoptive cellular immunotherapy has been developed as an antitumor therapy. However, its efficacy has not been tested in CRC. This study investigated the ability of an immune cell cocktail of dendritic cells (DCs), T cells, and natural killer (NK) cells to overcome immunological hurdles and improve the therapeutic efficacy of cell therapy for CRC.
Methods
CRC lysate-pulsed monocyte-derived DCs (Mo-DCs), CRC antigen-specifically expanded T cells (CTL), and in vitro-expanded NK cells were cultured from patient peripheral blood mononuclear cells (PBMC). The ability of the combined immune cells to kill autologous tumor cells was investigated by co-culturing the combined immune cells with patient-derived tumor cells.
Results
The Mo-DCs produced expressed T cell co-stimulating molecules like CD80, CD86, human leukocyte antigen (HLA)-DR and HLA-ABC, at high levels and were capable of activating naive T cells. The expanded T cells were predominantly CD8 T cells with high levels of CD8 effector memory cells and low levels of regulatory T cells. The NK cells expressed high levels of activating receptors and were capable of killing other cancer cell lines (K562 and HT29). The immune cell cocktail demonstrated a higher ability to kill autologous tumor cells than single types. An in vivo preclinical study confirmed the safety of the combined immune cell adaptive therapy showing no therapy-related death or general toxicity symptoms.
Conclusion
The results suggested that combined immune cell adaptive therapy could overcome the limited efficacy of cell immunotherapy.
Colorectal cancer
Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study
Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2024;40(1):27-35.   Published online February 28, 2024
DOI: https://doi.org/10.3393/ac.2022.01067.0152
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  • 3 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients’ quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.
Methods
In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.
Results
Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.
Conclusion
Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.

Citations

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  • Funktionelle Folgen von Radiotherapie, Chemotherapie und Operation bei der Behandlung des Rektumkarzinoms
    Philipp Rhode, Matthias Mehdorn, Undine Gabriele Lange, Sebastian Murad Rabe, Johannes Quart, Robert Nowotny, Patrick Sven Plum, Stefan Niebisch, Sigmar Stelzner
    Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2025; 150(04): 353.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
Colorectal cancer
Impact of consolidation chemotherapy in poor responders to neoadjuvant radiation therapy: magnetic resonance imaging–based clinical-radiological correlation in high-risk rectal cancers
Swapnil Patel, Suman Ankathi, Purvi Haria, Mufaddal Kazi, Ashwin L. Desouza, Avanish Saklani
Ann Coloproctol. 2023;39(6):474-483.   Published online December 21, 2023
DOI: https://doi.org/10.3393/ac.2023.00080.0011
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  • 3 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
The current study was conducted to examine the role of consolidation chemotherapy after neoadjuvant radiation therapy (NART) in decreasing the involvement of the mesorectal fascia (MRF) in high-risk locally advanced rectal cancers (LARCs).
Methods
In total, 46 patients who received consolidation chemotherapy after NART due to persistent MRF involvement were identified from a database. A team of 2 radiologists, blinded to the clinical data, studied sequential magnetic resonance imaging (MRI) scans to assess the tumor response and then predict a surgical plan. This prediction was then correlated with the actual procedure conducted as well as histopathological details to assess the impact of consolidation chemotherapy.
Results
The comparison of MRI-based parameters of sequential images showed significant downstaging of T2 signal intensity, tumor height, MRF involvement, diffusion restriction, and N category between sequential MRIs (P < 0.05). However, clinically relevant downstaging (standardized mean difference, > 0.3) was observed for only T2 signal intensity and diffusion restriction on diffusion-weighted imaging. No clinically relevant changes occurred in the remaining parameters; thus, no change was noted in the extent of surgery predicted by MRI. Weak agreement (Cohen κ coefficient, 0.375) and correlation (Spearman rank coefficient, 0.231) were found between MRI-predicted surgery and the actual procedure performed. The comparison of MRI-based and pathological tumor response grading also showed a poor correlation.
Conclusion
Evidence is lacking regarding the use of consolidation chemotherapy in reducing MRF involvement in LARCs. The benefit of additional chemotherapy after NART in decreasing the extent of planned surgery by reducing margin involvement requires prospective research.

Citations

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  • Survival benefit of adjuvant chemotherapy in high-risk patients with colon cancer regardless of microsatellite instability
    Sung Uk Bae, Jong Lyul Lee, Chun-Seok Yang, Eun Jung Park, Soo Yeun Park, Chang Woo Kim, Woong Bae Ji, Gyung Mo Son, Yoon Dae Han, So Hyun Kim, Min Sung Kim, Youn Young Park, Kyung Ha Lee, Chang Hyun Kim, Gi Won Ha, JaeIm Lee, Kyeong Eui Kim, Woon Kyung J
    European Journal of Surgical Oncology.2025; 51(6): 109674.     CrossRef
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    In Ja Park
    Ewha Medical Journal.2025; 48(3): e40.     CrossRef
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    Devesh S. Ballal, Tejas P. Vispute, Avanish P. Saklani
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Reviews
Colorectal cancer
Total neoadjuvant therapy for rectal cancer: evidence and challenge
Suk-Hwan Lee
Ann Coloproctol. 2023;39(4):301-306.   Published online August 29, 2023
DOI: https://doi.org/10.3393/ac.2023.00269.0038
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  • 8 Web of Science
  • 9 Citations
AbstractAbstract PDF
Recent advances in the management of rectal cancer have dramatically changed the clinical practice of colorectal surgeons because the main focus of rectal cancer treatment has changed from sphincter-saving to an organ-preserving strategies. Modifying the delivery of systemic chemotherapy to improve patients’ survival is another progress in colorectal cancer management, known as total neoadjuvant therapy (TNT). TNT is a new strategy used by colorectal surgeons to improve the quality of life and survival of patients after treatment. TNT poses limitations or obstacles, such as overtreatment issues in patients with stage I rectal cancer. However, considering the quality-of-life issues in patients with low-lying rectal cancer necessitating a permanent colostomy, the indication for TNT will be expanded. This review summarizes the recently conducted clinical trials and foresees future perspectives on TNT.

Citations

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  • Reply to the Letter to the Editor ‘Circulating tumor DNA after definitive therapy for locally advanced rectal cancer’ by Drs Sorscher and Rocha Lima
    A. Bercz, J.J. Smith, P.B. Romesser
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Colorectal cancer
Total neoadjuvant therapy in rectal cancer: a network meta-analysis of randomized trials
Sergey Sychev, Aleksey Ponomarenko, Stanislav Chernyshov, Mikhail Alekseev, Zaman Mamedli, Dmitriy Kuzmichev, Andrey Polynovskiy, Evgeny Rybakov
Ann Coloproctol. 2023;39(4):289-300.   Published online April 11, 2023
DOI: https://doi.org/10.3393/ac.2022.00920.0131
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AbstractAbstract PDFSupplementary Material
Purpose
To assess the efficacy of total neoadjuvant therapy (TNT) for rectal carcinoma in comparison with conventional chemoradiotherapy (CRT).
Methods
A systematic review was performed according to the PRISMA guidelines. A Bayesian network meta-analysis was done using NetMetaXL and WinBUGS. This study was registered in PROSPERO on March 3, 2022 (No. CRD-42022307867).
Results
Outcomes of 2,719 patients from 10 randomized trials between 2010 and 2022 were selected. Of these 1,191 (44%) had conventional long-course CRT (50–54 Gy) and capecitabine, 506 (18%) had induction chemotherapy followed by CRT (50–54 Gy) and capecitabine (iTNT), 230 (9%) had long-course CRT (50–54 Gy) followed by consolidation chemotherapy (cTNT), and 792 (29%) undergone modified short-course radiotherapy (25 Gy) with subsequent chemotherapy (mTNT). Total pathologic complete response (pCR) was 20% in the iTNT group, 21% in the mTNT group, 22% in the cTNT group, and 12% in the CRT group. Statistically significant difference in pCR rates was detected when comparing iTNT with CRT (odds ratio [OR], 1.76; 95% credible interval [CrI], 1.06–2.8), mTNT with CRT (OR, 1.90; 95% CrI, 1.25–2.74), and cTNT with CRT groups (OR, 2.54; 95% CrI, 1.26–5.08). No differences were found in R0 resection rates. No significant difference was found in long-term outcomes.
Conclusion
The early administration of systemic chemotherapy in the TNT regimen has improved short-term outcomes, though long-term results are underreported. Randomized trials with survival as the endpoint are necessary to evaluate the possible advantages of TNT modes.

Citations

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  • Network meta-analysis of RTCs for efficacy of neoadjuvant treatment in rectal cancer
    Nir Horesh, Sameh Hany Emile, Zoe Garoufalia, Rachel Gefen, Peter Rogers, Pauline Aeschbacher, Ebram Salama, Steven D. Wexner
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    In Ja Park
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    Maria Cristina Barba, Paola De Franco, Donatella Russo, Elisa Cavalera, Elisa Ciurlia, Sara De Matteis, Giuseppe Di Paola, Corradino Federico, Angela Leone, Antonella Papaleo, Bianca Santo, Dino Rubini, Giuseppe Rubini, Angela Sardaro
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    Amrallah Mohammed, Adel Bakry, Shimaa Gharieb, Amira Hanna, Ahmed Obaya, Waleed Abdelhady, Abdelrahman Metwalli
    Journal of Gastrointestinal Cancer.2024; 55(2): 869.     CrossRef
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    S. S. Gordeev, M. Yu. Fedyanin, M. V. Chernykh, Ye. G. Rubakov, A. M. Karachun, A. A. Nevolskikh, A. A. Tryakin, Z. Z. Mamedli
    Surgery and Oncology.2024; 14(1): 21.     CrossRef
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    Sergei Bedrikovetski, Luke Traeger, Warren Seow, Nagendra N. Dudi-Venkata, Sudarsha Selva-Nayagam, Michael Penniment, Tarik Sammour
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    Christopher J. Anker, Leila T. Tchelebi, J. Eva Selfridge, Salma K. Jabbour, Dmitriy Akselrod, Peter Cataldo, Gerard Abood, Jordan Berlin, Christopher L. Hallemeier, Krishan R. Jethwa, Ed Kim, Timothy Kennedy, Percy Lee, Navesh Sharma, William Small, Vone
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  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
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  • A randomized phase 3 trial of total neoadjuvant therapy (induction chemotherapy, neoadjuvant chemoradiation, neoadjuvant chemotherapy, and surgery) vs. standard long-term chemoradiation therapy (neoadjuvant chemoradiation, surgery, and adjuvant chemothera
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    Won Beom Jung
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Benign bowel disease
Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery
Jingting Wu, Hannah Chi, Shawn Kok, Jason M.W. Chua, Xi-Xiao Huang, Shipin Zhang, Shimin Mah, Li-Xin Foo, Hui-Yee Peh, Hui-Bing Lee, Phoebe Tay, Cherie Tong, Jasmine Ladlad, Cheryl H.M. Tan, Nathanelle Khoo, Darius Aw, Cheryl X.Z. Chong, Leonard M.L. Ho, Sharmini S. Sivarajah, Jialin Ng, Winson J.H. Tan, Fung-Joon Foo, Bin-Tean Teh, Frederick H. Koh
Ann Coloproctol. 2024;40(1):3-12.   Published online March 31, 2023
DOI: https://doi.org/10.3393/ac.2022.01207.0172
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  • 34 Web of Science
  • 33 Citations
AbstractAbstract PDF
Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

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Video
Video clip
Laparoscopic right hemicolectomy with aortocaval lymphadenectomy, and pelvic peritoneum partial resection for ascending colon cancer
Hannah Kim, An Na Seo, Soo Yeun Park
Ann Coloproctol. 2023;39(3):283-286.   Published online February 9, 2023
DOI: https://doi.org/10.3393/ac.2022.00780.0111
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  • 1 Web of Science
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AbstractAbstract PDFSupplementary Material
The aim of this video is to present the procedural details of laparoscopic right hemicolectomy with aortocaval (infrarenal aortic bifurcation) lymphadenectomy, partial resection of the pelvic peritoneum (peritoneal carcinomatosis index, 3), and hyperthermic intraperitoneal chemotherapy in a patient who received neoadjuvant chemotherapy for stage IVc colorectal cancer. The total operation time was 290 minutes, and the patient was discharged on a postoperative day 13 without any complications. No postoperative complications occurred until postoperative day 60. The pathological stage of the tumor was determined to be T3N2bM1c. The pelvic peritoneal nodule was pathologically confirmed as a metastatic lesion. Among the 12 harvested aortocaval lymph nodes, 6 were metastatic lymph nodes. The minimally invasive approach was safe and feasible in this highly selected patient with colon cancer, aortocaval lymph nodes, and peritoneal metastases.

Citations

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  • Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
    Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
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Review
Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis
Ian Jun Yan Wee, Chee Hoe Koo, Isaac Seow-En, Yvonne Ying Ru Ng, Wenjie Lin, Emile John Kwong-Wei Tan
Ann Coloproctol. 2023;39(1):3-10.   Published online January 3, 2023
DOI: https://doi.org/10.3393/ac.2022.00598.0085
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  • 493 Download
  • 24 Web of Science
  • 29 Citations
AbstractAbstract PDFSupplementary Material
Purpose
This study compared the short- and long-term clinical outcomes of laser hemorrhoidoplasty (LH) vs. conventional hemorrhoidectomy (CH) in patients with grade II/III hemorrhoids.
Methods
PubMed/Medline and the Cochrane Library were searched for randomized and nonrandomized studies comparing LH against CH in grade II/III hemorrhoids. The primary outcomes included postoperative use of analgesia, postoperative morbidity (bleeding, urinary retention, pain, thrombosis), and time of return to work/daily activities.
Results
Nine studies totaling 661 patients (LH, 336 and CH, 325) were included. The LH group had shorter operative time (P<0.001) and less intraoperative blood loss (P<0.001). Postoperative pain was lower in the LH group, with lower postoperative day 1 (mean difference [MD], –2.09; 95% confidence interval [CI], –3.44 to –0.75; P=0.002) and postoperative day 7 (MD, –3.94; 95% CI, –6.36 to –1.52; P=0.001) visual analogue scores and use of analgesia (risk ratio [RR], 0.59; 95% CI, 0.42–0.81; P=0.001). The risk of postoperative bleeding was also lower in the LH group (RR, 0.18; 95% CI, 0.12– 0.28; P<0.001), with a quicker return to work or daily activities (P=0.002). The 12-month risks of bleeding (P>0.999) and prolapse (P=0.240), and the likelihood of complete resolution at 12 months, were similar (P=0.240).
Conclusion
LH offers more favorable short-term clinical outcomes than CH, with reduced morbidity and pain and earlier return to work or daily activities. Medium-term symptom recurrence at 12 months was similar. Our results should be verified in future well-designed trials with larger samples.

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Case Report
Metastasis
Peritoneal metastatic mixed adenoneuroendocrine carcinoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a case report
Sungchul Lee, Euitae Kim, Dong-Guk Park
Ann Coloproctol. 2024;40(Suppl 1):S18-S22.   Published online November 21, 2022
DOI: https://doi.org/10.3393/ac.2022.00339.0048
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AbstractAbstract PDF
A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.

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  • Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract
    Sebastián Díaz-López, Jerónimo Jiménez-Castro, Carlos Enrique Robles-Barraza, Carlos Ayala-de Miguel, Manuel Chaves-Conde
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Original Articles
Colorecal cancer
Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients
Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2023;39(5):410-420.   Published online April 28, 2022
DOI: https://doi.org/10.3393/ac.2022.00143.0020
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  • 6 Web of Science
  • 5 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
This study aimed to evaluate the predictive value of lymph node yield (LNY) for survival outcomes according to tumor response after preoperative chemoradiotherapy (PCRT) in patients with rectal cancer.
Methods
This study was a retrospective study conducted in a tertiary center. A total of 1,240 patients with clinical stage II or III rectal cancer who underwent curative resection after PCRT between 2007 and 2016 were included. Patients were categorized into the good response group (tumor regression grade [TRG], 0–1) or poor response group (TRG, 2–3). Propensity score matching was performed for age, sex, and pathologic stage between LNY of ≥12 and LNY of <12 within tumor response group. The primary outcome was 5-year disease-free survival (DFS) and overall survival (OS).
Results
LNY and positive lymph nodes were inversely correlated with TRG. In good responders, 5-year DFS and 5-year OS of patients with LNY of <12 were better than those with LNY of ≥12, but there was no statistical significance. In poor responders, the LNY of <12 group had worse survival outcomes than the LNY of ≥12 group, but there was also no statistical significance. LNY of ≥12 was not associated with DFS and OS in multivariate analysis.
Conclusion
LNY of <12 showed contrasting outcomes between the good and poor responders in 5-year DFS and OS. LNY of 12 may not imply adequate oncologic surgery or proper staging in rectal cancer patients treated by PCRT. Furthermore, a decrease in LNY should be comprehended differently according to tumor response.

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  • Breaking Myths: Comparable Outcomes in Lymph Node Analysis Across Surgical Methods
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    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Effects of Adjuvant Chemotherapy on Oncologic Outcomes in Patients With Stage ⅡA Rectal Cancer Above the Peritoneal Reflection Who Did Not Undergo Preoperative Chemoradiotherapy
    Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(4): 392.     CrossRef
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    Minsung Kim, Sang Min Lee, Il Tae Son, Jaewoong Kang, Gyoung Tae Noh, Bo Young Oh
    Journal of Clinical Medicine.2024; 13(23): 7018.     CrossRef
  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
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Colorectal cancer
Efficacy of preoperative chemoradiotherapy in patients with cT2N0 distal rectal cancer
Min Young Park, Chang Sik Yu, Tae Won Kim, Jong Hoon Kim, Jin-hong Park, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2023;39(3):250-259.   Published online April 4, 2022
DOI: https://doi.org/10.3393/ac.2022.00066.0009
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
This study was designed to determine the feasibility of preoperative chemoradiotherapy (PCRT) in patients with clinical T2N0 distal rectal cancer.
Methods
Patients who underwent surgery for clinical T2N0 distal rectal cancer between January 2008 and December 2016 were included. Patients were divided into PCRT and non-PCRT groups. Non-PCRT patients underwent radical resection or local excision (LE) according to the surgeon’s decision, and PCRT patients underwent surgery according to the response to PCRT. Patients received 50.0 to 50.4 gray of preoperative radiotherapy with concurrent chemotherapy.
Results
Of 127 patients enrolled, 46 underwent PCRT and 81 did not. The mean distance of lesions from the anal verge was lower in the PCRT group (P=0.004). The most frequent operation was transanal excision and ultralow anterior resection in the PCRT and non-PCRT groups, respectively. Of the 46 patients who underwent PCRT, 21 (45.7%) achieved pathologic complete response, including 15 of the 24 (62.5%) who underwent LE. Rectal sparing rate was significantly higher in the PCRT group (11.1% vs. 52.2%, P<0.001). There were no significant differences in 3- and 5-year overall survival and recurrence-free survival regardless of PCRT or surgical procedures.
Conclusion
PCRT in clinical T2N0 distal rectal cancer patients increased the rectal sparing rate via LE and showed acceptable oncologic outcomes. PCRT may be a feasible therapeutic option to avoid abdominoperineal resection in clinical T2N0 distal rectal cancer.

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  • Lymph node metastasis following chemoradiotherapy in advanced rectal cancer: ypT2-focused analyses of total mesorectal excision specimens
    A. N. Singhi, T.-G. Lee, H.-M. Ahn, H.-R. Shin, M. J. Choi, M. H. Jo, H.-K. Oh, D.-W. Kim, S.-B. Kang
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Is there a role for total neoadjuvant treatment in early-stage rectal cancer?
    Kamil Erozkan, Metincan Erkaya, Jacob A. Miller, Ali Alipouriani, David Liska, Hermann Kessler, Scott R. Steele, Emre Gorgun
    Langenbeck's Archives of Surgery.2025;[Epub]     CrossRef
  • Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
    Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
    Annals of Coloproctology.2025; 41(5): 473.     CrossRef
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     CrossRef
  • Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Organ preservation for early rectal cancer using preoperative chemoradiotherapy
    Gyung Mo Son
    Annals of Coloproctology.2023; 39(3): 191.     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
An investigation into tumor regression grade as a parameter for locally advanced rectal cancer and 5-year overall survival rate
Supparerk Laohawiriyakamol, Wongsakorn Chaochankit, Worawit Wanichsuwan, Kanet Kanjanapradit, Teeranan Laohawiriyakamol
Ann Coloproctol. 2023;39(1):59-70.   Published online March 18, 2022
DOI: https://doi.org/10.3393/ac.2021.01011.0144
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AbstractAbstract PDF
Purpose
The standard treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiation (nCRT) followed by surgery. Several parameters are associated with patient survival in LARC. One of these parameters is tumor regression grade (TRG); however, the significance of TRG remains controversial. In this study, we aimed to examine the correlations of TRG with 5-year overall (OS) and relapse-free survival (RFS) and identify other factors that influence the survival rates in LARC after nCRT followed by surgery.
Methods
This retrospective study included 104 patients diagnosed with LARC who underwent nCRT followed by surgery at Songklanagarind Hospital from January 2010 to December 2015. All patients received fluoropyrimidine-based chemotherapy at a total dose of 45.0 to 50.4 Gy in 25 daily fractions. Tumor response was evaluated using the 5-tier Mandard TRG classification. TRG was categorized into good (TRG 1–2) and poor (TRG 3–5) responses.
Results
TRG (classified by either the 5-tier classification system or the 2-group classification system) was not correlated with 5-year OS or RFS. The 5-year OS rates were 80.0%, 54.5%, 80.8%, and 67.4% in patients with TRG 1, 2, 3, and 4, respectively (P=0.22). Poorly differentiated rectal cancer and systemic metastasis were associated with poor 5-year OS. Intraoperative tumor perforation, poor differentiation, and perineural invasion were correlated with inferior 5-year RFS.
Conclusion
TRG was probably not associated with either 5-year OS or RFS; however, poor differentiation and systemic metastasis were strongly associated with poor 5-year OS.

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  • Is Mandard tumor regression grade scoring sufficient for locally advanced rectal cancer?
    Buket Şahin Çelik, Aslı Geçgel, Erdem Göker
    Medical Science and Discovery.2025; 12(1): 1.     CrossRef
  • Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy
    Tuba Kurt Catal, Günay Can, İsmai̇l Demi̇rel, Sefi̇ka Ergen, Di̇dem Öksüz
    Oncology Letters.2025; 29(5): 1.     CrossRef
  • Evaluation of pre-treatment F-18 FDG PET/CT according to Mandard classification in locally advanced rectal cancer patients undergoing neoadjuvant chemoradiotherapy
    Feray Aras, Murtaza Parvizi, Olcay Ak Nalbant, Volkan Ozkol, Engin Kut
    BMC Cancer.2025;[Epub]     CrossRef
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     CrossRef
  • Risk-factors for locally advanced rectal cancer relapse after neoadjuvant chemoradiotherapy: A single center experience
    Dragana Stupar, Saša Jungić, Zdenka Gojković, Jelena Berendika, Živojin Janičić
    Medicine.2023; 102(44): e35519.     CrossRef
The pattern of bowel dysfunction in patients with rectal cancer following the multimodal treatment: anorectal manometric measurements at before and after chemoradiation therapy, and postoperative 1 year
Ri Na Yoo, Bong-Hyeon Kye, HyungJin Kim, Gun Kim, Hyeon-Min Cho
Ann Coloproctol. 2023;39(1):32-40.   Published online March 11, 2022
DOI: https://doi.org/10.3393/ac.2021.00696.0099
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Bowel dysfunction commonly occurs in patients with locally advanced rectal cancer treated with a multimodal approach of chemoradiation therapy (CRT) combined with sphincter-preserving rectal resection. This study investigated the decline in anorectal function using sequential anorectal manometric measurements obtained before and after the multimodal treatment as well as at a 1-year follow-up.
Methods
This was a retrospective cohort study conducted in a single center. The study population consisted of patients with locally advanced mid- to low rectal cancer who received the preoperative CRT followed by sphincter-preserving surgery from 2012 to 2016. The anorectal manometric value measured after each treatment modality was compared to demonstrate the degree of decline in anorectal function. A generalized linear model of repeated measures was performed using the manometric values measured pre- and post-CRT, and at 12 months postoperatively.
Results
Overall, 100 patients with 3 consecutive manometric data were included in the final analysis. In the overall cohort study, the mean resting and maximal squeezing pressures showed insignificant decrement post-neoadjuvant CRT. At a 1-year postoperative follow-up, the maximal squeezing pressure significantly decreased. The maximal rectal sensory threshold demonstrated significant reduction consecutively after each following treatment (P<0.001).
Conclusion
The short-term effect of neoadjuvant CRT on the anal sphincters was relatively trivial. The following sphincter-saving surgery resulted in a profound disruption of the anorectal function. Patients with rectal cancer should be consulted on the consequence of multimodal treatment.

Citations

Citations to this article as recorded by  
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     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
Malignant disease, Rectal cancer,Prognosis,Biomarker & risk factor
Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer?
Sang Hyun An, Ik Yong Kim
Ann Coloproctol. 2022;38(3):253-261.   Published online March 7, 2022
DOI: https://doi.org/10.3393/ac.2021.00633.0090
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  • 20 Citations
AbstractAbstract PDF
Purpose
Systemic inflammation is associated with various malignancies, including colorectal cancer, as possible prognostic predictors. We aimed to evaluate the correlation of pretreatment the platelet-to-lymphocyte (PLR) and the neutrophil-to-lymphocyte (NLR) ratio with long-term oncologic outcomes and pathologic complete response (pCR) in locally ad vanced rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy (CRT) followed by curative resection.
Methods
Between October 1996 and December 2015, 168 rectal cancer patients treated with preoperative CRT followed by surgery were enrolled. The set cut-off/mean PLR and NLR were 170 and 2.8. We analyzed the relationship between PLR, NLR, and the 5-year overall survival (OS), disease-free survival (DFS), and pCR rate.
Results
The 5-year OS rates were 75.9% and 59.8% in the highand low-PLR groups. The 5-year DFS rates were 62.9% and 50.8% in the high- and low-PLR groups, with no significant difference. In addition, the 5-year OS rates were 75.7% and 58.4%, and the 5-year DFS rates were 62.5% and 50.0% in the high- and low-NLR groups, respectively, both without any significant difference. Multivariate analysis showed only pretreatment PLR as an independent prognostic factor for OS (hazard ratio, 1.850; 95% confidence interval, 1.041–3.287; P=0.036), and both serologic markers were not independent prognostic factors for 5-year DFS.
Conclusion
Neither PLR nor NLR was associated with 5-year DFS nor pCR to neoadjuvant CRT. Only pretreatment PLR can be used in predicting OS in locally advanced rectal cancer patients who received neoadjuvant CRT followed by curative resection.

Citations

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  • Development of clinical inflammatory models to predict the efficacy of neoadjuvant chemoradiotherapy and survival in patients with locally advanced rectal cancer: a retrospective study
    Min Yang, Ruoyu Zhang, Yao Li, Fuhai Ma, Wenzhuo Jia, Tao Yu
    International Journal of Colorectal Disease.2025;[Epub]     CrossRef
  • Correlation between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with prognosis in gastric cancer patients undergoing neoadjuvant chemotherapy: a meta-analysis
    Shuang Yang, Zhuoyang Li, Tianhong Wang, Congcong Zou, Siman Wang, Shuang Deng, Yusi Hua
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Prognostic Value of Dynamic Changes in Immune-Inflammatory and Tumor Biomarkers Following Chemoradiotherapy in Locally Advanced Rectal Cancer
    Mahmoud Al-Masri, Yasmin Safi, Mohammad Almasri, Ramiz Kardan, Daliana Mustafa, Osama Alayyan, Bilal Kahalah, Rama AlMasri
    Cancers.2025; 17(20): 3383.     CrossRef
  • Immunomarkers could predict overall survival and disease-free survival after neoadjuvant therapy and surgery due to locally advanced rectal cancer
    Miguel A. Bonilla-Cozar, Anabel Garcia-Leon, Carlos J. Garcia-Sanchez, M. Luisa Reyes-Diaz, Irene Ramallo-Solis, Fernando De la Portilla, Javier Padillo, Rosa M. Jimenez-Rodriguez
    Cirugía Española (English Edition).2025; 103(10): 800199.     CrossRef
  • Prognostic value of platelet to lymphocyte ratio in patients with colorectal cancer undergoing chemotherapy: a systematic review and meta-analysis
    Yanfang Li, Juan Zhou, Hui Luo, Shaohua Li, Yanru Shi, Di Chen, Xuehui Hu
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Immunomarkers could predict overall survival and disease-free survival after neoadjuvant therapy and surgery due to locally advanced rectal cancer
    Miguel A. Bonilla-Cozar, Anabel Garcia-Leon, Carlos J. Garcia-Sanchez, M. Luisa Reyes-Diaz, Irene Ramallo-Solis, Fernando De la Portilla, Javier Padillo, Rosa M. Jimenez-Rodriguez
    Cirugía Española.2025; 103(10): 800199.     CrossRef
  • Prognostic value of the platelet-to-lymphocyte ratio in colorectal cancer patients undergoing chemotherapy: a systematic review and meta-analysis
    Hongmei Yu, Youfu He, Tingting Lv, Xiaofeng Lu, Yan Shu, Hongying Pan
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Effect of preoperative pan-immune-inflammation value on clinical and oncologic outcomes after colorectal cancer surgery: a retrospective study
    Yun Ju Seo, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
    Annals of Surgical Treatment and Research.2024; 106(3): 169.     CrossRef
  • Systemic Inflammatory Response Following Preoperative Chemoradiotherapy Can Affect Oncologic Outcomes in MSI-H/dMMR Rectal Cancer
    Hyukjin Choi, Jin Ho Baek, An Na Seo, Su Yeon Park, Hye Jin Kim, Jun Seok Park, Gyu Seog Choi, Jong Gwang Kim, Byung Woog Kang
    Chonnam Medical Journal.2024; 60(2): 105.     CrossRef
  • Prognostic role of platelet-to-lymphocyte ratio in patients with rectal cancer undergoing resection: a systematic review and meta-analysis
    Lijuan Ma, Fei Yang, Wentao Guo, Shufang Tang, Yarui Ling
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group
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The importance of topical metronidazole in the treatment of acute anal fissure: a double-blind study controlled for prospective randomization
Tuba Mert
Ann Coloproctol. 2023;39(2):131-138.   Published online January 18, 2022
DOI: https://doi.org/10.3393/ac.2021.00675.0096
  • 8,559 View
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  • 7 Web of Science
  • 9 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Acute anal fissure, a disease characterized by severe pain in the anorectal area, reduces quality of life and becomes chronic absent appropriate treatment. More recently, anaerobic infections have been noted as contributive to etiopathogenesis. This study investigates topical metronidazole’s effect in the treatment of acute anal fissure.
Methods
Our prospective randomized controlled double-blind study included 2 groups of 100 patients older than 18 years from our General Surgery Clinic with anal fissure complaints for less than 8 weeks. Topical diltiazem treatment was started in group 1, and topical diltiazem and metronidazole treatment in group 2. Pain levels were evaluated by the visual analogue scale (VAS) score, and recovery status was evaluated by physical examination findings ab initio and at the 1st, 4th, and 6th weeks. VAS score levels, demographic, clinical, and recovery status were then compared.
Results
There was no difference between the groups as to age, sex, pain on defecation, bleeding, constipation, and duration of pain, bleeding and constipation (P>0.05). From week 1, fissure epithelialization and healing rates were higher in group 2 (P<0.001); group 2 VAS score levels were lower than in group 1 (P<0.001) and achieved by group 1 only in week 4 (P=0.073).
Conclusion
Adding topical metronidazole to treatment reduces the duration and severity of pain, shortens healing time, and increases the healing rate.

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    Abhishek Jain, Rafat Khan, Nitin Garg
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    M. A. Ignatenko, A. A. Ponomarenko, M. V. Zhurina, N. A. Kostrikina, E. E. Zharkov, Yu. A. Nikolaev, A. R. Melkumyan
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  • Efficacy of local metronidazole with glyceryl trinitrate versus topical glyceryl trinitrate alone in the treatment of acute anal fissure: a randomized clinical trial
    Hesham M. Elgendy, Ahmed AbdelMawla, Ahmed F. Hussein
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  • Belgian consensus guideline on the management of anal fissures
    P Roelandt, G Bislenghi, G Coremans, D De Looze, M.A. Denis, H De Schepper, P Dewint, J Geldof, I Gijsen, N Komen, H Ruymbeke, J Stijns, M Surmont, D Van de Putte, S Van den Broeck, B Van Geluwe, J Wyndaele
    Acta Gastro Enterologica Belgica.2024; 87(2): 304.     CrossRef
  • Avances terapéuticos en el abordaje de las fisuras anales: explorando la sinergia entre Farmacología y Nanotecnología
    Carlos Ostwaldo Pazmiño-Chiluiza, María Luisa González Rodríguez
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    BMC Surgery.2023;[Epub]     CrossRef
  • Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial
    M Hasaan Shahid, Sidra Javed, Saryia Javed, Anwar Zeb Khan, Adeel Kaiser, Reda H Mithany
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Review
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Surgical technique
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Ann Coloproctol. 2021;37(6):425-433.   Published online December 22, 2021
DOI: https://doi.org/10.3393/ac.2021.00920.0131
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  • 31 Citations
AbstractAbstract PDF
From the perspective of survival outcomes, the cancer survival of colorectal cancer (CRC) in the whole stage has improved. Peritoneal metastasis (PM) is found in approximately 8% to 15% of patients with CRC, with a poorer prognosis than that associated with other sites of metastases. Randomized controlled trials and up-to-date meta-analyses provide firm evidence that cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) could significantly improve overall survival compared with systemic chemotherapy alone in selected patients with CRC-PM. Practical guidelines recommend that the management of CRC-PM should be led by a multidisciplinary team carried out in experienced centers and consider CRS plus HIPEC for selected patients. In this review, we aim to provide the latest results of land mark studies and an overview of recent insights with regard to the management of CRC-PM.

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    BMC Surgery.2025;[Epub]     CrossRef
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    Youngbae Jeon, Eun Jung Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Cancers.2022; 14(16): 3978.     CrossRef
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    Eun Jung Park, Sung-Joo Hwang, Seung Hyuk Baik
    Annals of Surgical Oncology.2022; 29(13): 8593.     CrossRef
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    Chan Wook Kim
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Original Articles
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy in Patients With Rectal Cancer: A Single-Center Experience and Literature Review
Min Chul Kim, Jae Hwan Oh
Ann Coloproctol. 2021;37(6):382-394.   Published online December 22, 2021
DOI: https://doi.org/10.3393/ac.2021.00913.0130
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  • 199 Download
  • 22 Web of Science
  • 22 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We aimed to evaluate the surgicopathological outcomes of lateral pelvic lymph node dissection (LPLD) and long-term oncological outcomes of selective LPLD after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer and compare them to those of total mesorectal excision (TME) alone based on pretreatment magnetic resonance imaging (MRI).
Methods
We compared the TME-alone group (2001–2009, n=102) with the TME with LPLD group (2011–2016, n=69), both groups having lateral lymph nodes (LLNs) of ≥5 mm in short axis diameter. The surgicopathological outcomes were analyzed retrospectively. Oncological outcomes were analyzed using the Kaplan-Meier method.
Results
The rates of overall postoperative 30-day morbidity (42.0% vs. 26.5%, P=0.095) and urinary retention (13.7% vs. 10.1%, P=0.484) were not significantly different between the LPLD and TME-alone groups, respectively. Pathologically proven LLN metastasis was identified in 24 (34.8%) LPLD cases after nCRT. The LPLD group showed a lower 5-year local recurrence (LR) rate (27.9% vs. 4.6%, P<0.001) and better recurrence-free survival (RFS) (59.6% vs. 78.2%, P=0.008) than those of the TME-alone group, while the 5-year overall survival was not significantly different between the 2 groups (76.2% vs. 86.5%, P=0.094).
Conclusion
This study suggests that LPLD is a safe and feasible procedure. The oncological outcomes suggest that selective LPLD improves LR and RFS in patients with clinically suspicious LLNs on pretreatment MRI. Considering that lateral nodal disease is not common, a multicenter large-scale study is necessary.

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    Ying-Zi Zheng, Fang-Fang Yan, Lian-Xiang Luo
    World Journal of Clinical Oncology.2024; 15(5): 591.     CrossRef
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    Tae-Gyun Lee, Hong-Min Ahn, Hye-Rim Shin, Mi Jeong Choi, Min Hyeong Jo, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang
    Diseases of the Colon & Rectum.2024; 67(6): e360.     CrossRef
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    Nobuaki Hoshino, Yudai Fukui, Kohei Ueno, Koya Hida, Kazutaka Obama, Kazuhiro Sakamoto, Hirotoshi Kobayashi, Michio Itabashi, Soichiro Ishihara, Kazushige Kawai, Yoichi Ajioka
    Annals of Gastroenterological Surgery.2024; 8(5): 732.     CrossRef
  • Survival analysis in rectal cancer patients after lateral lymph node dissection: Exploring the necessity of nCRT for suspected lateral lymph node metastasis
    Jiafei Liu, Peishi Jiang, Zhichun Zhang, Hongjie Yang, Yuanda Zhou, Peng Li, Qingsheng Zeng, Xipeng Zhang, Yi Sun
    Current Problems in Surgery.2024; 61(8): 101525.     CrossRef
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    Miao He, Jing Fan
    Asian Journal of Surgery.2024; 47(10): 4575.     CrossRef
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    Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
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    Surgical Endoscopy.2024; 38(10): 5584.     CrossRef
  • The Role of Lateral Pelvic Lymph Node Dissection in Middle and Lower Rectal Cancer (Stage II or III): A Literature Review
    Alexandra-Eleftheria Menni, Georgios Tzikos, Patroklos Goulas, Stylianos Apostolidis
    Cureus.2024;[Epub]     CrossRef
  • Lateral pelvic lymph node positivity (LPLNP) score: predictive clinic-radiological model of lateral pelvic lymph node involvement in rectal cancer patients
    Petr Tsarkov, Vladimir Balaban, Harutyun Babajanyan, Abe Fingerhut, Inna Tulina, Mingze He
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
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  • Development of a Diagnostic Artificial Intelligence Tool for Lateral Lymph Node Metastasis in Advanced Rectal Cancer
    Kosuke Ozaki, Yusuke Kurose, Kazushige Kawai, Hirotoshi Kobayashi, Michio Itabashi, Yojiro Hashiguchi, Takuya Miura, Akio Shiomi, Tatsuya Harada, Yoichi Ajioka
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Anorectal physiology & pelvic floor disorder
Efficacy and safety of anal encirclement combining the Leeds-Keio artificial ligament with injection sclerotherapy using aluminum potassium sulfate and tannic acid in the management of rectal prolapse: a single-center observational study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki
Ann Coloproctol. 2023;39(3):210-215.   Published online November 12, 2021
DOI: https://doi.org/10.3393/ac.2021.00731.0104
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  • 3 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
Perineal procedures are an important surgical option for frail and high-risk patients with rectal prolapse. This study aimed to evaluate the efficacy and safety of combined therapy using injection sclerotherapy, with aluminum potassium sulfate and tannic acid (ALTA), and the Thiersch procedure, using the Leeds-Keio ligament (ALTA-Thiersch).
Methods
This study included 106 consecutive patients (mean age, 81.2 years) who underwent ALTA-Thiersch for rectal prolapse. The procedure was performed under caudal epidural anesthesia. ALTA was injected into the submucosa from the tip of the prolapsed rectum down to the dentate line, circumferentially, at 20 to 40 locations. The ligament tape was placed outside the external sphincter muscle and at an approximate depth of 2 cm into the middle anal canal.
Results
Of 106 patients, rectal prolapse was cured shortly after surgery in 105 patients. An additional tape was inserted in 1 patient who had persistent prolapse. Postoperative complications were observed in 27 patients (25.5%). Fecal impaction occurred in 12 patients; however, since it was temporary, no tape removal was required. Of the 12 cases in which the tape was infected or exposed, 11 required tape removal. There were 18 cases of recurrence at a mean follow-up of 22.1 months. Cumulative recurrence rates at 3 and 5 years were 21.3% and 38.6%, respectively.
Conclusion
ALTA-Thiersch is a simple and safe procedure for rectal prolapse, having reasonable outcomes. The use of the Leeds-Keio ligament for anal encircling can help compensate for the disadvantages of the Thiersch operation.

Citations

Citations to this article as recorded by  
  • Outcomes of the Gant-Miwa-Thiersch Procedure Using the Leeds-Keio Mesh for Rectal Prolapse
    Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
    Journal of the Anus, Rectum and Colon.2025; 9(2): 252.     CrossRef
  • Gant-Miwa-Thiersch Procedure for Rectal Prolapse - Use of the Leeds-Keio Mesh
    Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
    Nihon Daicho Komonbyo Gakkai Zasshi.2025; 78(10): 398.     CrossRef
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    Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
    Annals of Coloproctology.2024; 40(4): 336.     CrossRef
  • Efficacy and Safety of a New Technique Combining Injection Sclerotherapy and External Hemorrhoidectomy for Prolapsed Hemorrhoids: A Single-center Observational Study
    Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Akane Ito, Kenji Watanabe, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki, Yusuke Saitoh, Masanori Murakami
    Journal of the Anus, Rectum and Colon.2024; 8(4): 331.     CrossRef
  • Simple Anal Reinforcement with Anal Encirclement Using an Artificial Ligament in Patients with fecal Incontinence: A Single-center Observational Study
    Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki
    Journal of the Anus, Rectum and Colon.2022; 6(3): 174.     CrossRef
Special issue, Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology
Modifications to Treatment Plan of Rectal Cancer in Response to COVID-19 at the Philippine General Hospital
Sofia Isabel T. Manlubatan, Marc Paul J. Lopez, Mark Augustine S. Onglao, Hermogenes J. Monroy III
Ann Coloproctol. 2021;37(4):225-231.   Published online August 6, 2021
DOI: https://doi.org/10.3393/ac.2021.00381.0054
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  • 88 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
The coronavirus disease 2019 (COVID-19) pandemic has strained healthcare resources worldwide. Despite the high number of cases, cancer management should remain one of the priorities of healthcare, as any delay would potentially cause disease progression.
Methods
This was an observational study that included nonmetastatic rectal cancer patients managed at the Philippine General Hospital from March 16 to May 31, 2020, coinciding with the lockdown. The treatment received and their outcomes were investigated.
Results
Of the 52 patients included, the majority were female (57.7%), belonging to the age group of 50 to 69 years (53.8%), and residing outside the capital (59.6%). On follow-up, 23.1% had no disease progression, 17.3% had local progression, 28.8% had metastatic progression, 19.2% have died, and 11.5% were lost to follow up. The initial plan for 47.6% patients was changed. Of the 21 patients with nonmetastatic disease, 2 underwent outright resection. The remaining 19 required neoadjuvant therapy. Eight have completed their neoadjuvant treatment, 8 are undergoing treatment, 2 had their treatment interrupted, and 1 has yet to begin treatment. Among the 9 patients who completed neoadjuvant therapy, only 1 was able to undergo resection on time. The rest were delayed, with a median time of 4 months. One has repeatedly failed to arrive for her surgery due to public transport limitations. There was 1 adjuvant chemotherapy-related mortality.
Conclusion
Delays in cancer management resulted in disease progression in several patients. Alternative neoadjuvant treatment options should be considered while taking into account oncologic outcomes, acceptable toxicity, and limitation of potential COVID-19 exposure.

Citations

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  • Was there any change in surgical treatment for colorectal cancer during the COVID-19 pandemic?
    Yeajin Moon, Seung Hun Lee, Seung Hyun Lee
    Kosin Medical Journal.2025; 40(3): 207.     CrossRef
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    In Ja Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
  • Short-Term Impact of Temporary Shutdown of a University-Affiliated Hospital on Patients With Colorectal Cancer During the Coronavirus Disease 2019 Pandemic
    Youn Young Park, Jaeim Lee, Kil-yong Lee, Seong Taek Oh
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Surgical safety in the COVID-19 era: present and future considerations
    Young Il Kim, In Ja Park
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    Gülten Çiçek Okuyan, Melih Yıldırım
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  • Epidemiology, risk factors, and prevention of colorectal cancer
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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  • Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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Case Report
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Late Recurrence in a Rectal Cancer Patient Who Underwent Preoperative Chemoradiotherapy Followed by Local Excision: A Case Report
Jin Soo Han, Seok-Byung Lim, Jin-hong Park, Yong Sang Hong
Ann Coloproctol. 2021;37(Suppl 1):S24-S27.   Published online July 27, 2021
DOI: https://doi.org/10.3393/ac.2020.00073.0010
  • 4,563 View
  • 57 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Some patients who have undergone preoperative chemoradiotherapy (CRT) following surgery have been diagnosed with late recurrence more than 5 years after treatment, raising questions about the possible benefit extending surveillance beyond the recommended 5 years. In 2011, a 71-year-old male patient was diagnosed with T3N+ low-lying rectal cancer located 3 cm from the anal verge before undergoing long-course preoperative CRT. After CRT, the patient was reexamined and diagnosed with ycT1–2N0 lesion, so local excision (LE) was performed. The patient underwent intensive surveillance for up to 5 years, and no evidence of recurrence was found. At 74 months after surgery, the patient was hospitalized for a hematochezia, and local recurrence at the excision site and peritoneal seeding nodules were identified. Considering the late recurrence in this patient, it might be necessary to long-term follow-up beyond 5 years in patients with preoperative CRT followed by LE.

Citations

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  • Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
    Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
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  • Coccygodynia in a Long-Term Cancer Survivor Diagnosed with Metastatic Cancer: A Case Report
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Original Articles
Benign proctology,Surgical technique
Injection of aluminum potassium sulfate and tannic acid in the treatment of fecal incontinence: a single-center observational study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki
Ann Coloproctol. 2022;38(6):403-408.   Published online July 21, 2021
DOI: https://doi.org/10.3393/ac.2021.00248.0035
  • 7,626 View
  • 168 Download
  • 3 Web of Science
  • 4 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Perianal injection of bulking agents is an attractive treatment option for patients with mild to moderate fecal incontinence (FI). Various bulking agents have been used for injection therapy, but the optimal injection materials and methods are yet to be standardized. This study aimed to evaluate the effects of injection therapy using aluminum potassium sulfate and tannic acid (ALTA) in the management of FI.
Methods
This study included consecutive patients who underwent ALTA injection therapy for FI at our institution. The procedure was performed with the patient in the jackknife position, under caudal epidural anesthesia. The procedure consisted of a 4-step injection to the 3 main cushions and a multipoint injection to the remaining submucosa of the anal canal.
Results
Seventy-seven patients (mean age, 76 years) were enrolled in the study. The mean Cleveland Clinic incontinence score of 11.9 ± 4.1 at baseline significantly improved to 7.3 ± 5.2 at 3 months following treatment. The mean maximal resting pressure also increased significantly 3 months after the intervention. Postoperative complications were observed in 3 patients (3.9%), and all events were mild. The mean duration of postoperative follow-up was 17.5 months. The cumulative recurrence-free rate at 3 years was 72.4%.
Conclusion
ALTA injection for FI is safe, easy to perform, and provides reasonable mid-term outcomes. Moreover, concomitant anorectal diseases that may be contraindicated by other injectable bulking agents could be treated simultaneously. Therefore, ALTA injection is a promising alternative in the absence of other injectable agents.

Citations

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  • Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device
    Juan Cabrera Garrido, Gonzalo López González
    Gastroenterology & Endoscopy.2024; 2(4): 176.     CrossRef
  • Tissue engineering and regenerative medicine approaches in colorectal surgery
    Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
    Annals of Coloproctology.2024; 40(4): 336.     CrossRef
  • Efficacy and Safety of a New Technique Combining Injection Sclerotherapy and External Hemorrhoidectomy for Prolapsed Hemorrhoids: A Single-center Observational Study
    Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Akane Ito, Kenji Watanabe, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki, Yusuke Saitoh, Masanori Murakami
    Journal of the Anus, Rectum and Colon.2024; 8(4): 331.     CrossRef
  • Simple Anal Reinforcement with Anal Encirclement Using an Artificial Ligament in Patients with fecal Incontinence: A Single-center Observational Study
    Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki
    Journal of the Anus, Rectum and Colon.2022; 6(3): 174.     CrossRef
Malignant disease,Rectal cancer, Prognosis and adjuvant therapy,Colorectal cancer
Effect of Adjuvant Chemotherapy on Elderly Stage II High-Risk Colorectal Cancer Patients
Yujin Lee, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keunho Yang, Byung-Noe Bae
Ann Coloproctol. 2021;37(5):298-305.   Published online July 6, 2021
DOI: https://doi.org/10.3393/ac.2020.00829.0118
  • 6,324 View
  • 100 Download
  • 16 Web of Science
  • 20 Citations
AbstractAbstract PDF
Purpose
Adjuvant chemotherapy (AC) is recommended for patients with stage II colorectal cancer with adverse features. However, the effect of adjuvant treatment in elderly patients with high-risk stage II colorectal cancer remains controversial. This study aimed to investigate the oncologic outcomes in elderly high-risk stage II colorectal cancer patients who underwent curative resection with or without AC.
Methods
Patients aged over 70 years having stage II colorectal adenocarcinoma with at least 1 adverse feature who underwent radical surgery between 2008 and 2017 at a single center were included. We compared recurrence-free survival (RFS) and overall survival (OS) between patients who received more than 80% of the planned AC cycle (the AC+ group) and those who did not receive it (the AC− group).
Results
The AC+ and AC– group contained 46 patients and 50 patients, respectively. The log-rank test revealed no significant intergroup differences in RFS (P = 0.083) and OS (P = 0.122). In the subgroup of 27 patients with more than 2 adverse features, the AC+ group (n = 16) showed better RFS (P = 0.006) and OS (P = 0.025) than the AC− group. In this subgroup, AC was the only significant factor affecting RFS in the multivariate analysis (P = 0.023). AC was significantly associated with OS (P = 0.033) in the univariate analysis, but not in the multivariate analysis (P = 0.332).
Conclusion
Among elderly patients with stage II high-risk colorectal cancer, the AC+ group did not show better RFS or OS than the AC− group. However, selected patients with more than 2 adverse features might benefit from AC.

Citations

Citations to this article as recorded by  
  • Tumor aggression-defense index–a novel indicator to predicts recurrence and survival in stage II-III colorectal cancer
    Tong Wu, Lin Fang, Yuli Ruan, Mengde Shi, Dan Su, Yue Ma, Ming Ma, Bojun Wang, Yuanyu Liao, Shuling Han, Xiaolin Lu, Chunhui Zhang, Chao Liu, Yanqiao Zhang
    Journal of Translational Medicine.2025;[Epub]     CrossRef
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    Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
    Annals of Coloproctology.2025; 41(3): 198.     CrossRef
  • Predicting venous thromboembolism and determining appropriate prophylaxis in elderly patients undergoing colorectal cancer surgery with Enhanced Recovery After Surgery (ERAS) using the adjusted Caprini score
    Young Sun Choi, Hyung Jin Cho, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Tae Gyu Kim
    Annals of Coloproctology.2025; 41(4): 279.     CrossRef
  • Oncologic outcomes of multivisceral resection for locally advanced colorectal cancer: a single-center retrospective cohort study
    Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    BMC Surgery.2025;[Epub]     CrossRef
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    Jian Li, Yu zhou Yang, Peng Xu, Cheng Zhang
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  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(2): 135.     CrossRef
  • Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
    Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
    Scientific Reports.2023;[Epub]     CrossRef
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    Youngbae Jeon, Eun Jung Park
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    Jeongwon Yeom, Hee-Sook Lim
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    Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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    Gyung Mo Son
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    Chang Hyun Kim
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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    Chang Hyun Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 197.     CrossRef
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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    Min Ki Kim
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Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Clinical Outcomes of Neoadjuvant Chemotherapy in Colorectal Cancer Patients With Synchronous Resectable Liver Metastasis: A Propensity Score Matching Analysis
Sung Hae Park, Jung Kyong Shin, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jin Seok Heo, Gyu Seong Choi, Seung Tae Kim, Young Suk Park, Hee Cheol Kim
Ann Coloproctol. 2021;37(4):244-252.   Published online June 29, 2021
DOI: https://doi.org/10.3393/ac.2020.00710.0101
  • 8,699 View
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  • 14 Web of Science
  • 14 Citations
AbstractAbstract PDF
Purpose
The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first.
Methods
We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared.
Results
Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups.
Conclusion
NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

Citations

Citations to this article as recorded by  
  • Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
    Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Cha
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    Eun Jung Park, Seung Hyuk Baik
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    Chan Wook Kim
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    In Ja Park
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    Chang Hyun Kim
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Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer
Prognostic Factors Affecting Disease-Free Survival and Overall Survival in T4 Colon Cancer
Taeyeong Eom, Yujin Lee, Jungbin Kim, Inseok Park, Geumhee Gwak, Hyunjin Cho, Keunho Yang, Kiwhan Kim, Byung-Noe Bae
Ann Coloproctol. 2021;37(4):259-265.   Published online June 24, 2021
DOI: https://doi.org/10.3393/ac.2020.00759.0108
Correction in: Ann Coloproctol 2023;39(5):444
  • 8,001 View
  • 110 Download
  • 19 Web of Science
  • 20 Citations
AbstractAbstract PDF
Purpose
It is known that as the T stage of a carcinoma progresses, the prognosis becomes poorer. However, there are few studies about factors that affect the prognosis of T4 advanced colon cancer. This study aimed to identify the prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in T4 colon cancer.
Methods
Patients diagnosed with stage T4 on histopathology after undergoing curative surgery for colon cancer between March 2009 and March 2018 were retrospectively analyzed for factors related to postoperative survival. Primary outcomes were DFS and OS.
Results
Eighty-two patients were included in the study. DFS and OS of the pathologic (p) T4b group were not inferior to that of the pT4a group. Multivariate analysis showed that differentiation (hazard ratio [HR], 4.994; P = 0.005), and laparoscopic surgery (HR, 0.323; P = 0.008) were significant prognostic factors for DFS, while differentiation (HR, 7.904; P ≤ 0.001) and chemotherapy (HR, 0.344; P = 0.038) were significant prognostic factors for OS.
Conclusion
Tumor differentiation, laparoscopic surgery, and adjuvant chemotherapy were found to be significant prognostic factors in patients with T4 colon cancer. Adjuvant chemotherapy and curative resections by laparoscopy might improve the prognosis in these patients.

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    Sebastián Jerí-McFarlane, Álvaro García-Granero, Marco Antonio Martínez-Ortega, Isabel Amengual-Antich, Ángela Rodríguez Robayo, Margarita Gamundí-Cuesta, Francisco Xavier González-Argenté
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Case Report
Malignant disease,Rare disease & stoma,Complication
Colonic Perforation After Treatment With Nivolumab in Esophageal Cancer: A Case Report
Hye Jung Cho, Woo Ram Kim, Joo-Hang Kim, Duk Hwan Kim, Dae Jung Kim, Haeyoun Kang
Ann Coloproctol. 2021;37(Suppl 1):S39-S43.   Published online June 24, 2021
DOI: https://doi.org/10.3393/ac.2020.00213.0030
  • 10,982 View
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  • 7 Web of Science
  • 9 Citations
AbstractAbstract PDF
With the advent of checkpoint inhibitors, it has opened up opportunities for numerous cancer patients. However, as is the case with every treatment, complications need to be weighed. Gastrointestinal adverse effects, such as diarrhea and colitis are well-known complications for checkpoint inhibitors. In severe cases, colitis-induced colonic perforation may occur with an estimation of 1.0% to 1.5% in anti-CTLA-4 antibodies. However, only a handful of cases of such devastating complications have been reported in anti-PD-1 antibodies such as pembrolizumab and nivolumab. We here report a case of intestinal perforation in a patient treated with nivolumab.

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  • Nivolumab

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Original Article
Malignant disease, Rectal cancer, Functional outcomes
Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection
Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti
Ann Coloproctol. 2022;38(3):230-234.   Published online June 10, 2021
DOI: https://doi.org/10.3393/ac.2021.00059.0008
  • 8,572 View
  • 232 Download
  • 5 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Citations

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  • Ghost Ileostomy Versus Protective Ileostomy in Rectal Cancer Followed by Low Anterior Resection: A Randomized Feasibility Trial
    Seyed Mostafa Meshkati Yazd, Mohammad Reza Keramati, Marzieh Ghanbari Ghalerudkhani, Reza Shahriarirad, Amir Parsa, Amir Keshvari
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    Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
    Medicina.2024; 60(12): 1966.     CrossRef
  • Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
    Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
    Updates in Surgery.2023; 75(4): 847.     CrossRef
  • Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates
    F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
    British Journal of Surgery.2022;[Epub]     CrossRef
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    Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
    International Journal of Surgery Case Reports.2022; 100: 107737.     CrossRef
  • Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
    Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
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Case Report
Benign proctology,Complication,Surgical technique
Rectal perforation and perirectal abscess following stapled hemorrhoidectomy for prolapsed hemorrhoids successfully managed with Endo-SPONGE endoluminal vacuum-assisted wound closure system
Emanuele Rosati, Manuel Valeri, Luigina Graziosi, Lavinia Amato, Stefano Avenia, Annibale Donini
Ann Coloproctol. 2022;38(5):387-390.   Published online June 9, 2021
DOI: https://doi.org/10.3393/ac.2021.02.07
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AbstractAbstract PDF
Active drains, which work by negative pressure, are commonly used to drain closed airtight wounds. Higher negative pressure is used in vacuum-assisted wound closure dressings. Gastrointestinal leaks may be difficult to treat by surgical approach because of their association with high morbidity and mortality. Recently, endoscopic approaches have been applied with several degrees of success. Most recently, endoluminal vacuum-assisted wound closure (EVAC) has been employed with high success rates in decreasing both morbidity and mortality. In the present paper, the authors describe the successful use of Endo-SPONGE (B. Braun Medical B.V.) EVAC system therapy to drain an open rectal wound, following a perforation occurred during stapled hemorrhoidectomy.

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  • Innovative Treatment of Combat-Related Extraperitoneal Penetrating Rectal Injury with Intraluminal Vacuum Therapy: A Case Report
    Yafa Shani Parnasa, Oded Cohen-Arazi, Gad Marom, Mahmoud Abu-Gazala, Noam Shussman, Miklosh Bala
    Trauma Care.2025; 5(2): 12.     CrossRef
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    Alper Sozutek, Ekin Y Tas, Kemal Yener, Julia Ozcomert
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Original Articles
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
  • 6,108 View
  • 82 Download
  • 8 Web of Science
  • 8 Citations
AbstractAbstract PDFSupplementary Material
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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  • Global-local Dirichlet processes for identifying pan-cancer subpopulations using both shared and cancer-specific data
    Arhit Chakrabarti, Yang Ni, Debdeep Pati, Bani K. Mallick
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    Mahmoud Al-Masri, Yasmin Safi, Mohammad Almasri, Ramiz Kardan, Daliana Mustafa, Osama Alayyan, Bilal Kahalah, Rama AlMasri
    Cancers.2025; 17(20): 3383.     CrossRef
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    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     CrossRef
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
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    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
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    Sanghee Kang
    Annals of Coloproctology.2021; 37(3): 129.     CrossRef
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor
Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer
Mok-Won Lee, Jin-Su Kim, Ji-Yeon Kim, Kyung-ha Lee
Ann Coloproctol. 2021;37(1):35-43.   Published online September 18, 2020
DOI: https://doi.org/10.3393/ac.2020.09.03
  • 6,138 View
  • 137 Download
  • 10 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose
There is no clear evidence of the benefit of adjuvant chemotherapy (AC) in stage IIA colon cancer. Therefore, we aimed to evaluate the prognostic factors and survival benefit of AC in this disease.
Methods
A retrospective data collection for patients who underwent radical surgery for colon cancer between January 2008 and December 2015 was undertaken. The cohort was divided into the no-AC and AC groups.
Results
We included 227 patients with stage IIA colon cancer in our study cohort, including 67 and 160 patients in the no-AC and AC groups, respectively. The number of retrieved lymph nodes and the presence of tumor complications as obstruction or perforation were independent risk factors for survival. In the no-AC group, there was a significant difference in survival according to the number of retrieved lymph nodes. In the AC group, there were significant differences in survival according to sidedness and preoperative carcinoembryonic antigen (CEA). There was no significant difference in survival between the no-AC and the AC groups.
Conclusion
The number of retrieved lymph nodes and the presence of tumor complications were prognostic factors for stage IIA colon cancer but lymphovascular and perineural invasion were not. Sidedness and preoperative CEA could be used as factors to predict the benefit of adjuvant chemotherapy. Currently, it is believed that there is no benefit of AC for stage IIA colon cancer. Further studies are needed to determine the survival benefit of adjuvant chemotherapy in stage IIA colon cancer.

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  • Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
    Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Annals of Surgical Treatment and Research.2023; 104(2): 109.     CrossRef
  • Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
    Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
    Cancers.2023; 15(20): 4927.     CrossRef
  • Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     CrossRef
  • The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
    Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Cancers.2022; 14(12): 2833.     CrossRef
  • Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
    Chang Hyun Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 197.     CrossRef
  • Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis
    Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han, Zhou Li
    International Journal of Colorectal Disease.2022; 37(12): 2481.     CrossRef
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    Chang Hyun Kim
    Journal of the Korean Medical Association.2022; 65(9): 586.     CrossRef
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    In Ja Park
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Case Report
Benign GI diease,Rare disease & stoma,Complication
Acute Ileal Perforation Caused by Radiation Enteritis After Restoration
Jong Beom Kim, Jong Lyul Lee, Seong Ho Park, Jihun Kim, Jin Cheon Kim
Ann Coloproctol. 2021;37(Suppl 1):S51-S54.   Published online September 18, 2020
DOI: https://doi.org/10.3393/ac.2020.07.30
  • 5,395 View
  • 63 Download
  • 3 Web of Science
  • 4 Citations
AbstractAbstract PDF
Few radiation-induced bowel perforations have been reported to date. Furthermore, perforation after ileal restoration in asymptomatic patients is rare. We report the case of a 61-year-old man who was administered preoperative chemoradiotherapy for advanced rectal cancer. The patient underwent ultra-low anterior resection with ileal diversion, followed by ileal restoration. Perforation was detected 9 days after restoration, and he underwent a right hemicolectomy. The histologic evaluation indicated ileal perforation caused by acute radiation enteritis.

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    Josip Nincevic, Gaiane M. Rauch, Jennifer S. Golia Pernicka
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    Yi-Ting Wang, Ya-Xi Zhu, Rui-Yan Huang, Yan Huang, Xiang-Bo Wan, Xiao-Yan Huang, Qing-Hua Zhong, Qi-Yuan Qin, Yun-Long Wang, Teng-Hui Ma, Xin-Juan Fan
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    Dongdong Liu, Meng Wei, Wenrui Yan, Hua Xie, Yingbao Sun, Bochuan Yuan, Yiguang Jin
    Expert Opinion on Drug Delivery.2023; 20(4): 435.     CrossRef
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    Wenwen Fu, Lina Zhang, Tenghui Ma
    Aging Research.2023; 1(2): 9340016.     CrossRef
Original Article
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy
Beware of Early Relapse in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy
Seul Gi Oh, In Ja Park, Ji-hyun Seo, Young Il Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2020;36(6):382-389.   Published online June 17, 2020
DOI: https://doi.org/10.3393/ac.2020.06.11
  • 5,789 View
  • 105 Download
  • 7 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
Recurrence patterns in rectal cancer patients treated with preoperative chemoradiotherapy (PCRT) are needed to evaluate for establishing tailored surveillance protocol.
Methods
This study included 2,215 patients with locally-advanced mid and low rectal cancer treated with radical resection between January 2005 and December 2012. Recurrence was evaluated according to receipt of PCRT; PCRT group (n = 1,258) and no-PCRT group (n = 957). Early recurrence occurred within 1 year of surgery and late recurrence after 3 years. The median follow-up duration was 65.7 ± 29 months.
Results
The overall recurrence rate was similar between the PCRT and no-PCRT group (25.8% vs. 24.9%, P = 0.622). The most common initial recurrence site was the lungs in both groups (50.6% vs. 49.6%, P = 0.864), followed by the liver, which was more common in the no-PCRT group (22.5% vs. 33.6%, P = 0.004). Most of the recurrence occurred within 3 years after surgery in both groups (85.3% vs. 85.8%, P = 0.862). Early recurrence was more common in the PCRT group than in the no-PCRT group (43.1% vs. 32.4%, P = 0.020). Recurrence within the first 6 months after surgery was significantly higher in the PCRT group than in the no-PCRT group (18.8% vs. 7.6%, P = 0.003). Lung (n = 27, 44.3%) and liver (n = 22, 36.1%) were the frequent the first relapsed site within 6 months after surgery in PCRT group.
Conclusion
Early recurrence within the first 1 year after surgery was more common in patients treated with PCRT. This difference would be considered for surveillance protocols and need to be evaluated in further studies.

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    Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
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    Chan Wook Kim
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    Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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    Min-Young Park, In-Ja Park, Hyo-Seon Ryu, Jay Jung, Min-Sung Kim, Seok-Byung Lim, Chang-Sik Yu, Jin-Cheon Kim
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    Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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    Eun Jung Park
    Annals of Coloproctology.2020; 36(6): 357.     CrossRef
Case Report
Benign GI diease,Rare disease & stoma,Complication
Intestinal Perforation as a Paradoxical Reaction to Antitubercular Therapy: A Case Report
Sung Hoon Kang, Hee Seok Moon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Kyung Ha Lee
Ann Coloproctol. 2021;37(Suppl 1):S18-S23.   Published online May 15, 2020
DOI: https://doi.org/10.3393/ac.2020.03.16.1
  • 6,798 View
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  • 5 Citations
AbstractAbstract PDF
Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a paradoxical reaction to antitubercular therapy. A 55-year-old man visited the outpatient department with lower abdominal pain and weight loss. He was diagnosed with intestinal TB and started antitubercular therapy. After 3 months of antitubercular therapy, a colonoscopy revealed improvement of the disease. Three days after the colonoscopy, the patient visited the emergency room complaining of abdominal pain. Abdominal computed tomography revealed extraluminal air-filled spaces in the pelvic cavity. We diagnosed a small bowel perforation and performed an emergency laparotomy and a right hemicolectomy with small bowel resection. This report describes the case of intestinal perforation presenting as a paradoxical reaction to antitubercular and provides a brief literature review.

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    Yoseph Mulatu Habte, Binyam Mulatu Habte, Yabetse Alemayehu Kifle, Esimael Musema Abdu, Makida Mulatu Habte, Shimelis Ayalew Yimer
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Original Article
Malignant disease
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy With Mitomycin C Used for Colorectal Peritoneal Carcinomatosis
Seung Jae Roh, Sung Chan Park, Jaehee Choi, Joon Sang Lee, Dong Woon Lee, Chang Won Hong, Kyung Su Han, Hyoung Chul Park, Dae Kyung Sohn, Jae Hwan Oh
Ann Coloproctol. 2020;36(1):22-29.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.04.30
  • 7,949 View
  • 178 Download
  • 23 Web of Science
  • 22 Citations
AbstractAbstract PDF
Purpose
This study aimed to assess the evaluation of clinical outcomes and consequences of complications after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for the peritoneal carcinomatosis (PC) from colorectal cancer.
Methods
A total 26 patients underwent CRS and HIPEC for PC from colorectal cancer between March 2009 and April 2018. All the patients underwent CRS with the purpose of complete or near-complete cytoreduction. Intraoperative HIPEC was performed simultaneously after the CRS. Mitomycin C was used as chemotherapeutic agent for HIPEC.
Results
Median disease-free survival was 27.8 months (range, 13.4–42.2 months). Median overall survival was 56.0 months (range, 28.6–83.5 months). The mean peritoneal cancer index (PCI) was 8.73 ± 5.54. The distributions thereof were as follows: PCI <10, 69.23%; PCI 10–19, 23.08%; and PCI ≥20, 7.69%. The completeness of cytoreduction was 96.2% of patients showed CC-0, with 3.8% achieved CC-1. The mean operation time was 8.5 hours, and the mean postoperative hospital stay was 21.6 days. The overall rate of early postoperative complications was 88.5%; the rate of late complications was 34.6%. In the early period, most complications were grades I–II complications (65.4%), compared to grades III–V (23.1%). All late complications, occurring in 7.7% of patients, were grades III–V. There was no treatment-related mortality.
Conclusion
Although the complication rate was approximately 88%, but the rate of severe complication rate was low. In selective patients with peritoneal recurrence, more aggressive strategies for management, such as CRS with HIPEC, were able to be considered under the acceptable general condition and life-expectancy.

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    Szilvia Lukácsi, Gyöngyi Munkácsy, Balázs Győrffy
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    Eun Jung Park, Seung Hyuk Baik
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    Chang Hyun Kim
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    Eun Jung Park, Seung Hyuk Baik
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    Chan Wook Kim
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Current Practice in Asia-Pacific Region
Malignant disease, Rectal cancer
Current Status of “Watch-and-Wait” Rectal Cancer Treatment in Asia-Pacific Countries
Jung Wook Huh, Kotaro Maeda, Zheng Liu, Xishan Wang, April Camilla Roslani, Woo Yong Lee
Ann Coloproctol. 2020;36(2):70-77.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2020.01.19
  • 6,277 View
  • 188 Download
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  • 16 Citations
AbstractAbstract PDF
Purpose
Current acceptance of the watch-and-wait (W&W) approach by surgeons in Asia-Pacific countries is unknown. An international survey was performed to determine status of the W&W approach on behalf of the Asia-Pacific Federation of Coloproctology (APFCP).
Methods
Surgeons in the APFCP completed an Institutional Review Board-approved anonymous e-survey and/or printed letters (for China) containing 19 questions regarding nonsurgical close observation in patients who achieved clinical complete response (cCR) to neoadjuvant chemoradiotherapy (nCRT).
Results
Of the 417 responses, 80.8% (n = 337) supported the W&W approach and 65.5% (n = 273) treated patients who achieved cCR after nCRT. Importantly, 78% of participants (n = 326) preferred a selective W&W approach in patients with old age and medical comorbidities who achieved cCR. In regard to restaging methods after nCRT, the majority of respondents based their decision to use W&W on a combination of magnetic resonance imaging results (94.5%, n = 394) with other test results. For interval between nCRT completion and tumor response assessment, most participants used 8 weeks (n = 154, 36.9%), followed by 6 weeks (n = 127, 30.5%) and 4 weeks (n = 102, 24.5%). In response to the question of how often responders followed-up after W&W, the predominant period was every 3 months (209 participants, 50.1%) followed by every 2 months (75 participants, 18.0%). If local regrowth was found during follow-up, most participants (79.9%, n = 333) recommended radical surgery as an initial management.
Conclusion
The W&W approach is supported by 80% of Asia-Pacific surgeons and is practiced at 65%, although heterogeneous hospital or society protocols are also observed. These results inform oncologists of future clinical study participation.

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    Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
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Original Articles
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy
Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer
Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Ann Coloproctol. 2020;36(4):229-242.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2019.10.03
  • 6,108 View
  • 104 Download
  • 11 Web of Science
  • 12 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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    Ellen Van Eetvelde, Manu Verweirder, Lore Decoster, Daniel Jacobs-Tulleneers-Thevissen
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    Jun Rong, Wensheng Deng
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  • Abdominal Aortic Calcification as a Predictor of Incomplete Adjuvant Chemotherapy in Stage III Colorectal Cancer: A Retrospective Cohort Study
    Kouki Imaoka, Manabu Shimomura, Hiroshi Okuda, Takuya Yano, Shintaro Akabane, Masahiro Ohira, Yuki Imaoka, Tetsuya Mochizuki, Minoru Hattori, Hideki Ohdan
    Cureus.2024;[Epub]     CrossRef
  • Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
    Hyeon Deok Choi, Sung Uk Bae
    Annals of Coloproctology.2024; 40(6): 564.     CrossRef
  • Differences in prognosis and underuse of adjuvant chemotherapy between elderly and non‐elderly patients in stage III colorectal cancer
    Takuya Shiraishi, Hiroomi Ogawa, Ikuma Shioi, Naoya Ozawa, Katsuya Osone, Takuhisa Okada, Makoto Sohda, Ken Shirabe, Hiroshi Saeki
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  • Multidisciplinary treatment strategy for early colon cancer
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  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
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Impact of Adjuvant Chemotherapy Completion on Oncologic Outcomes in ypTNMstage 2 Rectal Cancer Patients
Youn Young Park, Kang Young Lee, Nam Kyu Kim, Sat Byol Lee, Ga Ram Kim, Byung Soh Min, Seong-Taek Oh
Ann Coloproctol. 2019;35(6):335-341.   Published online December 31, 2019
DOI: https://doi.org/10.3393/ac.2019.03.10
  • 4,949 View
  • 64 Download
  • 3 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Adjuvant chemotherapy (aCT) in rectal cancer patients who have undergone curative resection after neoadjuvant chemoradiation (nCRT) is controversial. We aimed to investigate the benefits of using aCT and the clinical impact of completing aCT in ypstage 2 rectal cancer patients.
Methods
We retrospectively reviewed clinicopathological data from patients who had undergone radical resection after nCRT between January 2006 and December 2012. In total, 152 patients with ypT3/4N0M0 rectal cancer were included. Of these patients, 139 initiated aCT, while 13 did not receive aCT (no-aCT). Among those who received aCT, 132 patients completed their planned cycles (aCT-completion) whereas 7 did not (aCT-incompletion). All patients received longcourse chemoradiation; a 5-fluorouracil-based regimen was used for nCRT in most patients. The prognostic factors affecting disease-free survival (DFS) and overall survival (OS) were analyzed.
Results
The median follow-up duration was 41 months. Demographic data did not differ significantly among the 3 groups. In multivariate analysis, open surgery, a tumor size >2 cm, retrieval of <12 lymph nodes, circumferential resection margin (CRM) positivity and aCT incompletion were independent prognostic factors for poor DFS. Old age (≥60 years), open surgery, CRM positivity, aCT incompletion, and lack of aCT initiation compared to aCT completion were independent prognostic factors for poor OS.
Conclusion
In ypstage 2 rectal cancer patients, aCT after nCRT and total mesorectal excision affected both DFS and OS; however, only patients who completed planned aCT exhibited survival benefits. Therefore, improving patients’ compliance with the completion of aCT is desirable.

Citations

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  • The Benefits of Adjuvant Chemotherapy for ypT3-4N0M0 Rectal Cancer Following Neoadjuvant Chemoradiation and Surgery
    Chih-Hsien Chang, Hung-Hsin Lin, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Yuan-Tzu Lan
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    In Ja Park
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