Annals of Coloproctology

Original Articles

Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older: Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu; Received June 7, 2023 Accepted September 11, 2023 Published online August 5, 2024; DOI: https://doi.org/10.3393/ac.2023.00367.0052 [Epub ahead of print]

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Abstract PDF: Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Colorectal cancer

Lymphovascular invasion in colorectal cancers: can we predict it preoperatively?: Elbrus Zarbaliyev, Nihan Turhan, Sebahattin Çelik, Mehmet Çağlıkülekçi; Ann Coloproctol. 2024;40(3):245-252. Published online June 25, 2024; DOI: https://doi.org/10.3393/ac.2023.00458.0065

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Abstract PDF: Purpose
This study aimed to investigate preoperative predictors of lymphovascular invasion (LVI), which is a poor prognostic factor usually detected postoperatively in patients with colorectal cancer.
Methods
Results for all patients operated on for colorectal cancer between January 1, 2006, and December 31, 2021, were retrospectively analyzed. Potential preoperative factors and postoperative pathology results were recorded. The patients were categorized as those with LVI and those without LVI. Potential factors that may be associated with LVI were compared between the 2 groups.
Results
The study included 335 patients. The incidence of LVI was 3.11 times higher in patients with ascending colon tumors (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.34–7.23; P=0.008) and 4.28 times higher in those with metastatic tumors (OR, 4.28; 95% CI, 2.18–8.39; P<0.001). Diabetes mellitus was inversely related to LVI in colorectal cancer patients; specifically, LVI was 56% less common in colorectal cancer patients with diabetes mellitus, irrespective of its duration (OR, 0.44; 95% CI, 0.25–0.76; P<0.001).
Conclusion
The presence of preoperative LVI in colorectal cancer patients is difficult to predict. In particular, the effect of the effect of factors such as chronic disease accompanied by microvascular pathologies on LVI is still unclear. Advances in the neoadjuvant treatment of colorectal cancer patients, who are becoming more widespread every day, will encourage the investigation of different methods of preoperatively predicting LVI as a poor prognostic factor in these patients.

Colorectal cancer

Impact of consolidation chemotherapy in poor responders to neoadjuvant radiation therapy: magnetic resonance imaging–based clinical-radiological correlation in high-risk rectal cancers: Swapnil Patel, Suman Ankathi, Purvi Haria, Mufaddal Kazi, Ashwin L. Desouza, Avanish Saklani; Ann Coloproctol. 2023;39(6):474-483. Published online December 21, 2023; DOI: https://doi.org/10.3393/ac.2023.00080.0011

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Abstract PDF

Purpose
The current study was conducted to examine the role of consolidation chemotherapy after neoadjuvant radiation therapy (NART) in decreasing the involvement of the mesorectal fascia (MRF) in high-risk locally advanced rectal cancers (LARCs).
Methods
In total, 46 patients who received consolidation chemotherapy after NART due to persistent MRF involvement were identified from a database. A team of 2 radiologists, blinded to the clinical data, studied sequential magnetic resonance imaging (MRI) scans to assess the tumor response and then predict a surgical plan. This prediction was then correlated with the actual procedure conducted as well as histopathological details to assess the impact of consolidation chemotherapy.
Results
The comparison of MRI-based parameters of sequential images showed significant downstaging of T2 signal intensity, tumor height, MRF involvement, diffusion restriction, and N category between sequential MRIs (P < 0.05). However, clinically relevant downstaging (standardized mean difference, > 0.3) was observed for only T2 signal intensity and diffusion restriction on diffusion-weighted imaging. No clinically relevant changes occurred in the remaining parameters; thus, no change was noted in the extent of surgery predicted by MRI. Weak agreement (Cohen κ coefficient, 0.375) and correlation (Spearman rank coefficient, 0.231) were found between MRI-predicted surgery and the actual procedure performed. The comparison of MRI-based and pathological tumor response grading also showed a poor correlation.
Conclusion
Evidence is lacking regarding the use of consolidation chemotherapy in reducing MRF involvement in LARCs. The benefit of additional chemotherapy after NART in decreasing the extent of planned surgery by reducing margin involvement requires prospective research.

Citations

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The conundrum of total neoadjuvant therapy in rectal cancer
Devesh S. Ballal, Tejas P. Vispute, Avanish P. Saklani
Colorectal Disease.2024; 26(5): 1068. CrossRef

Review

Colorectal cancer

Total neoadjuvant therapy for rectal cancer: evidence and challenge: Suk-Hwan Lee; Ann Coloproctol. 2023;39(4):301-306. Published online August 29, 2023; DOI: https://doi.org/10.3393/ac.2023.00269.0038

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5 Citations

Abstract PDF

Recent advances in the management of rectal cancer have dramatically changed the clinical practice of colorectal surgeons because the main focus of rectal cancer treatment has changed from sphincter-saving to an organ-preserving strategies. Modifying the delivery of systemic chemotherapy to improve patients’ survival is another progress in colorectal cancer management, known as total neoadjuvant therapy (TNT). TNT is a new strategy used by colorectal surgeons to improve the quality of life and survival of patients after treatment. TNT poses limitations or obstacles, such as overtreatment issues in patients with stage I rectal cancer. However, considering the quality-of-life issues in patients with low-lying rectal cancer necessitating a permanent colostomy, the indication for TNT will be expanded. This review summarizes the recently conducted clinical trials and foresees future perspectives on TNT.

Citations

Citations to this article as recorded by

Current Surgical Methods in Local Rectal Excision
Kristina Šemanjski, Karla Lužaić, Jure Brkić
Gastrointestinal Tumors.2024; : 1. CrossRef
Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
A nomogram for predicting the overall survival in rectal cancer patients after total neoadjuvant therapy
Z. Liu, M. He, X. Wang
Techniques in Coloproctology.2024;[Epub] CrossRef
Impact of the laparoscopic approach, early closure and preoperative stimulation on outcomes of ileostomy closure after rectal resection
Andrea Norte, Carmen Martínez, Ana Pasalodos, Ivette Tort, Anna Sánchez, Pilar Hernández, Jesús Bollo, Eduard Maria Targarona
Cirugía Española (English Edition).2024;[Epub] CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef

Video

Video clip

Laparoscopic right hemicolectomy with aortocaval lymphadenectomy, and pelvic peritoneum partial resection for ascending colon cancer: Hannah Kim, An Na Seo, Soo Yeun Park; Ann Coloproctol. 2023;39(3):283-286. Published online February 9, 2023; DOI: https://doi.org/10.3393/ac.2022.00780.0111

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Abstract PDF Supplementary Material

The aim of this video is to present the procedural details of laparoscopic right hemicolectomy with aortocaval (infrarenal aortic bifurcation) lymphadenectomy, partial resection of the pelvic peritoneum (peritoneal carcinomatosis index, 3), and hyperthermic intraperitoneal chemotherapy in a patient who received neoadjuvant chemotherapy for stage IVc colorectal cancer. The total operation time was 290 minutes, and the patient was discharged on a postoperative day 13 without any complications. No postoperative complications occurred until postoperative day 60. The pathological stage of the tumor was determined to be T3N2bM1c. The pelvic peritoneal nodule was pathologically confirmed as a metastatic lesion. Among the 12 harvested aortocaval lymph nodes, 6 were metastatic lymph nodes. The minimally invasive approach was safe and feasible in this highly selected patient with colon cancer, aortocaval lymph nodes, and peritoneal metastases.

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Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef

Case Report

Metastasis

Peritoneal metastatic mixed adenoneuroendocrine carcinoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a case report: Sungchul Lee, Euitae Kim, Dong-Guk Park; Ann Coloproctol. 2024;40(Suppl 1):S18-S22. Published online November 21, 2022; DOI: https://doi.org/10.3393/ac.2022.00339.0048

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Abstract PDF

A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.

Citations

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Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract
Sebastián Díaz-López, Jerónimo Jiménez-Castro, Carlos Enrique Robles-Barraza, Carlos Ayala-de Miguel, Manuel Chaves-Conde
World Journal of Gastrointestinal Oncology.2024; 16(4): 1166. CrossRef

Review

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Surgical technique

Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer: Young Jin Kim, Chang Hyun Kim; Ann Coloproctol. 2021;37(6):425-433. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00920.0131

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25 Citations

Abstract PDF

From the perspective of survival outcomes, the cancer survival of colorectal cancer (CRC) in the whole stage has improved. Peritoneal metastasis (PM) is found in approximately 8% to 15% of patients with CRC, with a poorer prognosis than that associated with other sites of metastases. Randomized controlled trials and up-to-date meta-analyses provide firm evidence that cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) could significantly improve overall survival compared with systemic chemotherapy alone in selected patients with CRC-PM. Practical guidelines recommend that the management of CRC-PM should be led by a multidisciplinary team carried out in experienced centers and consider CRS plus HIPEC for selected patients. In this review, we aim to provide the latest results of land mark studies and an overview of recent insights with regard to the management of CRC-PM.

Citations

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Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
CILP2 is a potential biomarker for the prediction and therapeutic target of peritoneal metastases in colorectal cancer
Ye Jin Ha, Seong-Hwan Park, Ka Hee Tak, Jong Lyul Lee, Chan Wook Kim, Jeong-Hwan Kim, Seon-Young Kim, Seon-Kyu Kim, Yong Sik Yoon
Scientific Reports.2024;[Epub] CrossRef
Comparison of EPIC Versus HIPEC in the Treatment of Colorectal Peritoneal Metastases and Appendix Tumors Using Inverse Probability of Treatment Weighting
Min Hye Jeong, Su Jin Kang, Soo Yeun Park, Sang Gyu Kwak, An Na Seo, Suehyun Park, Jun Seok Park, Hye Jin Kim, Gyu-Seog Choi
Annals of Surgical Oncology.2024; 31(10): 7111. CrossRef
Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications
Hyun-Chang Kim, Dong Woo Han, Eun Jung Park, Yeon Hwa Hong, Young Song
Cancers.2024; 16(16): 2874. CrossRef
Inflammatory and nutritional markers in colorectal cancer: Implications for prognosis and treatment
Mesut Tez
World Journal of Clinical Oncology.2024; 15(10): 1264. CrossRef
Analgesic effects of combined transversus abdominis plane block and intramuscular electrical stimulation in patients undergoing cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy: a randomized controlled trial
Hyun-Chang Kim, Jinyoung Park, Jinyoung Oh, Minjae Kim, Eun Jung Park, Seung Hyuk Baik, Young Song
International Journal of Surgery.2023; 109(5): 1199. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. 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
Improving nanochemoimmunotherapy efficacy by boosting “eat-me” signaling and downregulating “don't-eat-me” signaling with Ganoderma lucidum polysaccharide-based drug delivery
Guibin Pang, Siqi Wei, Jian Zhao, Fu-Jun Wang
Journal of Materials Chemistry B.2023; 11(48): 11562. 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
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
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
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
The Onset of In-Vivo Dehydration in Gas -Based Intraperitoneal Hyperthermia and Its Cytotoxic Effects on Colon Cancer Cells
Agata Diakun, Tanja Khosrawipour, Agata Mikolajczyk-Martinez, Jakub Nicpoń, Zdzisław Kiełbowicz, Przemysław Prządka, Bartłomiej Liszka, Wojciech Kielan, Kacper Zielinski, Pawel Migdal, Hien Lau, Shiri Li, Veria Khosrawipour
Frontiers in Oncology.2022;[Epub] CrossRef
Patients with Metachronous Peritoneal Metastatic Mucinous Colorectal Adenocarcinoma Benefit More from Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) than Their Synchronous Counterparts
Zoltan Herold, Miklos Acs, Attila Marcell Szasz, Katalin Olasz, Jana Hussong, Max Mayr, Magdolna Dank, Pompiliu Piso
Cancers.2022; 14(16): 3978. CrossRef
ASO Author Reflections: Is it Correct to Use 5% Dextrose Solution as a Carrier Fluid for Oxaliplatin-based HIPEC?
Eun Jung Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8593. CrossRef
Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo
Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8583. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. 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 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
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
In Ja Park
Annals of Coloproctology.2021; 37(6): 349. CrossRef

Original Articles

Malignant disease,Rectal cancer, Prognosis and adjuvant therapy,Colorectal cancer

Effect of Adjuvant Chemotherapy on Elderly Stage II High-Risk Colorectal Cancer Patients: Yujin Lee, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keunho Yang, Byung-Noe Bae; Ann Coloproctol. 2021;37(5):298-305. Published online July 6, 2021; DOI: https://doi.org/10.3393/ac.2020.00829.0118

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Abstract PDF

Purpose
Adjuvant chemotherapy (AC) is recommended for patients with stage II colorectal cancer with adverse features. However, the effect of adjuvant treatment in elderly patients with high-risk stage II colorectal cancer remains controversial. This study aimed to investigate the oncologic outcomes in elderly high-risk stage II colorectal cancer patients who underwent curative resection with or without AC.
Methods
Patients aged over 70 years having stage II colorectal adenocarcinoma with at least 1 adverse feature who underwent radical surgery between 2008 and 2017 at a single center were included. We compared recurrence-free survival (RFS) and overall survival (OS) between patients who received more than 80% of the planned AC cycle (the AC+ group) and those who did not receive it (the AC− group).
Results
The AC+ and AC– group contained 46 patients and 50 patients, respectively. The log-rank test revealed no significant intergroup differences in RFS (P = 0.083) and OS (P = 0.122). In the subgroup of 27 patients with more than 2 adverse features, the AC+ group (n = 16) showed better RFS (P = 0.006) and OS (P = 0.025) than the AC− group. In this subgroup, AC was the only significant factor affecting RFS in the multivariate analysis (P = 0.023). AC was significantly associated with OS (P = 0.033) in the univariate analysis, but not in the multivariate analysis (P = 0.332).
Conclusion
Among elderly patients with stage II high-risk colorectal cancer, the AC+ group did not show better RFS or OS than the AC− group. However, selected patients with more than 2 adverse features might benefit from AC.

Citations

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A Prognostic Model Based on the Log Odds Ratio of Positive Lymph Nodes Predicts Prognosis of Patients with Rectal Cancer
Jian Li, Yu zhou Yang, Peng Xu, Cheng Zhang
Journal of Gastrointestinal Cancer.2024; 55(3): 1111. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] 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
Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan
Tomohito Tanaka, Suguru Yamashita, Haruo Kuroboshi, Junya Kamibayashi, Atsushi Sugiura, Kaori Yoriki, Taisuke Mori, Kazuharu Tanaka, Aiko Nagashima, Michihide Maeda, Shoji Kamiura, Yukako Mizuno, Noriko Ohtake, Tomoyuki Ichimura, Taiki Kikuchi, Yuri Nobut
International Journal of Clinical Oncology.2022; 27(6): 1084. CrossRef
Does adjuvant chemotherapy improve outcomes in elderly patients with colorectal cancer? A systematic review and meta-analysis of real-world studies
Jianbing Chen, Chengda Zhang, Yajuan Wu
Expert Review of Gastroenterology & Hepatology.2022; 16(4): 383. CrossRef
Risk factors for recurrence in elderly patients with stage II colorectal cancer: a multicenter retrospective study
Takuki Yagyu, Manabu Yamamoto, Akimitsu Tanio, Kazushi Hara, Ken Sugezawa, Chihiro Uejima, Kyoichi Kihara, Shigeru Tatebe, Yasuro Kurisu, Shunsuke Shibata, Toshio Yamamoto, Hiroshi Nishie, Setsujo Shiota, Hiroaki Saito, Takuji Naka, Kenji Sugamura, Kuniyu
BMC Cancer.2022;[Epub] CrossRef
Effects of the Enhanced Recovery After Surgery (ERAS) Program for Colorectal Cancer Patients Undergoing Laparoscopic Surgery
Jeongwon Yeom, Hee-Sook Lim
Clinical Nutrition Research.2022; 11(2): 75. CrossRef
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Epidemiology, risk factors, and prevention of colorectal cancer
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Korean Medical Association.2022; 65(9): 549. 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
Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis
Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han, Zhou Li
International Journal of Colorectal Disease.2022; 37(12): 2481. CrossRef
Elderly High-Risk Stage II Colorectal Cancer Patients: Candidates for Improving Outcome?
Min Ki Kim
Annals of Coloproctology.2021; 37(5): 267. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Prognostic Factors Affecting Disease-Free Survival and Overall Survival in T4 Colon Cancer: Taeyeong Eom, Yujin Lee, Jungbin Kim, Inseok Park, Geumhee Gwak, Hyunjin Cho, Keunho Yang, Kiwhan Kim, Byung-Noe Bae; Ann Coloproctol. 2021;37(4):259-265. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2020.00759.0108; Correction in: Ann Coloproctol 2023;39(5):444

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15 Web of Science
15 Citations

Abstract PDF

Purpose
It is known that as the T stage of a carcinoma progresses, the prognosis becomes poorer. However, there are few studies about factors that affect the prognosis of T4 advanced colon cancer. This study aimed to identify the prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in T4 colon cancer.
Methods
Patients diagnosed with stage T4 on histopathology after undergoing curative surgery for colon cancer between March 2009 and March 2018 were retrospectively analyzed for factors related to postoperative survival. Primary outcomes were DFS and OS.
Results
Eighty-two patients were included in the study. DFS and OS of the pathologic (p) T4b group were not inferior to that of the pT4a group. Multivariate analysis showed that differentiation (hazard ratio [HR], 4.994; P = 0.005), and laparoscopic surgery (HR, 0.323; P = 0.008) were significant prognostic factors for DFS, while differentiation (HR, 7.904; P ≤ 0.001) and chemotherapy (HR, 0.344; P = 0.038) were significant prognostic factors for OS.
Conclusion
Tumor differentiation, laparoscopic surgery, and adjuvant chemotherapy were found to be significant prognostic factors in patients with T4 colon cancer. Adjuvant chemotherapy and curative resections by laparoscopy might improve the prognosis in these patients.

Citations

Citations to this article as recorded by

Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
Cytotoxicity of Salvigenin from Asterohyptis stellulata in Combination with Clinical Drugs Against Colorectal Cancer
Briand André Rojas-Castaño, Adriana C. Hernández-Rojas, Rogelio Pereda-Miranda, Mabel Fragoso-Serrano
Revista Brasileira de Farmacognosia.2024; 34(5): 1172. CrossRef
Sorbate metal complexes as newer antibacterial, antibiofilm, and anticancer compounds
Amira I. Abousaty, Fifi M. Reda, Wessam A. Hassanin, Walaa M. Felifel, Walaa H. El-Shwiniy, Heba M. R. M. Selim, Mahmoud M. Bendary
BMC Microbiology.2024;[Epub] CrossRef
The Association Between Surgical Site Infection and Prognosis of T4 Colorectal Cancer
Takuya Koike, Masaya Mukai, Kyoko Kishima, Daiki Yokoyama, Sayuri Hasegawa, Lin Fung Chan, Hideki Izumi, Kazutake Okada, Tomoko Sugiyama, Takuma Tajiri
Cureus.2024;[Epub] CrossRef
Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Erratum to “Prognostic factors affecting disease-free survival and overall survival in T4 colon cancer”

Annals of Coloproctology.2023; 39(5): 444. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. 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
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Yi-Kai Kao, Hsin-Pao Chen, Kuang-Wen Liu, Ling-Chiao Song, Yi-Chieh Chen, Yu-Chun Lin, Chih-I Chen
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Prognostic risk factors for pT4 colon cancer: A retrospective cohort study
Tsutomu Kumamoto, Shigeki Yamaguchi, Ryosuke Nakagawa, Yoji Nagashima, Fumi Maeda, Kimitaka Tani, Hiroka Kondo, Kurodo Koshino, Yuka Kaneko, Yoshiko Bamba, Shimpei Ogawa, Yuji Inoue, Michio Itabashi
Oncology Letters.2022;[Epub] CrossRef
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Javier Fernández, Blanca Silván, Rodrigo Entrialgo-Cadierno, Claudio J. Villar, Raffaele Capasso, José Antonio Uranga, Felipe Lombó, Raquel Abalo
Biomedicine & Pharmacotherapy.2021; 143: 112241. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer: Mok-Won Lee, Jin-Su Kim, Ji-Yeon Kim, Kyung-ha Lee; Ann Coloproctol. 2021;37(1):35-43. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.03

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Abstract PDF

Purpose
There is no clear evidence of the benefit of adjuvant chemotherapy (AC) in stage IIA colon cancer. Therefore, we aimed to evaluate the prognostic factors and survival benefit of AC in this disease.
Methods
A retrospective data collection for patients who underwent radical surgery for colon cancer between January 2008 and December 2015 was undertaken. The cohort was divided into the no-AC and AC groups.
Results
We included 227 patients with stage IIA colon cancer in our study cohort, including 67 and 160 patients in the no-AC and AC groups, respectively. The number of retrieved lymph nodes and the presence of tumor complications as obstruction or perforation were independent risk factors for survival. In the no-AC group, there was a significant difference in survival according to the number of retrieved lymph nodes. In the AC group, there were significant differences in survival according to sidedness and preoperative carcinoembryonic antigen (CEA). There was no significant difference in survival between the no-AC and the AC groups.
Conclusion
The number of retrieved lymph nodes and the presence of tumor complications were prognostic factors for stage IIA colon cancer but lymphovascular and perineural invasion were not. Sidedness and preoperative CEA could be used as factors to predict the benefit of adjuvant chemotherapy. Currently, it is believed that there is no benefit of AC for stage IIA colon cancer. Further studies are needed to determine the survival benefit of adjuvant chemotherapy in stage IIA colon cancer.

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Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. 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
Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis
Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han, Zhou Li
International Journal of Colorectal Disease.2022; 37(12): 2481. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef

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
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Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications
Hyun-Chang Kim, Dong Woo Han, Eun Jung Park, Yeon Hwa Hong, Young Song
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Analgesic effects of combined transversus abdominis plane block and intramuscular electrical stimulation in patients undergoing cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy: a randomized controlled trial
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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Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo
Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik
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Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
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Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
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Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
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Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
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Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
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Chan Wook Kim
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Sarah S Alhumaidan, Abeer M Alharbi, Ayesha Farhana Syeda, Fatimah A Alghaidani, Manal M Almutairi, Nourah A Alharbi, Reham K Alenezi
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International Journal of Colorectal Disease.2020; 35(10): 1831. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy

Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer: Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2020;36(4):229-242. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.03

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Abstract PDF Supplementary Material

Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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Survival Benefits of Postoperative Chemotherapy in Patients With Colorectal Mucinous Adenocarcinoma: An Analysis Utilizing Propensity Score Matching From the Surveillance, Epidemiology, and End Results Database
Jun Rong, Wensheng Deng
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Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara
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Annals of Gastroenterological Surgery.2023; 7(1): 91. CrossRef
Clinical outcomes and cost comparison of laparoscopic versus open surgery in elderly colorectal cancer patients over 80 years
Aik Yong Chok, Ivan En-Howe Tan, Yun Zhao, Madeline Yen Min Chee, Hui Lionel Raphael Chen, Kwok Ann Ang, Marianne Kit Har Au, Emile John Kwong Wei Tan
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study
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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
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Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients
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Indication for and Effect of Adjuvant Chemotherapy for Stage IIa (T3N0M0) Colon Cancer: Chul-Hyo Jeon, Min Ki Kim, In Kyu Lee; Ann Coloproctol. 2019;35(5):254-261. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.12.04

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Abstract PDF

Purpose
The efficacy of adjuvant chemotherapy (AC) in stage IIa colon cancer is controversial. This study aimed to investigate the factors influencing survival in patients with stage IIa colon cancer, the role of AC, and the indications for AC utilization by surgical oncologists.
Methods
Between January 2004 and December 2010, 736 patients with stage IIa colon cancer underwent curative resection in 1 of 6 participating hospitals. Factors related to survival were identified and analyzed according to whether AC was administered or not. After high- and low-risk groups were identified, their respective results were analyzed.
Results
The 5-year overall survival (OS) of stage IIa colon cancer was 90.3%. With the exception of poorly differentiated histology, indications for AC did not include typical high-risk factors. The indications for AC were significantly younger patients, higher body mass index (BMI), lower American Society of Anesthesiologists (ASA) physical status classification, and higher histologic grade. BMI, preoperative carcinoembryonic antigen, and harvested lymph node (LN) count were significant factors for disease-free survival, while BMI and ASA physical status classification were significant factors for OS in the chemotherapy group. In the high-risk group, AC was associated with increased OS in univariate analysis. BMI and harvested LN count were statistically significant in multivariate analysis.
Conclusion
Surgical oncologists consider the patient’s condition and postoperative course rather than high-risk factors to determine use of AC. Regardless of AC use, both the extent of surgery and the patient’s subsequent status affected the survival rate in the high-risk group. None of the factors identified influenced survival rate in the low-risk group.

Citations

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Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer
Abdullah Al-Sawat, Jung Hoon Bea, Seung-Rim Han, Hyo Jin Lee, Mi Ran Yoon, Yoon Suk Lee, Do Sang Lee, Chul Seung Lee, In Kyu Lee
International Journal of Colorectal Disease.2022; 37(2): 365. CrossRef
Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer
Mok-Won Lee, Jin-Su Kim, Ji-Yeon Kim, Kyung-ha Lee
Annals of Coloproctology.2021; 37(1): 35. CrossRef

Efficacy and Feasibility of Adding Induction Chemotherapy to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Phase II Clinical Trial: Hamid Nasrolahi, Sepideh Mirzaei, Mohammad Mohammadianpanah, Ali Mohammad Bananzadeh, Maral Mokhtari, Mohammad Reza Sasani, Ahmad Mosalaei, Shapour Omidvari, Mansour Ansari, Niloofar Ahmadloo, Seyed Hasan Hamedi, Nezhat Khanjani; Ann Coloproctol. 2019;35(5):242-248. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.09.06

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Abstract PDF

Purpose
Currently, neoadjuvant chemoradiation (CRT) followed by total mesorectal resection is considered the standard of care for treating locally advanced rectal cancer. This study aimed to investigate the efficacy and feasibility of adding induction chemotherapy to neoadjuvant CRT in locally advanced rectal cancer.
Methods
This phase-II clinical trial included 54 patients with newly diagnosed, locally advanced (clinical T3–4 and/or N1–2, M0) rectal cancer. All patients were treated with 3 cycles of preoperative chemotherapy using the XELOX (capecitabine + oxaliplatin) regimen before and after a concurrent standard long course of CRT (45–50.4 Gy) followed by standard radical surgery. Pathologic complete response (PCR) rate and toxicity were the primary and secondary endpoints, respectively.
Results
The study participants included 37 males and 17 females, with a median age of 59 years (range, 20–80 years). Twenty-nine patients (54%) had clinical stage-II disease, and 25 patients (46%) had clinical stage-III disease. Larger tumor size (P = 0.006) and distal rectal location (P = 0.009) showed lower PCR compared to smaller tumor size and upper rectal location. Pathologic examinations showed significant tumor regression (6.1 ± 2.7 cm vs. 1.9 ± 1.8 cm, P < 0.001) with 10 PCRs (18.5%) compared to before the intervention. The surgical margin was free of cancer in 52 patients (96.3%). Treatment-related toxicities were easily tolerated, and all patients completed their planned treatment without interruption. Grade III and IV toxicities were infrequent.
Conclusion
The addition of induction chemotherapy to neoadjuvant CRT is an effective and well-tolerated treatment approach in patients with rectal cancer.

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Nanomedicine integrating the lipidic derivative of 5-fluorouracil, miriplatin and PD-L1 siRNA for enhancing tumor therapy
An Lu, Yuhao Guo, Yi Yan, Lin Zhai, Xiangyu Wang, Weiran Cao, Zijie Li, Zhixia Zhao, Yujie Shi, Yuanjun Zhu, Xiaoyan Liu, Huining He, Zhiyu Wang, Jian-Cheng Wang
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Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Intensified Total Neoadjuvant Therapy in Patients With Locally Advanced Rectal Cancer: A Phase II Trial
F. De Felice, G. D'Ambrosio, F. Iafrate, A. Gelibter, F.M. Magliocca, D. Musio, S. Caponetto, G. Casella, I. Clementi, A. Picchetto, G. Sirgiovani, M. Parisi, C. Orciuoli, G. Torrese, G. De Toma, V. Tombolini, E. Cortesi
Clinical Oncology.2021; 33(12): 788. CrossRef
Efficacy and safety of sequential neoadjuvant chemotherapy and short-course radiation therapy followed by delayed surgery in locally advanced rectal cancer: a single-arm phase II clinical trial with subgroup analysis between the older and young patients
Alimohammad Bananzadeh, Ali Akbar Hafezi, NamPhong Nguyen, Shapour Omidvari, Ahmad Mosalaei, Niloofar Ahmadloo, Mansour Ansari, Mohammad Mohammadianpanah
Radiation Oncology Journal.2021; 39(4): 270. CrossRef
Induction Chemotherapy in Patients With Anal Canal Cancer: A Pilot Study
Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Clinical Colorectal Cancer.2020; 19(3): e137. CrossRef

Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery: Yoo Jin Choi, Jung-Myun Kwak, Neul Ha, Tae Hoon Lee, Se Jin Baek, Jin Kim, Seon Hahn Kim; Ann Coloproctol. 2019;35(4):187-193. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.1

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Abstract PDF

Purpose
No guidelines exist detailing when to implement a temporary ileostomy closure in the setting of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer. The aim of this study was to evaluate the clinical and oncological outcomes of ileostomy closure during adjuvant chemotherapy in patients with curative resection of rectal cancer.
Methods
This retrospective study investigated 220 patients with rectal cancer undergoing sphincter-saving surgery with protective loop ileostomy from January 2007 to August 2016. Patients were divided into 2 groups: group 1 (n = 161) who underwent stoma closure during adjuvant chemotherapy and group 2 (n = 59) who underwent stoma closure after adjuvant chemotherapy.
Results
No significant differences were observed in operative time, blood loss, postoperative hospital stay, or postoperative complications in ileostomy closure between the 2 groups. No difference in overall survival (P = 0.959) or disease-free survival (P = 0.114) was observed between the 2 groups.
Conclusion
Ileostomy closure during adjuvant chemotherapy was clinically safe, and interruption of chemotherapy due to ileostomy closure did not change oncologic outcomes.

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Li Wang, Xinling Chen, Chen Liao, Qian Wu, Hongliang Luo, Fengming Yi, Yiping Wei, Wenxiong Zhang
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I. Vogel, N. Reeves, P. J. Tanis, W. A. Bemelman, J. Torkington, R. Hompes, J. A. Cornish
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Zhen Sun, Yufeng Zhao, Lu Liu, Jichao Qin, Zhongguang Luo
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Delayed ileostomy closure increases the odds of Clostridium difficile infection
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Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients
Marcin Zeman, Marek Czarnecki, Andrzej Chmielarz, Adam Idasiak, Maciej Grajek, Agnieszka Czarniecka
World Journal of Surgical Oncology.2020;[Epub] CrossRef

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