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Original Articles
Benign GI diease,Benign diesease & IBD,Surgical technique
Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature
Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon
Ann Coloproctol. 2022;38(2):160-165.   Published online January 18, 2022
DOI: https://doi.org/10.3393/ac.2021.00598.0085
  • 4,097 View
  • 188 Download
  • 4 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Citations

Citations to this article as recorded by  
  • Fistula formation between urinary bladder and abdominal wall caused by bladder injury from surgical clips following laparoscopic appendectomy
    Wei Zhou, Yong Suo, Tian-Yan Luo, Long-Gang Wang
    Asian Journal of Surgery.2025; 48(6): 3926.     CrossRef
  • Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
    Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
    Surgery.2024; 176(5): 1329.     CrossRef
  • Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
    Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
    World Journal of Emergency Surgery.2023;[Epub]     CrossRef
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
The Impact of Primary Tumor Resection on Survival in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases
Ki Yoon Doah, Ui Sup Shin, Byong Ho Jeon, Sang Sik Cho, Sun Mi Moon
Ann Coloproctol. 2021;37(2):94-100.   Published online April 30, 2021
DOI: https://doi.org/10.3393/ac.2020.09.15.1
  • 4,900 View
  • 89 Download
  • 16 Citations
AbstractAbstract PDF
Purpose
This study was conducted to evaluate the effectiveness of primary tumor resection (PTR) in asymptomatic colorectal cancer (CRC) patients with unresectable metastases using the inverse probability of treatment weighting (IPTW) method to minimize selection bias.
Methods
We selected 146 patients diagnosed with stage IV CRC with unresectable metastasis between 2001 and 2018 from our institutional database. In a multivariate logistic regression model using the patients’ baseline covariates associated with PTR, we applied the IPTW method based on a propensity score and performed a weighted Cox proportional regression analysis to estimate survival according to PTR.
Results
Upfront PTR was performed in 98 patients, and no significant differences in baseline factors were detected. The upweighted median survival of the PTR group was 18 months and that of the non-PTR group was 15 months (P = 0.15). After applying the IPTW, the PTR was still insignificant in the univariate Cox regression (hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.5–1.21). However, in the multivariate weighted Cox regression with adjustment for other covariates, the PTR showed a significantly decreased risk of cancer-related death (HR, 0.61; 95% CI, 0.40–0.94).
Conclusion
In this study, we showed that asymptomatic CRC patients with unresectable metastases could gain a survival benefit from upfront PTR by analysis with the IPTW method. However, randomized controlled trials are mandatory.

Citations

Citations to this article as recorded by  
  • A predictive model to identify optimal candidates for surgery among patients with metastatic colorectal cancer
    Xiqiang Zhang, Zhaoyi Jing, Longchao Wu, Ze Tao, Dandan Lu
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies
    Jun Huang, Jiahao Zhou, Ping Zhang, Qingbin Wu, Ziqiang Wang
    Langenbeck's Archives of Surgery.2024;[Epub]     CrossRef
  • Effect of primary tumor resection on survival in patients with asymptomatic unresectable metastatic colorectal cancer: a systematic review and meta-analysis
    Chengren Zhang, Cong Cao, Lili Liu, Yaochun Lv, Jingjing Li, Jiyong Lu, Shuai Wang, Binbin Du, Xiongfei Yang
    Expert Review of Anticancer Therapy.2023; 23(1): 107.     CrossRef
  • The role of upfront primary tumor resection in asymptomatic patients with unresectable stage IV colorectal cancer: A systematic review and meta-analysis
    Zongyu Liang, Zhiyuan Liu, Chengzhi Huang, Xin Chen, Zhaojun Zhang, Meijuan Xiang, Weixian Hu, Junjiang Wang, Xingyu Feng, Xueqing Yao
    Frontiers in Surgery.2023;[Epub]     CrossRef
  • Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview
    Junge Bai, Ming Yang, Zheng Liu, Sergey Efetov, Cuneyt Kayaalp, Audrius Dulskas, Darcy Shaw, Xishan Wang
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Palliative primary tumor resection in minimally symptomatic (asymptomatic) patients with colorectal cancer and synchronous unresectable metastases versus chemotherapy alone: a metaanalysis
    Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov, M. V. Alekseev
    Koloproktologia.2023; 22(2): 126.     CrossRef
  • The impact of primary tumor resection for asymptomatic colorectal cancer patients with unresectable metastases: a systematic review and meta-analysis
    Shuyuan Li, Liqiang Ji, Jie Huang, Ye Wang, Peng Liu, Wei Zhang, Zheng Lou
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • The impact of palliative primary tumor resection on overall survival in minimally symptomatic (asymptomatic) colorectal cancer and synchronous unresectable metastases vs chemotherapy only: a comparative study of outcomes
    Iu. V. Alimova, S. I. Achkasov, Yu. A. Shelygin, M. V. Alekseev, V. N. Kashnikov, M. Yu. Fedyanin, M. A. Danilov, E. G. Rybakov
    Koloproktologia.2023; 22(4): 10.     CrossRef
  • Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
    Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
    Cancers.2023; 15(24): 5791.     CrossRef
  • Palliative primary tumor resection in minimally symptomatic patients with colorectal cancer and synchronous unresectable metastases: when is it necessary? (systematic review)
    Iu. V. Alimova, Yu. A. Shelygin, E. G. Rybakov
    Koloproktologia.2022; 21(3): 99.     CrossRef
  • Surgical treatment for metastatic colorectal cancer
    Eun Jung Park, Seung Hyuk Baik
    Journal of the Korean Medical Association.2022; 65(9): 568.     CrossRef
  • Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
    Eun Jung Park, Seung Hyuk Baik
    Journal of the Anus, Rectum and Colon.2022; 6(4): 213.     CrossRef
  • Molecular analyses of peritoneal metastasis from colorectal cancer
    Chang Hyun Kim
    Journal of the Korean Medical Association.2022; 65(9): 586.     CrossRef
  • Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
    Chang Hyun Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 197.     CrossRef
  • Primary Tumor Resection in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases: Can It Improve Survival?
    Myong Hoon Ihn
    Annals of Coloproctology.2021; 37(2): 71.     CrossRef
  • Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
    Young Jin Kim, Chang Hyun Kim
    Annals of Coloproctology.2021; 37(6): 425.     CrossRef
Oncologic Outcomes in Patients Who Undergo Neoadjuvant Chemoradiotherapy and Total Mesorectal Excision for Locally Advanced Rectal Cancer: A 14-Year Experience in a Single Institution
Min Jung Kim, Seung-Yong Jeong, Ji Won Park, Seung-Bum Ryoo, Sang Sik Cho, Ki Young Lee, Kyu Joo Park
Ann Coloproctol. 2019;35(2):83-93.   Published online April 30, 2019
DOI: https://doi.org/10.3393/ac.2019.04.22.1
  • 5,130 View
  • 97 Download
  • 21 Web of Science
  • 19 Citations
AbstractAbstract PDF
Purpose
This study evaluated the oncologic outcomes of locally advanced rectal cancer patients who underwent preoperative neoadjuvant chemoradiotherapy (CRT) followed by surgery and determined the prognostic significance of pathologic complete response (pCR).
Methods
Between January 2002 and December 2015, 580 patients with rectal cancer who underwent surgery after neoadjuvant CRT were identified. Survival according to tumor response to CRT and pathologic stage was analyzed using the Kaplan-Meier method, and the Cox proportional hazard model was used to identify factors associated with survival outcomes.
Results
A total of 111 patients (23.7%) achieved pCR while the other 469 patients showed residual disease. Patients with pCR had a lower pretreatment carcinoembryonic antigen level and earlier cT classification than those with residual disease. With a median follow-up of 78 months, disease-free survival (DFS) and overall survival (OS) were significantly better in the pCR group than in the residual disease group. The 5-year DFS and 5-year OS for patients with ypStage 0, I, II, or III were 92.5%, 85.1%, 72.2%, 54.3% (P < 0.001) and 94.5%, 91.0%, 83.1%, 69.3%, respectively (P < 0.001). Pathologic AJCC stage after CRT was the most statistically significant independent predictor of OS (HR, 6.97 [95% confidence interval, 3.16–15.39] for stage III vs. stage 0) and DFS (HR, 7.30 [95% confidence interval, 3.63–14.67] for stage III vs. stage 0).
Conclusion
Rectal cancer patients who achieved pCR showed improved survival compared to those with residual disease after preoperative CRT. Moreover, pCR was an independent indicator of OS and DFS, and pathologic AJCC stage was correlated with survival after preoperative CRT.

Citations

Citations to this article as recorded by  
  • Analysis of clinical and pathological prognostic factors of survival in rectal adenocarcinoma treated with preoperative radiochemotherapy
    Sarhan Sydney Saad, Nora Forones, Gaspar Lopes Filho, Jaques Waisberg, Elesiario Caetano Júnior, Ricardo Artigiani-Neto, Delcio Matos
    Acta Cirúrgica Brasileira.2025;[Epub]     CrossRef
  • Lateral pelvic lymph node dissection based on nodal response to neoadjuvant chemoradiotherapy in mid/low rectal cancer: a retrospective comparative cohort study
    Tae-Gyun Lee, Duck-Woo Kim, Hong-min Ahn, Hye-Rim Shin, Mi Jeong Choi, Min Hyeong Jo, Heung-Kwon Oh, Sung-Bum Kang
    Annals of Surgical Treatment and Research.2025; 108(6): 333.     CrossRef
  • Predicting Positive Radial Margin on Restaging MRI of Patients with Low Rectal Cancer: Can We Do Better?
    Anurima Patra, Aisha Lakhani, Antony Augustine, Priyanka Mohapatra, Anu Eapen, Ashish Singh, Dipti Masih, Thomas S. Ram, Mark R. Jesudason, Rohin Mittal, Anuradha Chandramohan
    Indian Journal of Radiology and Imaging.2024; 34(01): 85.     CrossRef
  • A Review of Neoadjuvant Therapy and the Watch-and-Wait Protocol in Rectal Cancer: Current Evidence and Future Directions
    Iulian M Slavu, Octavian Munteanu, Florin Filipoiu, Raluca Tulin, Anca Monica Macovei Oprescu , Ileana Dima, Iulian A Dogaru, Adrian Tulin
    Cureus.2024;[Epub]     CrossRef
  • Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study
    Fatemeh Shahabi, Majid Ansari, Khadijeh Najafi Ghobadi, Abolfazl Ghahramani, Amiresmaeil Parandeh, Maryam Saberi‐Karimian, Ala Orafaie, Abbas Abdollahi
    Cancer Reports.2024;[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
  • 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
  • Watch and wait strategies for rectal cancer: A systematic review
    In Ja Park
    Precision and Future Medicine.2022; 6(2): 91.     CrossRef
  • Patient Survival With ypT0N+ Following Neoadjuvant Therapy in Rectal Cancer
    Mohamedraed Elshami, Robert N. Goldstone, Lawrence S. Blaszkowsky, James C. Cusack, Theodore S. Hong, Jennifer Y. Wo, Motaz Qadan
    Diseases of the Colon & Rectum.2022; 65(10): 1224.     CrossRef
  • Neoadjuvant Radiotherapy Dose Escalation in Locally Advanced Rectal Cancer: a Systematic Review and Meta-analysis of Modern Treatment Approaches and Outcomes
    N. Hearn, D. Atwell, K. Cahill, J. Elks, D. Vignarajah, J. Lagopoulos, M. Min
    Clinical Oncology.2021; 33(1): e1.     CrossRef
  • Can normalized carcinoembryonic antigen following neoadjuvant chemoradiation predict tumour recurrence after curative resection for locally advanced rectal cancer?
    Youngki Hong, Amandeep Ghuman, Keat Seong Poh, Dimitri Krizzuk, Arun Nagarajan, Sudha Amarnath, Juan J. Nogueras, Steven D. Wexner, Giovanna DaSilva
    Colorectal Disease.2021; 23(6): 1346.     CrossRef
  • Omission of or Poor Response to Preoperative Chemoradiotherapy Impacts Radial Margin Positivity Rates in Locally Advanced Rectal Cancer
    Ana Sofia Ore, Gabrielle E. Dombek, Carlos A. Cordova-Cassia, Jeanne F. Quinn, Thomas E. Cataldo, Benjamin L. Schlechter, Matthew J. Abrams, Evangelos Messaris
    Diseases of the Colon & Rectum.2021; 64(6): 669.     CrossRef
  • Optimal Postoperative Surveillance Strategies for Colorectal Cancer: A Retrospective Observational Study
    Min-Young Park, In-Ja Park, Hyo-Seon Ryu, Jay Jung, Min-Sung Kim, Seok-Byung Lim, Chang-Sik Yu, Jin-Cheon Kim
    Cancers.2021; 13(14): 3502.     CrossRef
  • Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
    Ye Won Jeon, In Ja Park, Jeong Eun Kim, Jin-Hong Park, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim
    World Journal of Gastrointestinal Surgery.2021; 13(9): 1000.     CrossRef
  • Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
    Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Cancers.2021; 13(19): 4823.     CrossRef
  • Neoadjuvant radiotherapy dose escalation for locally advanced rectal cancers in the new era of radiotherapy: A review of literature
    Durim Delishaj, Ilaria Costanza Fumagalli, Stefano Ursino, Agostino Cristaudo, Francesco Colangelo, Antonio Stefanelli, Alessandro Alghisi, Giuseppe De Nobili, Romerai D’Amico, Alessandra Cocchi, Antonio Ardizzoia, Carlo Pietro Soatti
    World Journal of Clinical Cases.2021; 9(30): 9077.     CrossRef
  • 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
    Annals of Coloproctology.2021; 37(6): 382.     CrossRef
  • Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
    Eun Jung Park, Seung Hyuk Baik
    Precision and Future Medicine.2021; 5(4): 164.     CrossRef
  • From Total Mesorectal Excision to Organ Preservation for the Treatment of Rectal Cancer
    Seong Kyu Baek
    Annals of Coloproctology.2019; 35(2): 51.     CrossRef
Role of Peritoneal Lavage Cytology and Prediction of Prognosis and Peritoneal Recurrence After Curative Surgery for Colorectal Cancer
Sung Joon Bae, Ui Sup Shin, Young-Jun Ki, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park
Ann Coloproctol. 2014;30(6):266-273.   Published online December 31, 2014
DOI: https://doi.org/10.3393/ac.2014.30.6.266
  • 5,398 View
  • 55 Download
  • 11 Web of Science
  • 10 Citations
AbstractAbstract PDF
Purpose

In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection.

Methods

From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival.

Results

Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001).

Conclusion

Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.

Citations

Citations to this article as recorded by  
  • Intraoperative flow cytometry in detecting free carcinoma cells in peritoneal lavage fluid of gastric carcinoma cases
    Thulasi Raman Ramalingam, Bharaneedharan Marimuthu, Harsha N. Rasheed, Archana Lakshmanan, Swetha Lakshmi Narla, Lakshman Vaidhyanathan, Ajit Pai
    Cytometry Part B: Clinical Cytometry.2025;[Epub]     CrossRef
  • Development and validation of a nomogram to predict overall survival in patients with incidental gallbladder cancer: A retrospective cohort study
    Zhi-Hua Xie, Xuebing Shi, Ming-Qi Liu, Jinghan Wang, Yong Yu, Ji-Xiang Zhang, Kai-Jian Chu, Wei Li, Rui-Liang Ge, Qing-Bao Cheng, Xiao-Qing Jiang
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Effect of Intraperitoneal Chemotherapy with Regorafenib on IL-6 and TNF-α Levels and Peritoneal Cytology: Experimental Study in Rats with Colorectal Peritoneal Carcinomatosis
    Stefanos Bitsianis, Ioannis Mantzoros, Elissavet Anestiadou, Panagiotis Christidis, Christos Chatzakis, Konstantinos Zapsalis, Savvas Symeonidis, Georgios Ntampakis, Kalliopi Domvri, Anastasia Tsakona, Chryssa Bekiari, Orestis Ioannidis, Stamatios Aggelop
    Journal of Clinical Medicine.2023; 12(23): 7267.     CrossRef
  • Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
    Mohamed Shalaby, Tarek S El Baradie, Mohamed Salama, Hebat A M Shaaban, Rasha M Allam, Ehab O.A. Hafiz, Mohamed Aly Abdelhamed, Amr Attia
    JGH Open.2021; 5(2): 264.     CrossRef
  • Interleukin 10 level in the peritoneal cavity is a prognostic marker for peritoneal recurrence of T4 colorectal cancer
    Seung-Yong Jeong, Byeong Geon Jeon, Ji-Eun Kim, Rumi Shin, Hye Seong Ahn, Heejin Jin, Seung Chul Heo
    Scientific Reports.2021;[Epub]     CrossRef
  • Risk factors for developing peritoneal metastases after curative surgery for colorectal cancer: A systematic review and meta‐analysis
    Yuanxin Zhang, Xiusen Qin, Wenle Chen, Duo Liu, Jian Luo, Huaiming Wang, Hui Wang
    Colorectal Disease.2021; 23(11): 2846.     CrossRef
  • Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
    Young Jin Kim, Chang Hyun Kim
    Annals of Coloproctology.2021; 37(6): 425.     CrossRef
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    Lieselotte Lemoine, Paul Sugarbaker, Kurt Van der Speeten
    World Journal of Gastroenterology.2016; 22(34): 7692.     CrossRef
  • The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer
    Tsuyoshi Ozawa, Soichiro Ishihara, Takeshi Nishikawa, Toshiaki Tanaka, Junichiro Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa, Shinsuke Kazama, Hironori Yamaguchi, Eiji Sunami, Joji Kitayama, Toshiaki Watanabe
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    Duck-Woo Kim
    Annals of Coloproctology.2014; 30(6): 248.     CrossRef
Is Microsatellite Instability Really a Good Prognostic Factor of Colorectal Cancer?
Ui Sup Shin, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park, Sun Hee Jee, Eun-Joo Jung, Dae-Yong Hwang
Ann Coloproctol. 2014;30(1):28-34.   Published online February 28, 2014
DOI: https://doi.org/10.3393/ac.2014.30.1.28
  • 5,608 View
  • 43 Download
  • 34 Web of Science
  • 26 Citations
AbstractAbstract PDF
Purpose

The aim of this study was to investigate the clinicopathologic features of and the prognosis for colorectal cancers (CRCs) with microsatellite instabilities (MSIs).

Methods

Between 2006 and 2009, genotyping was performed on 245 patients with stage II/III CRCs to establish the MSI status. The clinicopathologic differences and the prognostic value of MSI were analyzed. The median follow-up period was 38 months (range, 7-68 months).

Results

Of the total 245 patients, 20 (8.2%) had MSI-high (H) and 225 (91.8%) had MSI-low (L) or stable (S) CRCs. Adjuvant chemotherapies were performed on 101 stage II (87.8%) and 107 stage III patients (82.3%). Patients with MSI-H CRCs more frequently had a family history of colon cancer (10% vs. 2.7%, P = 0.003), more frequently had a cancer located at the proximal colon (90.0% vs. 19.1%, P < 0.0001), and more often showed a mucinous phenotype or poor differentiation (35.0% vs. 7.1%, P = 0.001). Despite less frequent lymph node metastasis (25% vs. 55.6%, P = 0.01), the number of retrieved lymph nodes was higher (26.3 ± 13.1 vs. 20.7 ± 1.2, P = 0.04) in the MSI-H group. The overall survival and the disease-free survival (DFS) did not differ with respect to MSI status. However, in the stage II subgroup, the DFS for patients with MSI-H CRCs was significantly worse (72.2% vs. 90.7%, P = 0.03). The multivariate analysis performed on this subgroup revealed that MSI-H was an independent poor prognostic factor (adjusted hazard ratio, 4.0; 95% confidence interval, 1.0-15.6, P = 0.046).

Conclusion

MSI-H CRCs had distinct clinicopathologic features, and MSI-H was an independent poor prognostic factor in stage II CRCs. Considering the majority of stage II patients were administrated adjuvant chemotherapy, the efficacy of adjuvant chemotherapy for treating MSI CRCs might be different from that for treating MSI-L/S tumors.

Citations

Citations to this article as recorded by  
  • Reassessing the Prognostic Value of Lymph Node Metastasis in Deficient Mismatch Repair Colorectal Cancer
    Zilan Ye, Dakui Luo, Fan Chen, Jiayu Chen, Zezhi Shan, Junyong Weng, Yu Zhang, Qingguo Li, Xinxiang Li
    Current Oncology.2025; 32(5): 254.     CrossRef
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    Xuan Dai, Zhujiang Dai, Jihong Fu, Zhonglin Liang, Peng Du, Tingyu Wu
    World Journal of Surgical Oncology.2024;[Epub]     CrossRef
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    Wen-Xuan Fan, Fei Su, Yan Zhang, Xiao-Ling Zhang, Yun-Yi Du, Yang-Jun Gao, Wei-Ling Li, Wen-Qing Hu, Jun Zhao
    Biomarker Research.2024;[Epub]     CrossRef
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    Yi Ma, Zhihao Shi, Ying Wei, Feng Shi, Guochu Qin, Zhengyang Zhou
    Scientific Reports.2024;[Epub]     CrossRef
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    Petri Rantanen, Anne Keränen, Shabane Barot, Sam Ghazi, Annelie Liljegren, Caroline Nordenvall, Annika Lindblom, Ulrik Lindforss
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Preoperative albumin–bilirubin score as a prognostic indicator in patients with stage III colon cancer
    Hyun Gu Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Jin Cheon Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Radiomics features based on internal and marginal areas of the tumor for the preoperative prediction of microsatellite instability status in colorectal cancer
    Yi Ma, Changsong Lin, Song Liu, Ying Wei, Changfeng Ji, Feng Shi, Fan Lin, Zhengyang Zhou
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Anatomical Distribution of Colon Cancer: A Retrospective 10-Year Study to Evaluate Rightward Shift in Two Referral Hospitals in Iran
    Ahmad R Mafi, Shima Azimi Oliaei, Ramin Heshmat, Hossein Yahyazadeh, Ali G Motlagh
    International Journal of Cancer Management.2022;[Epub]     CrossRef
  • Current status on microsatellite instability, prognosis and adjuvant therapy in colon cancer: A nationwide survey of medical oncologists, colorectal surgeons and gastrointestinal pathologists
    James W. T. Toh, Hema Mahajan, Pierre Chapuis, Kevin Spring
    Cancer Reports.2021;[Epub]     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
  • Computed Tomography-Based Radiomics Model to Preoperatively Predict Microsatellite Instability Status in Colorectal Cancer: A Multicenter Study
    Zhi Li, Qi Zhong, Liang Zhang, Minhong Wang, Wenbo Xiao, Feng Cui, Fang Yu, Chencui Huang, Zhan Feng
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  • Colon cancer patients with mismatch repair deficiency are more likely to present as acute surgical cases
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