Annals of Coloproctology

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Original Articles

Colorectal cancer

Evaluation of the utility of a nomogram for predicting lymph node metastasis in T1 colorectal cancer in shared decision-making in clinical practice: a survey-based study: Hyeon Seung Kim, Kyung Su Han, Min Wan Lee, Dae Kyung Sohn, Chang Won Hong, Dong Woon Lee, Kiho You, Sung Chan Park, Byung Chang Kim, Bun Kim, Jae Hwan Oh; Ann Coloproctol. 2025;41(4):303-309. Published online August 25, 2025; DOI: https://doi.org/10.3393/ac.2025.00318.0045

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Abstract PDF: Purpose
In 2019, we reported a novel nomogram to predict lymph node metastasis (LNM) in T1 colorectal cancer. Herein, we conducted a survey-based study to evaluate the clinical utility of this nomogram in determining the need for additional surgery after endoscopic resection for high-risk T1 colorectal cancer.
Methods
A survey was conducted among 77 members of the Korean Society of Coloproctology and 25 members of the Korean Society of Gastrointestinal Endoscopy. The survey assessed decision-making regarding additional surgery after endoscopic resection for high-risk T1 colorectal cancer according to various predicted LNM rates (3%, 10%, and 27%) and tumor locations (anal verge [AV] 2, 7, and 25 cm). Additionally, participants provided feedback regarding the reliability, usefulness, and potential adoptability of the prediction model in patient counseling.
Results
Of the 2,314 surveys distributed, 102 responses were analyzed. A trend was observed in which tumors located closer to the anus and associated with a lower predicted risk of LNM were less likely to lead respondents to opt for surgery (e.g., AV 2 cm and 3% of predicted LNM risk, 21.6% opt for surgery vs. AV 25 cm and 27% of predicted LNM risk, 98.0% opt for surgery). Additionally, 94.1% of the respondents reported that the prediction model would be helpful in clinical decision-making and patient counseling.
Conclusion
Our findings suggest that the nomogram is an effective and reliable tool for guiding treatment strategies and enhancing consultations in patients with T1 colorectal cancer.

Colorectal cancer

Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer: Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh; Ann Coloproctol. 2024;40(1):62-73. Published online February 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00094.0013

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Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.
Methods
This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.
Results
In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.
Conclusion
LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.

Citations

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Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
Eun Jung Park
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Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef

Translational/basic research

Exfoliate cancer cell analysis in rectal cancer surgery: comparison of laparoscopic and transanal total mesorectal excision, a pilot study: Kiho You, Jung-Ah Hwang, Dae Kyung Sohn, Dong Woon Lee, Sung Sil Park, Kyung Su Han, Chang Won Hong, Bun Kim, Byung Chang Kim, Sung Chan Park, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):502-512. Published online December 26, 2023; DOI: https://doi.org/10.3393/ac.2023.00479.0068

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Graphical Abstract Abstract PDF Supplementary Material: Purpose
Minimally invasive surgery (MIS) is currently the standard treatment for rectal cancer. However, its limitations include complications and incomplete total mesorectal resection (TME) due to anatomical features and technical difficulties. Transanal TME (TaTME) has been practiced since 2010 to improve this, but there is a risk of local recurrence and intra-abdominal contamination. We aimed to analyze samples obtained through lavage to compare laparoscopic TME (LapTME) and TaTME.
Methods
From June 2020 to January 2021, 20 patients with rectal cancer undergoing MIS were consecutively and prospectively recruited. Samples were collected at the start of surgery, immediately after TME, and after irrigation. The samples were analyzed for carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) through a quantitative real-time polymerase chain reaction. The primary outcome was to compare the detected amounts of CEA and CK20 immediately after TME between the surgical methods.
Results
Among the 20 patients, 13 underwent LapTME and 7 underwent TaTME. Tumor location was lower in TaTME (7.3 cm vs. 4.6 cm, P=0.012), and negative mesorectal fascia (MRF) was more in LapTME (76.9% vs. 28.6%, P=0.044). CEA and CK20 levels were high in 3 patients (42.9%) only in TaTME. There was 1 case of T4 with incomplete purse-string suture and 1 case of positive MRF with dissection failure. All patients were followed up for an average of 32.5 months without local recurrence.
Conclusion
CEA and CK20 levels were high only in TaTME and were related to tumor factors or intraoperative events. However, whether the detection amount is clinically related to local recurrence remains unclear.

Colorectal cancer

Stratification of rate of lymph node metastasis according to risk factors and oncologic outcomes in patients who underwent radical resection for rectal neuroendocrine tumors: Myung Jae Jin, Sung Sil Park, Dong-Eun Lee, Sung Chan Park, Dong Woon Lee, Kiho You, Hee Jin Chang, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):467-473. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2022.00913.0130

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Abstract PDF Supplementary Material

Purpose
Most predictive factors for lymph node metastasis in rectal neuroendocrine tumors (NETs) have been based on local and endoscopic resection. We aimed to evaluate the risk factors for lymph node metastasis in patients who underwent radical resection for rectal NETs and stratify the risk of lymph node metastasis.
Methods
Sixty-four patients who underwent radical resection for rectal NETs between January 2001 and January 2018 were included. We investigated the risk factors of lymph node metastasis using clinicopathologic data. We also performed a risk stratification for lymph node metastases using the number of previously known risk factors. For oncologic outcomes, the 5-year overall survival and recurrence-free survival were evaluated in both groups.
Results
Among the patients who underwent radical surgery, 32 (50.0%) had lymph node metastasis and 32 (50.0%) had non–lymph node metastasis. In the multivariable analysis, only the male sex was identified as a risk factor for lymph node metastasis (odds ratio, 3.695; 95% confidence interval, 1.128–12.105; P=0.031). When there were 2 or more known risk factors, the lymph node metastasis rate was significantly higher than when there were one or no risk factors (odds ratio, 3.667; 95% confidence interval, 1.023–13.143; P=0.046). There was also no statistical difference between the 2 groups in 5-year overall survival (P=0.431) and 5-year recurrence-free survival (P=0.144).
Conclusion
We found that the rate of lymph node metastasis increased significantly when the number of known risk factors is 2 or more.

Citations

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Lateral pelvic lymph nodes dissection of rectal neuroendocrine neoplasms: A prospective case-series and literature review
Yueyang Zhang, Yi Yang, Changyuan Gao, Hong Zhao, Haitao Zhou
Surgery.2024; 176(5): 1360. CrossRef

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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Abstract PDF Supplementary 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.

Citations

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MRI-based scoring systems for selective lateral lymph node dissection in locally advanced low rectal cancer after neoadjuvant chemoradiotherapy
Min Jeong Cho, Kyunghwa Han, Hye Jung Shin, Woong Sub Koom, Kang Young Lee, Joo Hee Kim, Joon Seok Lim
European Radiology.2025; 35(8): 4967. CrossRef
Feasibility and limitations of combined treatment for lateral pelvic lymph node metastases in rectal cancer
Ying-Zi Zheng, Fang-Fang Yan, Lian-Xiang Luo
World Journal of Clinical Oncology.2024; 15(5): 591. CrossRef
Totally Extraperitoneal Approach for Recurrent Lateral Pelvic Lymph Nodes After Rectal Cancer Surgery
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
Identification of lateral pelvic nodes without metastasis in patients with rectal cancer treated with preoperative chemoradiotherapy or chemotherapy based on magnetic resonance imaging
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
Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement
Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang
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Literature research on the low rectal cancer complicated with lateral pelvic lymph node metastasis
Miao He, Jing Fan
Asian Journal of Surgery.2024; 47(10): 4575. CrossRef
Innovációk a colorectalis sebészetben
Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
Orvosi Hetilap.2024; 165(2): 43. CrossRef
Meta-analysis of the efficacy and safety of robot-assisted comparative laparoscopic surgery in lateral lymph node dissection for rectal cancer
Hao Shi, Xianhao Yi, Xin Yan, Wenjie Wu, Hui Ouyang, Chengke Ou, Xiangheng Chen
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
Short-term outcomes of 47 selective laparoscopic lymph node dissection for rectal cancer: A retrospective study
Xiajuan Xue, Shuijie Lin, Qunzhang Zeng, Yincong Guo
Medicine.2024; 103(43): e39684. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
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
Diseases of the Colon & Rectum.2023; 66(12): e1246. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
In Ja Park
The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer
Hyo Seon Ryu, Jin Kim
Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer
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 Korean Medical Association.2022; 65(9): 558. CrossRef
Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. 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
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
Sung Uk Bae
Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
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Malignant disease, Rectal cancer,Prognosis

Initial local excision for clinical T1 rectal cancer showed comparable overall survival despite high local recurrence rate: a propensity-matched analysis: Jong Hee Hyun, Mohamed K. Alhanafy, Hyoung-Chul Park, Su Min Park, Sung-Chan Park, Dae Kyung Sohn, Duck-Woo Kim, Sung-Bum Kang, Seung-Yong Jeong, Kyu Joo Park, Jae Hwan Oh, on behalf of the Seoul Colorectal Research Group (SECOG); Ann Coloproctol. 2022;38(2):166-175. Published online October 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00479.0068

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Abstract PDF

Purpose
Local excision (LE) is an alternative initial treatment for clinical T1 rectal cancer, and has avoided potential morbidity. This study aimed to evaluate the clinical outcomes of LE compared with total mesorectal excision (TME) for clinical T1 rectal cancer.
Methods
Between January 2000 and December 2011, we retrospectively reviewed from multicenter data in patients with clinically suspected T1 rectal cancer treated with either LE or TME. Of 1,071 patients, 106 were treated with LE and 965 were treated with TME. The data were analyzed using propensity score matching, with each group comprising 91 patients.
Results
After propensity score matching, the median follow-up time was 60.8 months (range, 0.6–150.6 months). After adjustment for the necessary variables, patients who underwent LE showed a significantly higher local recurrence rate than did those who underwent TME; however, there were no differences in disease-free survival and overall survival. In the multivariate analysis, age (hazard ratio [HR], 9.620; 95% confidence interval [CI], 3.415–27.098; P<0.001) and angiolymphatic invasion (HR, 3.63; 95% confidence interval, 1.33–9.89; P=0.012) were independently associated with overall survival. However, LE was neither associated with overall survival nor disease-free survival.
Conclusion
LE for clinical T1 rectal cancer yielded a higher local recurrence rate than did TME. Nevertheless, LE provided comparable overall survival rate and can be proposed as an optional treatment in terms of organ-preserving strategies.

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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
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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Survival prognostic in different age groups of patients undergoing local versus radical excision for rectal cancer: a study based on the SEER database
Jinghui Li, Liang Wen, Yongli Ma, Guosheng Zhang, Ping Wang, Chengzhi Huang, Xueqing Yao
Updates in Surgery.2024; 76(3): 975. 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
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
The risk-benefit trade-off in local excision of early rectal cancer
Chang Hyun Kim
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Case Report

Benign GI diease

Small Bowel Perforation Associated With Gastrointestinal Graft-Versus-Host Disease and Cytomegalovirus Enteritis in a Patient With Leukemia: A Case Report With Literature Review: Kwang-Seop Song, Min Jung Kim, Han-Ki Lim, Yoon Hwa Hong, Sung Sil Park, Chang Won Hong, Sung Chan Park, Dae Kyung Sohn, Kyung Su Han, Jae Hwan Oh; Ann Coloproctol. 2020;36(4):281-284. Published online August 31, 2020; DOI: https://doi.org/10.3393/ac.2018.10.01.1

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Gastrointestinal graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation. Concomitant cytomegalovirus (CMV) enteritis worsens the prognosis of this condition. We report a case of small bowel perforation associated with gastrointestinal GVHD and CMV enteritis in a patient with leukemia who was successfully treated surgically. A 39-year-old man presented with intestinal perforation necessitating emergency surgical intervention. He was diagnosed with T-cell acute lymphoblastic leukemia and developed severe gastrointestinal GVHD and CMV enteritis after hematopoietic stem cell transplantation. His terminal ileum showed a perforation with diffuse wall thinning, and petechiae were observed over long segments of the distal ileum and the proximal colon. Small bowel segmental resection and a subtotal colectomy with a double-barreled ileocolostomy were performed. The patient recovered uneventfully after the operation. Based on reports described in the literature, surgery plays a minor role in the management of gastrointestinal GVHD; however, timely surgical intervention could be effective in selected patients.

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Cytomegalovirus enteritis resistant to antiviral drugs improved following total colectomy
Sae Kawata, Jumpei Takamatsu, Yuichi Yasue, Aya Fukuhara, Jinkoo Kang
Surgical Case Reports.2023;[Epub] CrossRef

Original Articles

Malignant disease

Long-term Oncologic Outcome and Its Relevant Factors in Anal Cancer in Korea: A Nationwide Data Analysis: Hyuk Hur, Kyu-Won Jung, Byung-Woo Kim, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim; Ann Coloproctol. 2020;36(1):35-40. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.07.17

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Abstract PDF Supplementary Material

Purpose
Anal cancer is a rare disease in Korea, and thus survival analyses are limited by small sample sizes. This study used the Korea Central Cancer Registry (KCCR) for a survival analysis and for assessing characteristics of anal cancer in a large sample of Koreans.
Methods
From the KCCR, data on 3,615 patients who were diagnosed and treated for anal cancer from 1993 to 2015 were retrieved. Clinicopathologic variables including age, sex, histological type, and Surveillance Epidemiology and End Results (SEER) stage were reviewed, and a survival analysis was performed according to these variables.
Results
The 5-year relative survival rate improved from 39.7% in 1993–1995 to 66.5% in 2011–2015. Squamous cell carcinoma was the most common and showed the highest survival rate. Males and older patients (≥40 years and ≥70 years) showed poor prognoses.
Conclusion
The survival rate for anal cancer in Korea has improved steadily over time. The characteristics related to survival were the histological type, sex, and age. These statistics will be fundamental for future Korean anal cancer research.

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Risk of Anorectal Cancer Associated with Benign Anal Inflammatory Diseases: A Retrospective Matched Cohort Study
Wonjeong Chae, Seung Yeon Kang, Sung-In Jang, Yoon Dae Han
International Journal of Environmental Research and Public Health.2022; 19(12): 7467. CrossRef
Immune Checkpoint Blockade in Lower Gastrointestinal Cancers: A Systematic Review
K. C. Wilson, M. P. Flood, D. Oh, N. Calvin, M. Michael, R. G. Ramsay, A. G. Heriot
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Acknowledging the Unsung Role of the Cancer Registry in Rare Cancers
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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

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Abstract 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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Alpaslan Tanoglu, Esra Guzel Tanoglu, Erdal Polat, Muhammed Fevzi Esen, Nagehan Ozdemir Barisik
Brazilian Archives of Biology and Technology.2024;[Epub] CrossRef
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Mehdi Karimi, Niyousha Shirsalimi, Eshagh Sedighi
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Hyun-Chang Kim, Jinyoung Park, Jinyoung Oh, Minjae Kim, Eun Jung Park, Seung Hyuk Baik, Young Song
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Guillaume Economos, Vahan Kepenekian, Cécile Barbaret, Laurent Villeneuve, Julie Haesebaert, Olivier Glehen
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Suk Jun Lee, Youngbae Jeon, Hae Won Lee, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
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Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection: Jung Ho Park, Hyoung-Chul Park, Sung Chan Park, Jae Hwan Oh, Duck-Woo Kim, Sung-Bum Kang, Seung Chul Heo, Min Jung Kim, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park, for the Seoul Colorectal Group (SECOG); Ann Coloproctol. 2018;34(6):286-291. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.10.29

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Abstract PDF

Purpose
Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer.
Methods
From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS.
Results
The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1–134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19–1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29–2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08–2.15; P < 0.01) and a high (≥0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63–5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC.
Conclusion
Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

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Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer
Shuanhu Wang, Yakui Liu, Yi Shi, Jiajia Guan, Mulin Liu, Wenbin Wang
Journal of International Medical Research.2021;[Epub] CrossRef

Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator: Jung Ryul Oh, Sung Chan Park, Sung Sil Park, Beonghoon Sohn, Hyoung Min Oh, Bun Kim, Min Jung Kim, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Jae Hwan Oh; Ann Coloproctol. 2018;34(6):292-298. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.04.06

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Abstract PDF

Purpose
This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator.
Methods
From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery.
Results
Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size.
Conclusion
RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

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Review

Lateral Lymph Node Dissection With the Focus on Indications, Functional Outcomes, and Minimally Invasive Surgery: Min Jung Kim, Jae Hwan Oh; Ann Coloproctol. 2018;34(5):229-233. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.10.26

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Abstract PDF

The lateral lymph node dissection (LLND) is still a subject of great debate as to the appropriate treatment for patients with mid to low advanced rectal cancer. The guidelines of the Japanese Society for Cancer of the Colon and Rectum recommend a LLND for patients with T3/4 rectal cancer below the peritoneal reflection. However, in most Western countries, a routine LLND is not recommended unless a node or nodes are clinically suspicious for metastasis. Even after preoperative chemoradiotherapy (CRT), an 8% to 12% lateral pelvic recurrence was noted. The size of the lateral lymph node and responsiveness to preoperative CRT should be the main factors for selecting appropriate patients to undergo a LLND. In addition, from the recent literature, a laparoscopic LLND is safe and oncologically feasible and might have some advantages in short-term outcomes.

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Original Articles

Optimal Time Interval for Surgery After Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer: Analysis of Health Insurance Review and Assessment Service Data: Min Jung Kim, Jin Suk Cho, Eun Mi Kim, Woo Ah Ko, Jae Hwan Oh; Ann Coloproctol. 2018;34(5):241-247. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.01.01

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Abstract PDF

Purpose
Pathologic downstaging of rectal cancer has been suggested to be associated with the time interval from chemoradiotherapy (CRT) completion to surgery. We aimed to evaluate the effect of this time interval for patients with rectal cancer on the pathologic response.
Methods
All patients with rectal cancer undergoing neoadjuvant CRT with evaluable data were selected from among the Health Insurance Review and Assessment Service data. Patients were divided into groups according to the time between CRT and surgery. CRT responses were analyzed.
Results
Two hundred forty-nine patients were included, of whom 86 (34.5%) were in the 5- to 7-week interval, 113 (45.4%) in the 7- to 9-week interval, 38 (15.3%) in the 9- to 11-week interval, and 12 (4.8%) in the >11-week interval. The median time interval between CRT completion and surgery was 7.4 weeks (range: 5–22.7 weeks; interquartile range, 6.7–8.7 weeks). Surgery 9–11 weeks after CRT completion resulted in the highest, but not statistically significant, pathologic complete response (pCR) rate (3 patients, 8.6%; P = 0.886), no pCR was noted in the >11-week interval group. Results for downstaging in the 9- to 11-week interval group were as follows: T downstaging, 38.2% (P = 0.735); N downstaging, 50.0% (P = 0.439); and TN downstaging, 52.9% (P = 0.087). The 3-year overall survival rates for the 5- to 7-week, 7- to 9-week, 9- to 11-week, and >11-week interval groups were 93.0%, 85.0%, 81.6%, and 91.7%, respectively (P = 0.326).
Conclusion
Delaying surgery by 9 to 11 weeks may increase TN downstaging, but delaying for over 11 weeks may not increase additional tumor downstaging from long-course CRT.

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Characteristics and Survival of Korean Patients With Colorectal Cancer Based on Data From the Korea Central Cancer Registry Data: Hyuk Hur, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim; Ann Coloproctol. 2018;34(4):212-221. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.08.02.1

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Abstract PDF

Purpose
The incidence of colorectal cancer (CRC) in Korea has increased remarkably during the past few decades. The present study investigated the characteristics and survival of patients with CRC in Korea as a function of time, tumor distribution, stage, sex, and age.
Methods
We retrieved clinical data on 326,712 CRC patients diagnosed between 1996 and 2015 from the Korea Central Cancer Registry. The incidence and the 5-year relative survival rates were compared across time period, tumor distribution, stage, sex, and age group.
Results
The percentage of patients with colon cancer increased from 49.5% in 1996–2000 to 66.4% in 2011–2015 while the percentage of patients with rectal cancer decreased from 50.5% to 33.6%. The 5-year relative survival rates for all CRCs improved from 58.7% in 1996–2000 to 75.0% in 2011–2015. For 1996–2000, survival rates were highest for patients with left-sided colon cancers, followed by those with right-sided, transverse, rectal, rectosigmoid cancers. For 2011–2015, the survival rates for patients with left-sided cancers were highest, followed by those with rectosigmoid, rectal, transverse, and right-sided colon cancers. Patients with local and regional, but not distant, SEER (Surveillance, Epidemiology, and End Results) stage tumors experienced significantly increased survival rates for 2006–2010 and 2011–2015. The proportion of CRC patients by age decreased in the order ≥70, 60–69, 50–59, 40–49, ≤39 years whereas survival rates decreased in the order 50–59, 60–69, 40–49, ≤39, ≥70 years.
Conclusion
Korean CRC has some distinct characteristics and survival patterns in terms of tumor distribution, stage, sex, and age. With time, survival outcomes have improved for both local and regional, but not distant, stage tumors.

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Preoperative Colonoscopic Tattooing Using a Direct Injection Method with Indocyanine Green for Localization of Colorectal Tumors: An Efficacy and Safety Comparison Study
Young Jin Kim, Ji Won Park, Han-Ki Lim, Yoon-Hye Kwon, Min Jung Kim, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
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Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery: Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh; Ann Coloproctol. 2018;34(4):206-211. Published online July 26, 2018; DOI: https://doi.org/10.3393/ac.2017.09.25

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Abstract PDF

Purpose
The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods
Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results
The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion
Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.

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Editorial

Transanal Minimally Invasive Surgery After Chemoradiotherapy: Widening Scope of Indications for Local Excision: Min Jung Kim, Jae Hwan Oh; Ann Coloproctol. 2017;33(2):43-43. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.43

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PDF

Case Report

Mucosa-Associated Lymphoid-Tissue Lymphoma of the Cecum and Rectum: A Case Report: Myung Jin Nam, Byung Chang Kim, Sung Chan Park, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Weon Seo Park, Hee Jin Chang, Jae Hwan Oh; Ann Coloproctol. 2017;33(1):35-38. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.35

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Abstract PDF

A colonic mucosa-associated lymphoid-tissue (MALT) lymphoma is relatively rare compared to lymphomas of the stomach or small intestine. We present a case of a MALT lymphoma in the cecum and rectum found during screening colonoscopy. A 54-year-old female, who had undergone right-breast-conserving surgery with axillary dissection due to an invasive ductal carcinoma and a left-breast excisional biopsy due to microcalcification following adjuvant chemoradiation therapy 3 years earlier, was found to have 3-mm-sized smooth elevated lesions in both the cecum and rectum. No pathologic lesion or lymphadenopathy was found at any other site, but chronic gastritis negative for Helicobacter pylori infection was found. The polyps were removed by using an endoscopic biopsy and revealed an extra nodal marginal zone B-cell MALT lymphoma, showing positive for CD3 and CD20 by immunohistochemical staining. The patient underwent close observation without any additional treatment and has shown no evidence of recurrence as of her last visit.

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Original Articles

Importance of Early Follow-up Colonoscopy in Patients at High Risk for Colorectal Polyps: Sung Taek Jung, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Ji Won Park, Kyung Su Han, Hee Jin Chang, Hyo Sung Choi, Jae Hwan Oh; Ann Coloproctol. 2013;29(6):243-247. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.243

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5 Citations

Abstract PDF

Purpose

Minimizing the polyp miss rate during colonoscopy is important for patients at high risk for colorectal polyps. We investigated the polyp miss rate and the factors associated with it in high-risk patients.

Methods

The medical records of 163 patients who underwent follow-up colonoscopy between January 2001 and April 2010, which was within 9 months after a polypectomy, because the index colonoscopy had shown multiple (more than 3) adenomas or advanced adenoma were retrospectively reviewed. Miss rates were calculated for all polyps, for neoplastic polyps and for advanced adenomas. Factors associated with the miss rates in these patients, such as the location, shape and size of the polyp, were analyzed.

Results

The miss rates for polyps, adenomas, adenomas <5 mm, adenomas ≥5 mm and advanced adenomas were 32.6%, 20.9%, 17.7%, 3.2%, and 0.9%, respectively. No carcinoma, except for one small carcinoid tumor, was missed. Flat shape and small size (<5 mm) were significantly associated with adenoma miss rate. The miss rate was significantly higher for flat-type advanced adenomas than for protruded-type advanced adenomas (27.7% vs 4.1%).

Conclusion

The polyp miss rate in patients at high risk for colorectal polyps was higher than expected. Efforts are needed to reduce miss rates and improve the quality of colonoscopy. Also, early follow-up colonoscopy is mandatory, especially in patients at high risk.

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Martina Lösle, K. E. Grund, B. Duckworth-Mothes
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Mathivadani Vairavel, Ezhilarasan Devaraj, Rajeshkumar Shanmugam
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Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data: Hyoung-Chul Park, Kyu-Won Jung, Byung-Woo Kim, Aesun Shin, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee; Ann Coloproctol. 2013;29(5):182-185. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.182

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10 Citations

Abstract PDF

Purpose

In Korea, anal cancer is rare disease entity with specific clinical characteristics. Therefore, no survival analysis with a sufficient patient population has been performed. The aim of this study was to evaluate the characteristics of Korean anal cancer, focusing on the survival according to tumor histologies, sex, and a specific age group, using the nationwide cancer registry.

Methods

Using the Korea Central Cancer Registry, we analyzed a total of 2,552 cases from 1993 to 2010. We assessed the 5-year relative survival by using tumor histology. In addition, survival differences of Surveillance Epidemiology and End Results (SEER) stage were analyzed for both sexes and for young-age cancer (younger than 40 years) and advanced-age cancer (older than 70 years).

Results

The 5-year relative survival among anal cancer patients increased from 38.9% for the period 1993-1995 to 65.6% for the period 2006-2010. The anal squamous cell carcinoma was the most common histology and showed better survival than other types of cancer. Females demonstrated better survival than males in all SEER stages. The 5-year survivals for patients in whom anal cancer developed before the age of 40 and at or after the age of 40 were 62.4% and 51.6%, respectively. The 5-year survival for patients in whom cancer developed at or after the age of 70 was much worse than that for patients in whom the cancer had developed prior to that age.

Conclusion

Korean anal cancer has certain distinctive characteristics of survival according to tumor histology, sex, and age. Despite limitations on available data, this study used the nationwide database to provide important information on the survival of Korean patients with anal cancer.

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Dijing You, Jianchao Quan, David Bishai, Wendy Wing Tak Lam, Karen Ann Grépin, Linda Chan, Diana Dan Wu, David Ka Ki Wong, William Chi Wai Wong, Jiandong Zhou
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Long-term Oncologic Outcome and Its Relevant Factors in Anal Cancer in Korea: A Nationwide Data Analysis
Hyuk Hur, Kyu-Won Jung, Byung-Woo Kim, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim
Annals of Coloproctology.2020; 36(1): 35. CrossRef
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Oncologic outcomes of squamous cell carcinoma of the anal canal after chemoradiation therapy
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Asian Pacific Journal of Cancer Prevention.2015; 16(13): 5297. CrossRef
Reply on "Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data"
Hyoung-Chul Park, Bong Hwa Lee
Annals of Coloproctology.2014; 30(1): 56. CrossRef
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Peng-Lai Chen, Ting Zhao, Rui Feng, Jing Chai, Gui-Xian Tong, De-Bin Wang
Asian Pacific Journal of Cancer Prevention.2014; 15(15): 6327. CrossRef
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Mohammad Mohammadianpanah
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Nam Kyu Kim
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Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry: Hyoung-Chul Park, Aesun Shin, Byung-Woo Kim, Kyu-Won Jung, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee; Ann Coloproctol. 2013;29(4):144-149. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.144

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35 Citations

Abstract PDF

Purpose

The incidence rates of colorectal cancer (CRC) in Korea have been increasing during the past decade. Therefore, it is important to understand the characteristics, including survival, of Korean CRC patients. The aim of this study was to use the nationwide cancer registry to evaluate the characteristics of Korean CRC, focusing on the survival, according to tumor location, sex, and specific age groups.

Methods

Using the Korea Central Cancer Registry (KCCR), we analyzed a total of 226,352 CRC cases diagnosed from 1993 to 2010. The five-year relative survivals were compared for the proximal colon, the distal colon, and the rectum. Survival rates were compared between men and women and between patients of young age (less than 40 years old) and patients of advanced age (70 years old or older).

Results

The 5-year survival rates were improved in all subsites between 1993 and 2010. Distal colon cancer showed favorable survival compared to proximal colon or rectal cancer. Females demonstrated worse survival for local or regional cancers, and this difference was significant in for patients in their seventies. Young patients (<40 years old) showed better survival rates for overall and proximal colon cancer comparable to those for older patients (≥40 years old), but advanced age patients (≥70 years old) had worse survivals for all tumor subsites compared to their younger counterparts (<70 years old). These trends were similar in distant CRC.

Conclusion

Korean CRC has certain distinct characteristics of survival according to tumor location, sex, and age. Despite the limitations of available data, this study contributes to a better understanding of survival differences in Korean CRC.

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Investigation of Clinical Manifestations in Korean Colorectal Cancer Patients: Hye Young Koo, Kyu Joo Park, Jae Hwan Oh, Sung Bum Kang, Seong Taek Oh, Woo Yong Lee; Ann Coloproctol. 2013;29(4):139-143. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.139

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Abstract PDF

Purpose

Early diagnostic work-up in patients with clinical symptoms of colorectal cancer (CRC) is important to achieve good treatment results. In this study, we investigated clinical symptoms when a diagnosis of CRC was made in patients who had a surgical resection, especially focusing on the relevance of constipation to CRC.

Methods

The clinical symptoms of 17,415 CRC patients who had curative surgery from January 2010 to December 2012 were collected from 24 training hospitals of surgery.

Results

The number of symptomatic patients before the diagnosis of CRC was 11,085 (63.7%). Hematochezia or melena, abdominal pain, anemia, and constipation were more often found in female than male patients while bowel habit change was more common in male patients. Considering age, bowel habit change and hematochezia or melena were more common in patients younger than 60. Anemia and constipation, however, were more common in patients older than 60. According to the group classification based on age, patients older than 60 had experienced more constipation (P = 0.049). Moreover, patients with constipation tended to have a more advanced disease status (P < 0.001).

Conclusion

In patients who had surgery due to CRC, bleeding, abdominal pain, bowel habit change and constipation were the most frequent symptoms before diagnosis. Although whether or not constipation is a cause of CRC is unclear, it is one of the important clinical symptoms that presents in patients with CRC, and patients with a symptom of constipation tend to present with a more advanced CRC stage.

Citations

Citations to this article as recorded by

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Editorial

Should Abdominoperineal Excision Be Considered as the Initial Treatment for a Primary Anorectal Malignant Melanoma?: Jae Hwan Oh; J Korean Soc Coloproctol. 2011;27(1):4-4. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.4

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