Minimally invasive surgery
- Robotic surgery may lead to reduced postoperative inflammatory stress in colon cancer: a propensity score–matched analysis
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Eun Ji Park, Gyong Tae Noh, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Byung Soh Min
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Ann Coloproctol. 2024;40(6):594-601. Published online December 6, 2024
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DOI: https://doi.org/10.3393/ac.2024.00171.0024
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 Abstract
 PDF Supplementary Material
- Purpose
Robot-assisted surgery is readily applied to every type of colorectal surgeries. However, studies showing the safety and feasibility of robotic surgery (RS) have dealt with rectal cancer more than colon cancer. This study aimed to investigate how technical advantages of RS can translate into actual clinical outcomes that represent postoperative systemic response.
Methods
This study retrospectively reviewed consecutive cases in a single tertiary medical center in Korea. Patients with primary colon cancer who underwent curative resection between 2006 and 2012 were included. Propensity score matching was done to adjust baseline patient characteristics (age, sex, body mass index, American Society of Anesthesiologists physical status, tumor profile, pathologic stage, operating surgeon, surgery extent) between open surgery (OS), laparoscopic surgery (LS), and RS groups.
Results
After propensity score matching, there were 66 patients in each group for analysis, and there was no significant differences in baseline patient characteristics. Maximal postoperative leukocyte count was lowest in the RS group and highest in the OS group (P=0.021). Similar results were observed for postoperative neutrophil count (P=0.024). Postoperative prognostic nutritional index was highest in the RS group and lowest in the OS group (P<0.001). The time taken to first flatus and soft diet resumption was longest in the OS group and shortest in the RS group (P=0.001 and P<0.001, respectively). Among all groups, other short-term postoperative outcomes such as hospital stay and complications did not show significant difference, and oncological survival results were similar.
Conclusion
Better postoperative inflammatory indices in the RS group may correlate with their faster recovery of bowel motility and diet resumption compared to LS and OS groups.
Colorecal cancer
- Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients
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Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim
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Ann Coloproctol. 2023;39(5):410-420. Published online April 28, 2022
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DOI: https://doi.org/10.3393/ac.2022.00143.0020
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3,836
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 Graphical Abstract
Abstract
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 - 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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Citations
Citations to this article as recorded by  - Breaking Myths: Comparable Outcomes in Lymph Node Analysis Across Surgical Methods
Salvatore Pezzino, Tonia Luca, Mariacarla Castorina, Giulia Fuccio Sanzà, Gaetano Magro, Stefano Puleo, Ornella Coco, Sergio Castorina
Cancers.2025; 17(8): 1312. 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 - Artificial Intelligence-Driven Volumetric Analysis of Muscle Mass as a Predictor of Tumor Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer
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
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Colorectal cancer
- Efficacy of preoperative chemoradiotherapy in patients with cT2N0 distal rectal cancer
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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
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Ann Coloproctol. 2023;39(3):250-259. Published online April 4, 2022
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DOI: https://doi.org/10.3393/ac.2022.00066.0009
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3,889
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152
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5
Web of Science
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5
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Graphical Abstract
Abstract
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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Citations
Citations to this article as recorded by - 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 - 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
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