Predicting venous thromboembolism and determining appropriate prophylaxis in elderly patients undergoing colorectal cancer surgery with Enhanced Recovery After Surgery (ERAS) using the adjusted Caprini score Young Sun Choi, Hyung Jin Cho, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Tae Gyu Kim Annals of Coloproctology.2025; 41(4): 279. CrossRef
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Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.
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Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer.
Methods
We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR.
Results
There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR ≤ 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 ≥ LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor.
Conclusions
LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.
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The prognostic performance of the log odds of positive lymph nodes in patients with esophageal squamous cell carcinoma: A population study of the US SEER database and a Chinese single‐institution cohort Hongdian Zhang, Wanyi Xiao, Peng Ren, Kai Zhu, Ran Jia, Yueyang Yang, Lei Gong, Zhentao Yu, Peng Tang Cancer Medicine.2021; 10(17): 6149. CrossRef
Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer Giovanni Li Destri, Giuseppe Privitera, Gaetano La Greca, Roberto Scilletta, Antonio Pesce, Teresa Rosanna Portale, Erminia Conti, Stefano Puleo International Surgery.2021; 105(1-3): 122. CrossRef
Rectal cancers with microscopic circumferential resection margin involvement (R1 resections): Survivals, patterns of recurrence, and prognostic factors Gianpiero Gravante, David Hemingway, James Andrew Stephenson, David Sharpe, Ahmed Osman, Melissa Haines, Vafa Pirjamali, Roberto Sorge, Justin Ming Yeung, Michael Norwood, Andrew Miller, Kirsten Boyle Journal of Surgical Oncology.2016; 114(5): 642. CrossRef
Prognostic Impact of the Metastatic Lymph Node Ratio on Survival in Rectal Cancer Wafi Attaallah, Omer Gunal, Manuk Manukyan, Gulden Ozden, Cumhur Yegen Annals of Coloproctology.2013; 29(3): 100. CrossRef
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An appraisal of lymph node ratio in colon and rectal cancer: not one size fits all M. Medani, Niall Kelly, George Samaha, G. Duff, Vourneen Healy, Elizabeth Mulcahy, Eoghan Condon, David Waldron, Jean Saunders, J. Calvin Coffey International Journal of Colorectal Disease.2013; 28(10): 1377. CrossRef
The lung is the second most common site of metastasis from colorectal cancer. Of all patients who undergo a curative resection for colorectal cancer, 10% to 15% will develop lung metastasis. As a hepatic resection of colorectal liver metastases results in improved survival, many reports have suggested that a pulmonary resection of a colorectal lung metastasis would also improve survival. The aim of this study was to analyze the postoperative outcomes of and the prognostic factors for a surgical resection of a lung metastasis.
Methods
Between August 1997 and March 2006, 27 patients underwent surgical resections for colorectal lung metastases at Seoul St. Mary's hospital. A retrospective review of patients' characteristics and various tumor factors was performed.
Results
The mean interval between colorectal resection and lung metastasis was 24.0 ± 15.1 months. The overall 3- and 5-year survival rates were 76.5% and 22.2%, respectively. The mean follow-up after pulmonary resection was 39.5 ± 21.6 months (range, 3.3 to 115 months). Except for the existence of hilar-lymph-node metastasis (P < 0.001), no risk factors that we studied were statistically significant. Two patients had hilar-lymph-node metastasis. They survived for only for 3.3- and 11.6-months, respectively.
Conclusion
In our study, we found that a pulmonary resection for metastases from colorectal cancer may improve survival in selected patients.
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Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms, though they cover more than 90% of the intestinal surface. However, diagnosis and treatment are difficult and present an ongoing challenge for both gastrointestinal surgeons and gastroenterologists. The aim of this study was to investigate the clinical features of small bowel tumors.
Methods
Between November 1994 and November 2007, 81 patients underwent treatments for primary tumors in the jejuno-ileal region at the Department of Surgery, Kangnam St. Mary's Hospital, the Catholic University of Korea. A retrospective review of the patients' characteristics and variable tumor factors was performed.
Results
The mean age of the patients was 53.2 years with 48 men and 33 women. The most common symptom was abdominal pain (59.3%), followed by bleeding (22.2%) and an abdominal mass (6.2%). We found that the patients with ileal tumors complained mainly of abdominal pain (72.9%) whereas the patients with jejunal tumors presented with gastrointestinal bleeding (36.4%) (P = 0.048). Seventy-six of the 81 patients (93.8%) had malignant tumors, including 40 (49.4%) gastrointestinal stromal tumors, 26 (32.1%) lymphomas and 5 (6.2%) adenocarcinomas. No postoperative mortalities were observed. The overall 5-year survival rate of the patients with malignant small bowel tumors was 31.8%.
Conclusion
Because the clinical features of a primary tumor of the small bowel are obscure and its diagnosis is difficult, maintaining a high degree of suspicion and recognizing the possibility of a primary small bowel tumor are important.
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