Annals of Coloproctology

Original Articles

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

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16 Citations

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.

Methods

Between 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.

Results

Of 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).

Conclusion

In 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

Clinicopathological features and evaluation of microsatellite stability of colorectal carcinoma with cribriform comedo pattern
Tuğba Günler, Pinar Karabağli, Hicret Tiyek, Özge Keskin, Muslu K. Körez
Indian Journal of Pathology and Microbiology.2024; 67(2): 275. CrossRef
Correlation of clinical, pathologic, and genetic parameters with intratumoral immune milieu in mucinous adenocarcinoma of the colon
Azfar Neyaz, Amaya Pankaj, Andrew Crabbe, Steffen Rickelt, Lieve Leijssen, Anne Dinaux, Martin Taylor, Stuti G. Shroff, Rory Crotty, M. Lisa Zhang, Omer H. Yilmaz, Osman Yılmaz, Deepa T. Patil, Aparna R. Parikh, David T. Ting, David Berger, Vikram Deshpan
Modern Pathology.2022; 35(11): 1723. CrossRef
The Molecular Associations of Signet-Ring Cell Carcinoma in Colorectum: Meta-Analysis and System Review
Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
Medicina.2022; 58(7): 836. CrossRef
Rate of dissemination and prognosis in early and advanced stage colorectal cancer based on microsatellite instability status: systematic review and meta-analysis
James W. T. Toh, Kevin Phan, Faizur Reza, Pierre Chapuis, Kevin J. Spring
International Journal of Colorectal Disease.2021; 36(8): 1573. CrossRef
Tumour infiltrating lymphocyte status is superior to histological grade, DNA mismatch repair and BRAF mutation for prognosis of colorectal adenocarcinomas with mucinous differentiation
David S. Williams, Dmitri Mouradov, Marsali R. Newman, Elham Amini, David K. Nickless, Catherine G. Fang, Michelle Palmieri, Anuratha Sakthianandeswaren, Shan Li, Robyn L. Ward, Nicholas J. Hawkins, Iain Skinner, Ian Jones, Peter Gibbs, Oliver M. Sieber
Modern Pathology.2020; 33(7): 1420. CrossRef
Prognostic value of KRAS mutation status in colorectal cancer patients: a population-based competing risk analysis
Dongjun Dai, Yanmei Wang, Liyuan Zhu, Hongchuan Jin, Xian Wang
PeerJ.2020; 8: e9149. CrossRef
Implication of Microsatellite Instability in Chinese Cohort of Human Cancers

Meiying Cui, Pan Li, Ying Mao, Lan Zhang, Peiyi Xia, Enjie Liu, Weiwei Wang, Jianying Zhang, Guozhong Jiang, Wencai Li
Cancer Management and Research.2020; Volume 12: 10287. CrossRef
Outcomes for Metastatic Colorectal Cancer Based on Microsatellite Instability: Results from the South Australian Metastatic Colorectal Cancer Registry
Li Chia Chong, Amanda Rose Townsend, Joanne Young, Amitesh Roy, Cynthia Piantadosi, Jennifer E. Hardingham, David Roder, Christos Karapetis, Robert Padbury, Guy Maddern, James Moore, Timothy Jay Price
Targeted Oncology.2019; 14(1): 85. CrossRef
Signet ring cell colorectal cancer: genomic insights into a rare subpopulation of colorectal adenocarcinoma
Krittiya Korphaisarn, Van Morris, Jenifer S. Davis, Michael J. Overman, David R. Fogelman, Bryan K. Kee, Arvind Dasari, Kanwal P. S. Raghav, Imad Shureiqi, Metha Trupti, Robert A. Wolff, Cathy Eng, David G. Menter, Stanley Hamilton, Scott Kopetz
British Journal of Cancer.2019; 121(6): 505. CrossRef
SILAC-Based Quantification of TGFBR2-Regulated Protein Expression in Extracellular Vesicles of Microsatellite Unstable Colorectal Cancers
Fabia Fricke, Malwina Michalak, Uwe Warnken, Ingrid Hausser, Martina Schnölzer, Jürgen Kopitz, Johannes Gebert
International Journal of Molecular Sciences.2019; 20(17): 4162. CrossRef
Is microsatellite instability-high really a favorable prognostic factor for advanced colorectal cancer? A meta-analysis
Bingyan Wang, Fei Li, Xin Zhou, Yanpeng Ma, Wei Fu
World Journal of Surgical Oncology.2019;[Epub] CrossRef
Cáncer de colon en Colombia, fenotipo molecular: tamizaje para síndromes con agregación familiar
Mabel Elena Bohórquez L, Ángel Alexandro Criollo R, Luis Carvajal Carmona, María Magdalena Echeverry de Polanco
Revista de la Asociación Colombiana de Ciencias Biológicas.2019; : 87. CrossRef
Evaluation of Long-Term Outcomes of Microsatellite Instability Status in an Asian Cohort of Sporadic Colorectal Cancers
Winson Jianhong Tan, Julie Liana Hamzah, Sanchalika Acharyya, Fung Joon Foo, Kiat Hon Lim, Iain Bee Huat Tan, Choong Leong Tang, Min Hoe Chew
Journal of Gastrointestinal Cancer.2018; 49(3): 311. CrossRef
What are the Clinicopathological Features and Outcomes of Sporadic Colorectal Cancer (CRC) in an Ethiopian Cohort with focus on young-onset CRC?
Dominic Worku
Journal of Cancer Prevention & Current Research.2017;[Epub] CrossRef
Mismatch Repair Proteins and Microsatellite Instability in Colorectal Carcinoma (MLH1, MSH2, MSH6 and PMS2): Histopathological and Immunohistochemical Study
Nour El Hoda S. Ismael, Samar A. El Sheikh, Suzan M. Talaat, Eman M. Salem
Open Access Macedonian Journal of Medical Sciences.2017; 5(1): 9. CrossRef
Impact of Microsatellite Instability in Signet-Ring Cell and Mucinous Components in Patients With Colorectal Carcinoma
Ik Yong Kim
Annals of Coloproctology.2016; 32(2): 45. CrossRef

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

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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.

Methods

From 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.

Results

The 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.

Conclusion

Postoperative 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

Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study: Tae Jung Kim, In Kyu Lee, Jong Kyung Park, Yoon Suk Lee, Youn Si, Hun Jung, Hyung Jin Kim, Sang Chul Lee, Dae Young Cheung, Lee D. Gorden, Seung Taek Oh; J Korean Soc Coloproctol. 2011;27(4):188-193. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.188

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13 Citations

Abstract PDF

Purpose

The goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment.

Methods

This study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included.

Results

The period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery.

Conclusion

Conservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

Citations

Citations to this article as recorded by

Unusual Variations and Atypical Presentations of Diverticulitis
Sarah Kling, Simran Kripalani, Joceline V. Vu
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
The outcomes of right-sided and left-sided colonic diverticulitis following non-operative management: a systematic review and meta-analysis
Sih-Shiang Huang, Chih-Wei Sung, Hsiu-Po Wang, Wan-Ching Lien
World Journal of Emergency Surgery.2022;[Epub] CrossRef
Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature
Isabelle Uhe, Jeremy Meyer, Manuela Viviano, Surrennaidoo Naiken, Christian Toso, Frédéric Ris, Nicolas C. Buchs
Colorectal Disease.2021; 23(10): 2515. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Recurrence of Acute Right Colon Diverticulitis Following Nonoperative Management: A Systematic Review and Meta-analysis
Yongjin F. Lee, Dalun D. Tang, Samik H. Patel, Michael A. Battaglia, Beth-Ann Shanker, Robert K. Cleary
Diseases of the Colon & Rectum.2020; 63(10): 1466. CrossRef
Reste-t-il des indications pour la chirurgie à froid ?
B. Schiltz, C. Dumont, N. C. Buchs, Ph. Morel, F. Ris
Côlon & Rectum.2017; 11(1): 25. CrossRef
Right colonic diverticulitis in Caucasians: presentation and outcomes versus left-sided disease
Laura Valbousquet Schneider, Ingrid Millet, Isabelle Boulay-Coletta, Patrice Taourel, Jérôme Loriau, Marc Zins
Abdominal Radiology.2017; 42(3): 810. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack
Hyoung-Chul Park, Byung Seup Kim, Kwanseop Lee, Min Jeong Kim, Bong Hwa Lee
International Journal of Colorectal Disease.2014; 29(10): 1217. CrossRef
Solitary Cecal Diverticulitis: An Unusual Cause of Acute Right Iliac Fossa Pain—A Case Report and Review of the Literature
Nikolaos Mudatsakis, Marinos Nikolaou, Konstantinos Krithinakis, Michail Matalliotakis, Nikolaos Politis, Emmanouil Andreadakis
Case Reports in Surgery.2014; 2014: 1. CrossRef
Prediction and management of recurrent right colon diverticulitis
Sun Min Park, Taek Soo Kwon, Dong Jin Kim, Yoon Suk Lee, Dae Young Cheung, Seong Taek Oh, Jun-Gi Kim, In Kyu Lee
International Journal of Colorectal Disease.2014; 29(11): 1355. CrossRef
Mesalamine Did Not Prevent Recurrent Diverticulitis in Phase 3 Controlled Trials
Jeffrey B. Raskin, Michael A. Kamm, M. Mazen Jamal, Juan Márquez, Ehud Melzer, Robert E. Schoen, Tibor Szalóki, Karen Barrett, Paul Streck
Gastroenterology.2014; 147(4): 793. CrossRef

Clinical Trial

Prognostic Value of Erythrocyte Sedimentation Rate in Patients with Colorectal Cancer.: Kim, Young Ki , Hong, Seong Woo , Chun, Jung Woo , Chang, Yeo Goo , Paik, In Wook , Lee, Hyucksang; J Korean Soc Coloproctol. 2008;24(5):351-356.; DOI: https://doi.org/10.3393/jksc.2008.24.5.351

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Abstract PDF: PURPOSE
Prognostic indicators are used increasingly in clinical trials and to guide surveillance for patients with colorectal cancer (CRC). The significance of a preoperative, elevated erythrocyte sedimentation rate (ESR) as a predictive indicator for malignancy and for prognosis in colorectal cancer has not been elucidated. Hence, the current study was conducted to evaluate the ESR as a prognostic indicator in patients with CRC.
METHODS
This study enrolled 232 patients who underwent surgery in our hospital between 1997 and 2004. ESR with clinicopathologic features and overall survival were evaluated retrospectively.
RESULTS
The ESRs of 139 patients were elevated, and those of 93 patients were normal. Elevated ESR was associated with the male gender, decreased hemoglobin, increased platelet count, high preoperative CEA, high preoperative CA19-9, tumor size (> or =5 cm), T stage, and TNM stage. Patients with elevated ESR had poorer survival (P=0.001), but a multivariate analysis did not reveal an elevated ESR as an independent factor for prognosis.
CONCLUSIONS
Preoperative elevation of ESR in patients with CRC suggests the presence of a tumor with aggressive behavior and a poor outcome.

Case Report

Neutropenic Enterocolitis after Chemotherapy for Colon Cancer.: Chun, Jung Woo , Hong, Seong Woo , Chang, Yeo Goo , Lee, Hye Kyoung , Lee, Hyucksang; J Korean Soc Coloproctol. 2006;22(1):62-65.

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Abstract PDF: Neutropenic enterocolitis is observed in approximately 10~46% of patients with acute leukemia, as well as in patients with other diseases, like acquired immunodeficiency syndrom (AIDS), that lead to profound neutropenia. Patients who become neutropenic after combined chemotherapy are at special risk of developing neutropenic enterocolitis. With the recently increasing numbers of patients with solid tumors treated with high-dose chemotherapy, the frequency of this disease is expected to increase. However, this disease has been rarely reported in patients with colon cancer treated with leucovorin and 5-fluorouracil for adjuvant chemotherapy. We report a case of neutropenic enterocolitis after a treatment of 5-fluorouracil and leucovorin for sigmoid colon cancer.

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