- Impact of Adjuvant Therapy Type on Survival in Stage II/III Rectal Cancer Without Preoperative Chemoradiation: A Korean Multicenter Retrospective Study
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Byung Mo Kang, Jeong-Heum Baek, Sun Jin Park, Seong Kyu Baek, Ki-Jae Park, Hong-Jo Choi, Byung-Noe Bae, Sun Keun Choi, Kap Tae Kim, Jin-Su Kim, Suk-Hwan Lee
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Ann Coloproctol. 2018;34(3):144-151. Published online June 30, 2018
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DOI: https://doi.org/10.3393/ac.2017.09.26.1
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This study compared the oncologic impact of postoperative chemotherapy and chemoradiotherapy on patients with rectal cancer without preoperative chemoradiation.
Methods This retrospective study analyzed 713 patients with a mean follow-up of 58 months who had undergone radical resection for stage II/III rectal cancer without preoperative treatment in nine hospitals from January 2004 to December 2009. The study population was categorized a chemotherapy group (CG, n = 460) and a chemoradiotherapy group (CRG, n = 253). Five-year overall survival (OS) and disease-free survival (DFS) were analyzed, and independent factors predicting survival were identified.
Results The patients in the CRG were significantly younger (P < 0.001) and had greater incidences of low rectal cancer (P < 0.001) and stage III disease (P < 0.001). Five-year OS (P = 0.024) and DFS (P = 0.012) were significantly higher in the CG for stage II disease; however, they were not significantly different for stage III disease. In the multivariate analysis, independent predictive factors were male sex, low rectal cancer and stage III disease for OS and male sex, abdominoperineal resection, stage III disease and tumor-positive circumferential margin for DFS. However, adjuvant therapy type did not independently affect OS (hazard ratio [HR], 1.243; 95% confidence interval [CI], 0.794–1.945; P = 0.341) and DFS (HR, 1.091; 95% CI, 0.810–1.470; P = 0.566).
Conclusion Adjuvant therapy type did not affect survival of stage II/III rectal cancer patients without neoadjuvant chemoradiotherapy. These results suggest that adjuvant therapy can be chosen based on the patient’s condition and the policies of the surgeons and hospital facilities.
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Citations
Citations to this article as recorded by 
- Management and Outcomes of Pathologic Upstaging of Clinical Stage I Rectal Cancers: An Exploratory Analysis
Alisha Lussiez, Samantha J. Rivard, Kamren Hollingsworth, Sherif R.Z. Abdel-Misih, Philip S. Bauer, Katherine A. Hrebinko, Glen C. Balch, Lillias H. Maguire Diseases of the Colon & Rectum.2023; 66(4): 543. CrossRef - The oncological outcomes of postoperative radiotherapy in patients with stage II and III upper rectal cancer
Ilknur ALSAN CETIN, Sıtkı Utku AKAY Marmara Medical Journal.2022;[Epub] CrossRef - Selection of Adjuvant Treatment Without Neoadjuvant Chemoradiotherapy for Patients With Rectal Cancer: Room for Further Investigation
In Ja Park Annals of Coloproctology.2018; 34(3): 109. CrossRef
- Intestinal Anastomosis by Use of a Memory-shaped Compression Anastomosis Clip (Hand CAC 30): Early Clinical Experience
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Hak-Youn Lee, Jin-Hee Woo, Si-Young Park, Nam-Wook Kang, Ki-Jae Park, Hong-Jo Choi
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J Korean Soc Coloproctol. 2012;28(2):83-88. Published online April 30, 2012
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DOI: https://doi.org/10.3393/jksc.2012.28.2.83
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4,792
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The safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections. MethodsA non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded. ResultsA total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture. ConclusionShort-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.
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- Comparative early histologic healing quality of magnetic versus stapled small bowel anastomosis
Ana Sofia Ore, Ashley Althoff, David R. Kull, Thomas J. Baldwin, Jeffrey L. Van Eps, Evangelos Messaris Surgery.2023; 173(4): 1060. CrossRef - An Automatic Suturing Machine for Intestinal Anastomosis: Advantages Compared With Hand-Suturing Technique
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Xiaodong Zhang, Zuoqian Yu, Feizhao Jiang, Lechi Ye, Jinlei Li, Xingzhao Ye, Chungen Xing Journal of Macromolecular Science, Part A.2019; 56(7): 667. CrossRef - Anastomosis colorrectales por compresión utilizando el dispositivo NiTi
Quintín Héctor González-Contreras, Mónica de Jesús-Mosso, Jesús Alberto Bahena-Aponte, Omar Aldana-Martínez, Karen Pineda-Solís, Sari Narsil Mejia-Arcadia Cirugía y Cirujanos.2016; 84(6): 482. CrossRef - Laparoscopic colonic anastomosis using a degradable stent in a porcine model
Liang Ma, Xiu-Jun Cai, Hai-Hong Wang, Yan-Lan Yu, Di-Yu Huang, Guang-Ju Ge, Hai-Yi Hu, Shi-Cheng Yu World Journal of Gastroenterology.2016; 22(19): 4707. CrossRef - Colorectal anastomosis using a compression device
Quintín Héctor González-Contreras, Mónica de Jesús-Mosso, Jesús Alberto Bahena-Aponte, Omar Aldana-Martínez, Karen Pineda-Solís, Sari Narsil Mejia-Arcadia Cirugía y Cirujanos (English Edition).2016; 84(6): 482. CrossRef - Long term results of the use of compression anastomosis clips (CAC) in gastrointestinal surgery – the first report
Katarzyna Kuśnierz, Paweł Lampe Polish Journal of Surgery.2015;[Epub] CrossRef - A nickel–titanium memory-shape device for gastrojejunostomy: comparison of the compression anastomosis clip and a hand-sewn anastomosis
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- Adjuvant Chemotherapy Using the FOLFOX Regimen in Colon Cancer
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Hyeong-Joon Jeon, Jin-Hee Woo, Hak-Yoon Lee, Ki-Jae Park, Hong-Jo Choi
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J Korean Soc Coloproctol. 2011;27(3):140-146. Published online June 30, 2011
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DOI: https://doi.org/10.3393/jksc.2011.27.3.140
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6,289
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Great progress has been made in the adjuvant treatment of colon cancer. The aim of this study was to evaluate the efficacy of postoperative adjuvant chemotherapy using the FOLFOX regimen in patients with stage III and high-risk stage II colon cancer. MethodsEighty-two patients who underwent a potentially curative resection for stage III or high-risk stage II colon cancer were enrolled in this retrospective study. They received FOLFOX4 or modified FOLFOX6. The primary endpoint was disease-free survival. ResultsDuring the median follow-up of 37 months (range, 21 to 61 months), 14 patients experienced disease relapse. The disease-free survival rate at 3 years was 82.9%: 84.6% for stage II and 82.6% for stage III. At the time of the analysis, 8 patients were dead from recurrence. The probability of overall survival at 5 years was 74.5%: 90% for stage II and 74.6% for stage III. Grade 3 or 4 hematologic adverse events included neutropenia (40.2%), anemia (2.4%), and thrombocytopenia (1.2%). Gastrointestinal toxicities included grade 3 or 4 nausea (4.9%) and stomatitis (2.4%). Peripheral sensory neuropathy was observed in 81.7% of the patients during treatment. Of the 11 patients (13.4%) who had grade 3 peripheral sensory neuropathy during treatment, grade 3 symptoms were persistent in 3 patients with gait disturbance at the time of analysis. No treatment-related deaths were recorded. ConclusionPostoperative chemotherapy using the FOLFOX regimen, oxaliplatin in combination with 5-fluorouracil and leucovorin, is effective and tolerable in patients with stage III and high-risk stage II colon cancer.
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T. Quang Nguyen, T. Oanh Bui, P. Thao Tran, V. Thuan Tran, V. Hieu Nguyen, Q. Hoan Chu, T. A. Tuyet Bui, N. Quynh Le, V. Quang Le, V. Tu Dao Cancer Control.2019;[Epub] CrossRef - Operative Versus Nonoperative Management of Appendicitis: A Long-Term Cost Effectiveness Analysis
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