Annals of Coloproctology

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Colorectal cancer

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; Ann Coloproctol. 2024;40(1):13-26. Published online February 28, 2024; DOI: https://doi.org/10.3393/ac.2023.00892.0127

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8 Citations

Purpose
The integration of artificial intelligence (AI) and magnetic resonance imaging in rectal cancer has the potential to enhance diagnostic accuracy by identifying subtle patterns and aiding tumor delineation and lymph node assessment. According to our systematic review focusing on convolutional neural networks, AI-driven tumor staging and the prediction of treatment response facilitate tailored treatment strategies for patients with rectal cancer.
Methods
This paper summarizes the current landscape of AI in the imaging field of rectal cancer, emphasizing the performance reporting design based on the quality of the dataset, model performance, and external validation.
Results
AI-driven tumor segmentation has demonstrated promising results using various convolutional neural network models. AI-based predictions of staging and treatment response have exhibited potential as auxiliary tools for personalized treatment strategies. Some studies have indicated superior performance than conventional models in predicting microsatellite instability and KRAS status, offering noninvasive and cost-effective alternatives for identifying genetic mutations.
Conclusion
Image-based AI studies for rectal cancer have shown acceptable diagnostic performance but face several challenges, including limited dataset sizes with standardized data, the need for multicenter studies, and the absence of oncologic relevance and external validation for clinical implantation. Overcoming these pitfalls and hurdles is essential for the feasible integration of AI models in clinical settings for rectal cancer, warranting further research.

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Artificial intelligence in CT for predicting lymph node metastasis in rectal cancer patients: a meta-analysis
D. Hou, H. Her, W. Han, X. Ge
Clinical Radiology.2026; 92: 107001. CrossRef
MRI to guide clinical management of rectal cancer: updated consensus recommendations from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR)—PART I primary staging
Juan-Ramón Ayuso, Svetlana Balyaniskova, Regina G. H. Beets-Tan, Ivana Blazic, Lennart Blomqvist, Damiano Caruso, Filippo Crimì, Luís Curvo-Semedo, Raphaëla C. Dresen, Marc J. Gollub, Vicky Goh, Kirsten Gormly, Sofia Gourtsoyianni, Bengi Gurses, Christine
European Radiology.2026;[Epub] CrossRef
Enhancing the role of MRI in rectal cancer: advances from staging to prognosis prediction
Xiaoling Gong, Zheng Ye, Yu Shen, Bin Song
European Radiology.2025; 35(9): 5714. CrossRef
Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review
In Ja Park
Ewha Medical Journal.2025; 48(3): e40. CrossRef
L’intelligence artificielle pourrait-elle aider le chirurgien digestif dans la prise en charge du cancer du rectum ?
Arnaud Alves, Karem Slim
Journal de Chirurgie Viscérale.2024; 161(4): 253. CrossRef
Can artificial intelligence help a digestive surgeon in management of rectal cancer?
Arnaud Alves, Karem Slim
Journal of Visceral Surgery.2024; 161(4): 231. CrossRef
Artificial intelligence for the colorectal surgeon in 2024 – A narrative review of Prevalence, Policies, and (needed) Protections
Kurt S. Schultz, Michelle L. Hughes, Warqaa M. Akram, Anne K. Mongiu
Seminars in Colon and Rectal Surgery.2024; 35(3): 101037. CrossRef
Artificial Intelligence in Coloproctology: A Review of Emerging Technologies and Clinical Applications
Joana Mota, Maria João Almeida, Miguel Martins, Francisco Mendes, Pedro Cardoso, João Afonso, Tiago Ribeiro, João Ferreira, Filipa Fonseca, Manuel Limbert, Susana Lopes, Guilherme Macedo, Fernando Castro Poças, Miguel Mascarenhas
Journal of Clinical Medicine.2024; 13(19): 5842. CrossRef

Benign proctology

A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence: Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son; Ann Coloproctol. 2022;38(3):183-196. Published online June 9, 2022; DOI: https://doi.org/10.3393/ac.2022.00276.0039

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6 Citations

Abstract PDF

The complexity in the molecular mechanism of the internal anal sphincter (IAS) limits preclinical or clinical outcomes of fecal incontinence (FI) treatment. So far, there are no systematic reviews of IAS translation and experimental studies that have been reported. This systematic review aims to provide a comprehensive understanding of IAS critical role in FI. Previous studies revealed the key pathway for basal tone and relaxation of IAS in different properties as follows; calcium, Rho-associated, coiled-coil containing serine/threonine kinase, aging-associated IAS dysfunction, oxidative stress, renin-angiotensin-aldosterone, cyclooxygenase, and inhibitory neurotransmitters. Previous studies have reported improved functional outcomes of cellular treatment for regeneration of dysfunctional IAS, using various stem cells, but did not demonstrate the interrelationship between those results and basal tone or relaxation-related molecular pathway of IAS. Furthermore, these results have lower specificity for IAS-incontinence due to the included external anal sphincter or nerve injury regardless of the cell type. An acellular approach using bioengineered IAS showed a physiologic response of basal tone and relaxation response similar to human IAS. However, in both cellular and acellular approaches, the lack of human IAS data still hampers clinical application. Therefore, the IAS regeneration presents more challenges and warrants more advances.

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A single-center retrospective analysis of endorectal advancement flaps used for the treatment of simple rectovaginal fistulas
Xuexiao Li, Wanjin Shao, Guidong Sun
Scandinavian Journal of Gastroenterology.2025; 60(4): 307. CrossRef
Anal sphincter reconstruction for fecal incontinence: Techniques, outcomes, and future directions
Hai-Liang Li, Hao-Ran Zhang, Yuan Wu, Kai-Qiang He, Tian-Jie Chen, Jing Wang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef
3D spheroids versus 2D-cultured human adipose stem cells to generate smooth muscle cells in an internal anal sphincter-targeting cryoinjured mouse model
Iltae Son, Minsung Kim, Ji-Seon Lee, Dogeon Yoon, You-Rin Kim, Ji Hye Park, Bo-Young Oh, Wook Chun, Sung-Bum Kang
Stem Cell Research & Therapy.2024;[Epub] CrossRef
Differentiation of Adipose-Derived Stem Cells into Smooth Muscle Cells in an Internal Anal Sphincter-Targeting Anal Incontinence Rat Model
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, You-Rin Kim, Wook Chun, Jong Wan Kim, Il Tae Son
Journal of Clinical Medicine.2023; 12(4): 1632. CrossRef
Improving Efficiency and Accuracy in English Translation Learning: Investigating a Semantic Analysis Correction Algorithm
Lingmei Cao, Junru Fu
Applied Artificial Intelligence.2023;[Epub] CrossRef

Original Article

Colorecal cancer

Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients: Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2023;39(5):410-420. Published online April 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00143.0020

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6 Web of Science
5 Citations

Graphical Abstract Abstract PDF

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.

Citations

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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
A predictive nomogram for assessing the likelihood of retrieving 12 lymph nodes after rectal cancer surgery: a single-center study
Jian Ma, Runyang Hao, Shuai Jiao, Qingmin Chen, Baohong Yang, Xu Guan, Jiale Li, Xinxuan Zhao, Yu Huo, Qingxia Xu, Haiyi Liu, Wen Su, Xishan Wang
Frontiers in Oncology.2025;[Epub] 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

Case Report

Intramural Recurrence Without Mucosal Lesions After an Endoscopic Mucosal Resection for Early Colorectal Cancer: Min Sung Kim, Nam Kyu Kim, Ji Hye Park; Ann Coloproctol. 2013;29(3):126-129. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.126

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7 Citations

Abstract PDF

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.

Citations

Citations to this article as recorded by

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
Growth-inhibition of S180 residual-tumor by combination of cyclophosphamide and chitosan oligosaccharides in vivo
Xingchen Zhai, Shoujun Yuan, Xin Yang, Pan Zou, Yong Shao, A.M. Abd El-Aty, Ahmet Hacımüftüoğlu, Jing Wang
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Handling and Pathology Reporting of Gastrointestinal Endoscopic Mucosal Resection
Bita Geramizadeh, David A. Owen
Middle East Journal of Digestive Diseases.2017; 9(1): 5. CrossRef
Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI
Young Chul Kim, Jai Keun Kim, Myeong-Jin Kim, Jei Hee Lee, Young Bae Kim, Sung Jae Shin
European Radiology.2016; 26(2): 297. CrossRef
Antitumor Effects of Orally and Intraperitoneally Administered Chitosan Oligosaccharides (COSs) on S180‐Bearing/Residual Mouse
Pan Zou, Xin Yang, Yanxin Zhang, Pengfei Du, Shoujun Yuan, Dexuan Yang, Jing Wang
Journal of Food Science.2016;[Epub] CrossRef
Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review
S. Cai, Y. Zhong, P. Zhou, J. Xu, L. Yao
Gastroenterology Report.2014; 2(1): 27. CrossRef
Anticancer activity of tuftsin-derived T peptide in postoperative residual tumors
Yinghong An, Linna Li, Dexuan Yang, Na Jia, Chengwang Xu, Qiong Wang, Shanshan Wang, Shoujun Yuan
Anti-Cancer Drugs.2014; 25(8): 857. CrossRef

Review

Update and Debate Issues in Surgical Treatment of Middle and Low Rectal Cancer: Nam Kyu Kim, Min Sung Kim, Sami F. AL-Asari; J Korean Soc Coloproctol. 2012;28(5):230-240. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.230

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38 Download
11 Citations

Abstract PDF

Based on a review of the literature, this paper provides an update on surgical treatment of middle and low rectal cancer and discusses issues of debate surrounding that treatment. The main goal of the surgical treatment of rectal cancer is radical resection of the tumor and surrounding lymphatic tissue. Local excision of early rectal cancer can be another treatment option, in which the patient can avoid possible complications related to radical surgery. Neoadjuvant chemoradiation therapy (CRT) has been recommended for patients with cT3-4N0 or any T N+ rectal cancer because CRT shows better local control and less toxicity than adjuvant CRT. However, recent clinical trials showed promising results for local excision after neoadjuvant CRT in selected patients with low rectal cancer. In addition, the "wait and see" concept is another modality that has been reported for the management of tumors that show complete clinical remission after neoadjuvant CRT. Although radical surgery for middle and low rectal cancer is the cornerstone therapy, an ultralow anterior resection with or without intersphincteric resection (ISR) has become an alternative standard surgical method for selected patients. Many studies have reported on the oncological safety of the ISR, but few of them have addressed the issue the functional outcome. Furthermore, an abdominoperineal resection (APR) has problems with high rates of tumor perforations and positive circumferential resection margins, and those factors have contributed to its having a high rate of local recurrence and a poor survival rate for rectal cancer compared with sphincter-saving procedures. Recently, great efforts have been made to reduce these problems, and the total levator excision or the extended APR concept has emerged. Surgical management for low rectal cancer should aim to radically excise the tumor and to preserve as much of the sphincter function as possible by using multidisciplinary approaches. However, further prospective clinical trials are needed for tailored treatment of rectal cancer patients.

Citations

Citations to this article as recorded by

Neoadjuvant chemoradiotherapy up-regulates PD-L1 in radioresistant colorectal cancer
Sung Uk Bae, Hye Won Lee, Jee Young Park, Incheol Seo, Jae-Min Cho, Jin Young Kim, Ju Yup Lee, Yoo Jin Lee, Seong Kyu Baek, Nam Kyu Kim, Sang Jun Byun, Shin Kim
Clinical and Translational Radiation Oncology.2025; 51: 100906. CrossRef
Neoadjuvant chemoradiation alters biomarkers of anticancer immunotherapy responses in locally advanced rectal cancer
Incheol Seo, Hye Won Lee, Sang Jun Byun, Jee Young Park, Hyeonji Min, Sung Hwan Lee, Ju-Seog Lee, Shin Kim, Sung Uk Bae
Journal for ImmunoTherapy of Cancer.2021; 9(3): e001610. CrossRef
Anus-Preserving Surgery in Advanced Low-Lying Rectal Cancer: A Perspective on Oncological Safety of Intersphincteric Resection
Guglielmo Niccolò Piozzi, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon Hahn Kim
Cancers.2021; 13(19): 4793. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Factors influencing changing bowel habits in patients undergoing sphincter‐saving surgery for rectal cancer
Hyeonju Jeong, JeongYun Park
International Wound Journal.2019; 16(S1): 71. CrossRef
Critical and Challenging Issues in the Surgical Management of Low-Lying Rectal Cancer
Aeris Jane D. Nacion, Youn Young Park, Seung Yoon Yang, Nam Kyu Kim
Yonsei Medical Journal.2018; 59(6): 703. CrossRef
Prognostic significance of tumor regression in locally advanced rectal cancer after preoperative radiochemotherapy
Mirko Omejc, Maja Potisek
Radiology and Oncology.2017; 52(1): 30. CrossRef
The influence of the distal resection margin length on local recurrence and long- term survival in patients with rectal cancer after chemoradiotherapy and sphincter- preserving rectal resection
Jan Grosek, Vaneja Velenik, Ibrahim Edhemovic, Mirko Omejc
Radiology and Oncology.2017; 51(2): 169. CrossRef
Robotic Total Mesorectal Excision using a Wristed Suction-irrigation Device for Efficient Traction and Visualization
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
The Journal of Minimally Invasive Surgery.2017; 20(3): 120. CrossRef
The Role of Robotic Surgery for Rectal Cancer: Overcoming Technical Challenges in Laparoscopic Surgery by Advanced Techniques
Seungwan Park, Nam Kyu Kim
Journal of Korean Medical Science.2015; 30(7): 837. CrossRef
Oncological superiority of extralevator abdominoperineal resection over conventional abdominoperineal resection: a meta-analysis
Ao Huang, Hongchao Zhao, Tianlong Ling, Yingjun Quan, Minhua Zheng, Bo Feng
International Journal of Colorectal Disease.2014; 29(3): 321. CrossRef

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