- Prognostic Impact of Microsatellite Instability in Colorectal Cancer Presenting With Mucinous, Signet-Ring, and Poorly Differentiated Cells
-
Sang Hun Jung, So Hyun Kim, Jae Hwang Kim
-
Ann Coloproctol. 2016;32(2):58-65. Published online April 30, 2016
-
DOI: https://doi.org/10.3393/ac.2016.32.2.58
-
-
4,519
View
-
57
Download
-
15
Web of Science
-
16
Citations
-
Abstract
PDF
- Purpose
Mucinous cells (MUCs), signet-ring cells (SRCs), and poorly differentiated cells (PDCs) are uncommon histologic types and have been associated with advanced tumor stage and poor prognosis. However, MUCs, SRCs, and PDCs are commonly observed in cancers with high microsatellite instability (MSI), which have favorable outcomes compared with cancers with microsatellite stability (MSS). The purpose of this study was to evaluate the prognostic impact of high-MSI in patients with sporadic colorectal cancer presenting with MUCs, SRCs, and/or PDCs. MethodsBetween January 2006 and December 2012, 176 with proven microsatellite status who also presented with MUCs, SRCs, and PDCs were selected for this study and were divided into 2 groups, high-MSI and MSS; their outcomes were analyzed. ResultsOf the 176 patients, 56 and 120, respectively, had high-MSI and MSS cancers. High-MSI cancers had larger tumors, proximal tumor location, and a lower TNM stage. The recurrence rate was lower in the high-MSI group (13.7% vs. 35.4%, P = 0.006). Common patterns of distant metastasis for MUC, SRC, PDC cancers were peritoneal spread (46.9%) and hematogenous metastasis (46.4%). The 5-year CSS rates were 88.2% and 61.2% for patients with high-MSI and MSS cancers, respectively (P < 0.0001). In the multivariate analysis, except for stage-IV cancer, MSI status was an independent risk factor for cancer-specific survival (MSS: hazard ratio, 4.34; 95% confidence interval, 1.68-11.21). ConclusionIn patients with colorectal cancer presenting with MUCs, SRCs, and/or PDCs, those with high-MSI cancers had better outcomes.
-
Citations
Citations to this article as recorded by 
- Comparative Study of Postoperative Complications in Patients With and Without an Obstruction Who Had Left-Sided Colorectal Cancer and Underwent a Single-Stage Operation After Mechanical Bowel Preparation
-
Sang Hun Jung, Jae Hwang Kim
-
Ann Coloproctol. 2014;30(6):251-258. Published online December 31, 2014
-
DOI: https://doi.org/10.3393/ac.2014.30.6.251
-
-
3,297
View
-
43
Download
-
5
Web of Science
-
3
Citations
-
Abstract
PDF
- Purpose
The purpose of this study is to compare postoperative complications for single-stage surgery after mechanical bowel preparation in patients who experienced obstruction and those who did not. MethodsFrom 2000 to 2011, 1,224 patients underwent a single-stage operation for left colorectal cancer after bowel preparation. Nonobstruction (NOB) and obstruction (OB) colorectal cancer patients were 1,053 (86.0%) and 171 (14.0%), respectively. Postoperative morbidity and mortality were compared between groups. ResultsThe OB group had poor preoperative conditions (age, white blood cell, hemoglobin, albumin level, and advanced tumor stage) compared with the NOB group (P < 0.05). Mean on-table lavage time for the OB group was 17.5 minutes (range, 14-60 minutes). Mean operation time for the OB group was statistically longer than that of the NOB group (OB: 210 minutes; range, 120-480 minutes vs. NOB: 180 minutes; range, 60-420 minutes; P < 0.001). Overall morbidity was similar between groups (NOB: 19.7% vs. OB: 23.4%, P = 0.259). Major morbidity was more common in the OB group than in the NOB group, but the difference was without significance (OB: 11.7% vs. NOB: 7.6%, P = 0.070). Postoperative death occurred in 16 patients (1.3%), and death in the OB group (n = 7) was significantly higher than it was in the NOB group (n = 9) (4.1% vs. 0.9%, P = 0.001). Twelve patients had surgical complications, which were the leading cause of postoperative death: postoperative bleeding in five patients and leakage in seven patients. ConclusionPostoperative morbidity for a single-stage operation for obstructive left colorectal cancer is comparable to that for NOB, regardless of poor conditions of the patient.
-
Citations
Citations to this article as recorded by 
- Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery: A propensity-score-matching analysis
Gan-Bin Li, Chen-Tong Wang, Xiao Zhang, Xiao-Yuan Qiu, Wei-Jie Chen, Jun-Yang Lu, Lai Xu, Bin Wu, Yi Xiao, Guo-Le Lin World Journal of Gastrointestinal Surgery.2024; 16(5): 1259. CrossRef - Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Koji Murono, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Hironori Yamaguchi, Toshiaki Watanabe Surgery Today.2017; 47(5): 627. CrossRef - Surgical Treatment of Obstructed Left-Sided Colorectal Cancer Patients
Young Jin Kim Annals of Coloproctology.2014; 30(6): 245. CrossRef
|