Annals of Coloproctology

Review

Malignant disease, Rectal cancer,Colorectal cancer,Prognosis,Biomarker & risk factor

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer: Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim; Ann Coloproctol. 2022;38(2):97-108. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.01004.0143

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We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

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THE ROLE OF SERUM MIDKINE IN THE DIAGNOSIS AND PROGNOSIS OF THE COLORECTAL CARCINOMA
Ali H. Abd-Allah, Haider A. Jabbar, Mazen J. Ibrahim
Military Medical Science Letters.2024; 93(3): 274. CrossRef
Comparison of the efficacy and safety of single-port versus multi-port robotic total mesorectal excision for rectal cancer: A propensity score-matched analysis
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Predictors of Timely Initiation and Completion of Adjuvant Chemotherapy in Stage II/III Colorectal Adenocarcinoma
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The American Surgeon™.2024; 90(11): 2724. CrossRef
Associations of lifestyle characteristics with circulating immune markers in the general population based on NHANES 1999 to 2014
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C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging
Tatsunosuke Harada, Masakatsu Numata, Shota Izukawa, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Teni Godai, Hiroyuki Mushiake, Nobuhiro Sugano, Mamoru Uchiyama, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Chikara Kunisaki, A
Surgical Endoscopy.2024; 38(8): 4236. CrossRef
The conditional recurrence-free survival after R0 hepatectomy for locally advanced intrahepatic cholangiocarcinoma: A competing risk analysis based on inflammation-nutritional status
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Heliyon.2024; 10(13): e33931. CrossRef
Predictive value of flexible proctosigmoidoscopy and laboratory findings for complete clinical responses after neoadjuvant chemoradiotherapy in patients with locally advanced primary rectal cancer: a retrospective cohort study
Alireza Hadizadeh, Hamed Kazemi-Khaledi, Mohammad-Sadegh Fazeli, Seyed-Mohsen Ahmadi-Tafti, Amir Keshvari, Reza Akbari-Asbagh, Mohammad-Reza Keramati, Alireza Kazemeini, Amir-Reza Fazeli, Behnam Behboudi, Mohammadamin Parsaei
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Clinical significance of positive resection margin for patients with rectal neuroendocrine tumors within 20 mm following initial endoscopic resection: A multi-center study
Mengping Duan, Zhanzhen Liu, Yan Qiao, Pinzhu Huang, Hao Xie, Wei Xiao, Shuangling Luo, Zhuochao Xie, Qiufeng Sun, Liwei Wang, Taixuan Wan, Zhihong Zhang, Huashan Liu, Haoqi Zheng, Yebohao Zhou, Dongxu Lei, Yunxing Shi, Sichong Lai, Ziwei Zhou, Fujin Ye,
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Elevated fibrinogen-albumin ratio is an adverse prognostic factor for patients with primarily resected gastroesophageal adenocarcinoma
Gerd Jomrich, Winny Yan, Dagmar Kollmann, Ivan Kristo, Daniel Winkler, Hannah Puhr, Aysegül lhan-Mutlu, Marlene Hollenstein, Reza Asari, Sebastian F. Schoppmann
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Erkan Kayikcioglu, Gokce Iscan
Cureus.2023;[Epub] CrossRef
Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer
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Development of preoperative and postoperative machine learning models to predict the recurrence of huge hepatocellular carcinoma following surgical resection
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Oncology Letters.2023;[Epub] CrossRef
Cancer and Diabetes: Predictive Factors in Patients with Metabolic Syndrome
Mihai Cosmin Stan, Daniel Georgescu, Ciprian Camil Mireștean, Florinel Bădulescu
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ASO Author Reflections: Could the Application of Machine Learning Enhance the Accuracy of Prognosis Estimation Using Serum Inflammatory Markers in Colorectal Cancer Patients?
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Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
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Clinical Significance of Combining Preoperative and Postoperative Albumin-Bilirubin Score in Colorectal Cancer
Doyoun Kim, Jae-Hoon Lee, Eun-Suk Cho, Su-Jin Shin, Hye Sun Lee, Hwa-Hee Koh, Kang Young Lee, Jeonghyun Kang
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Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
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Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
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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

Original Articles

Malignant disease, Rectal cancer,Prognosis,Biomarker & risk factor

Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer?: Sang Hyun An, Ik Yong Kim; Ann Coloproctol. 2022;38(3):253-261. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00633.0090

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13 Citations

Abstract PDF

Purpose
Systemic inflammation is associated with various malignancies, including colorectal cancer, as possible prognostic predictors. We aimed to evaluate the correlation of pretreatment the platelet-to-lymphocyte (PLR) and the neutrophil-to-lymphocyte (NLR) ratio with long-term oncologic outcomes and pathologic complete response (pCR) in locally ad vanced rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy (CRT) followed by curative resection.
Methods
Between October 1996 and December 2015, 168 rectal cancer patients treated with preoperative CRT followed by surgery were enrolled. The set cut-off/mean PLR and NLR were 170 and 2.8. We analyzed the relationship between PLR, NLR, and the 5-year overall survival (OS), disease-free survival (DFS), and pCR rate.
Results
The 5-year OS rates were 75.9% and 59.8% in the highand low-PLR groups. The 5-year DFS rates were 62.9% and 50.8% in the high- and low-PLR groups, with no significant difference. In addition, the 5-year OS rates were 75.7% and 58.4%, and the 5-year DFS rates were 62.5% and 50.0% in the high- and low-NLR groups, respectively, both without any significant difference. Multivariate analysis showed only pretreatment PLR as an independent prognostic factor for OS (hazard ratio, 1.850; 95% confidence interval, 1.041–3.287; P=0.036), and both serologic markers were not independent prognostic factors for 5-year DFS.
Conclusion
Neither PLR nor NLR was associated with 5-year DFS nor pCR to neoadjuvant CRT. Only pretreatment PLR can be used in predicting OS in locally advanced rectal cancer patients who received neoadjuvant CRT followed by curative resection.

Citations

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Effect of preoperative pan-immune-inflammation value on clinical and oncologic outcomes after colorectal cancer surgery: a retrospective study
Yun Ju Seo, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
Annals of Surgical Treatment and Research.2024; 106(3): 169. CrossRef
Systemic Inflammatory Response Following Preoperative Chemoradiotherapy Can Affect Oncologic Outcomes in MSI-H/dMMR Rectal Cancer
Hyukjin Choi, Jin Ho Baek, An Na Seo, Su Yeon Park, Hye Jin Kim, Jun Seok Park, Gyu Seog Choi, Jong Gwang Kim, Byung Woog Kang
Chonnam Medical Journal.2024; 60(2): 105. CrossRef
Prognostic role of platelet-to-lymphocyte ratio in patients with rectal cancer undergoing resection: a systematic review and meta-analysis
Lijuan Ma, Fei Yang, Wentao Guo, Shufang Tang, Yarui Ling
Frontiers in Oncology.2024;[Epub] CrossRef
Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group
Giuditta Chiloiro, Angela Romano, Silvia Mariani, Gabriella Macchia, Diana Giannarelli, Luciana Caravatta, Pierfrancesco Franco, Luca Boldrini, Alessandra Arcelli, Almalina Bacigalupo, Liliana Belgioia, Antonella Fontana, Elisa Meldolesi, Giampaolo Montes
Clinical and Translational Radiation Oncology.2023; 39: 100579. CrossRef
Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis
Giuseppe Portale, Patrizia Bartolotta, Danila Azzolina, Dario Gregori, Valentino Fiscon
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Neutrophil-to-lymphocyte ratio predicts survival of patients with rectal cancer receiving neo-adjuvant chemoradiation followed by radical resection: a meta-analysis
Giuseppe Colloca, Antonella Venturino, Domenico Guarneri
Expert Review of Anticancer Therapy.2023; 23(4): 421. CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. 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
Body composition parameters combined with blood biomarkers and magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] 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
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef
Study on the Relationship between NEUT, NLR, PLR and the Severity of Coronary Artery Disease in Patients with ACS
延春蒋
Advances in Clinical Medicine.2022; 12(11): 9836. CrossRef

Malignant disease, Rectal cancer

Influence of the Enhanced Recovery After Surgery Protocol on Postoperative Inflammation and Short-term Postoperative Surgical Outcomes After Colorectal Cancer Surgery: Heba Essam Jaloun, In Kyu Lee, Min Ki Kim, Na Young Sung, Suhail Abdullah Al Turkistani, Sun Min Park, Dae Youn Won, Sang Hyun Hong, Bong-Hyeon Kye, Yoon Suk Lee, Hae Myung Jeon; Ann Coloproctol. 2020;36(4):264-272. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.03.25

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170 Download
17 Web of Science
17 Citations

Abstract PDF

Purpose
Many studies have shown that the enhanced recovery after surgery (ERAS) protocols improve postoperative surgical outcomes. The purpose of this study was to observe the effects on postoperative inflammatory markers and to explore the effects of a high degree of compliance and the use of epidural anesthesia on inflammation and surgical outcomes.
Methods
Four hundred patients underwent colorectal cancer surgery at 2 hospitals during 2 different periods, namely, from January 2006 to December 2009 and from January 2017 to July 2017. Data related to the patient’s clinicopathological features, inflammatory markers, percentage of compliance with elements of the ERAS protocol, and use of epidural anesthesia were collected from a prospectively maintained database.
Results
The complication rate and the length of hospital stay (LOS) were less in the ERAS group than in the conventional group (P = 0.005 and P ≤ 0.001, respectively). The postoperative white blood cell count and the duration required for leukocytes to normalize were reduced in patients following the ERAS protocol (P ≤ 0.001). Other inflammatory markers, such as lymphocyte count (P = 0.008), neutrophil/lymphocyte ratio (P = 0.032), and C-reactive protein level (P ≤ 0.001), were lower in the ERAS protocol group. High compliance ( ≥ 70%) was strongly associated with the complication rate and the LOS (P = 0.008 and P ≤ 0.001, respectively).
Conclusion
ERAS protocols decrease early postoperative inflammation and improves short-term postoperative recovery outcomes such as complication rate and the LOS. High compliance ( ≥ 70%) with the ERAS protocol elements accelerates the positive effects of ERAS on surgical outcomes; however, the effect on inflammation was very small.

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Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients
Ji-Chun Tang, Jia-Wei Ma, Jin-Jin Jian, Jie Shen, Liang-Liang Cao
World Journal of Gastrointestinal Oncology.2024; 16(2): 364. CrossRef
Dysregulation of systemic immunity in colorectal cancer and its clinical applications as biomarkers and therapeutics
Changqin Li, Jian Li
Critical Reviews in Oncology/Hematology.2024; 204: 104543. CrossRef
The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
International Journal of Surgery.2024; 110(10): 6282. CrossRef
Enhanced recovery pathway in open and minimally invasive colorectal cancer surgery: a prospective study on feasibility, compliance, and outcomes in a high-volume resource limited tertiary cancer center
Martin Thomas, Vandana Agarwal, Ashwin DeSouza, Riddhi Joshi, Minal Mali, Karuna Panhale, Omkar K. Salvi, Reshma Ambulkar, Shailesh Shrikhande, Avanish Saklani
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Initial experience of abdominal total mesorectal excision for rectal cancer using the da Vinci single port system
Wed Alshalawi, Chul Seung Lee, In Kyeong Kim, Yoon Suk Lee
Journal of Minimally Invasive Surgery.2023; 26(4): 208. CrossRef
Association between enrollment in an enhanced recovery program for colorectal cancer surgery and long‐term recurrence and survival
Andres Zorrilla‐Vaca, Javier Ripolles‐Melchor, Ane Abad‐Motos, Inés Rubiera Mingu, Nekane Moreno‐Jurado, Fátima Martínez‐Durán, Isabel Pérez‐Martínez, Alfredo Abad‐Gurumeta, María L. FuenMayor‐Varela, Gabriel E. Mena, Michael C. Grant
Journal of Surgical Oncology.2022; 125(8): 1269. CrossRef
Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef
Effect of Enhanced Recovery after Surgery with Integrated Traditional Chinese and Western Medicine on Postoperative Stress Response of Patients with Gastrointestinal Tumors
Haiping Zhao, Wenhui Sun, Tao Huang
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Commentary: Preoperative neutrophil to lymphocyte ratio predicts complications after esophageal resection that can be used as inclusion criteria for enhanced recovery after surgery
Cheng Shen, Qiang Pu, Guowei Che
Frontiers in Surgery.2022;[Epub] CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
Sung Uk Bae
Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef
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Woo Jin Song, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
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Effect of the Enhanced Recovery After Surgery protocol After Colorectal Cancer Surgery
Dae Ro Lim
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Case Report

Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians: Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan; Ann Coloproctol. 2019;35(1):47-49. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.03.15

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Abstract PDF

Purpose
Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015.
Methods
The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution.
Results
The median age at diagnosis was 64 years (range, 55–72 years). Magnetic resonance imaging (MRI) was the initial investigation for all patients and showed a hyperintense T2-weighted image. One patient underwent an abdominoperineal resection following neoadjuvant chemoradiotherapy and remained disease free during the 12-month follow-up. Three patients received neoadjuvant therapy with intent for surgery, but did not undergo surgery due to either worsening health or metastatic spread. One patient declined intervention. The median overall survival was 10.5 months (range, 2–19 months).
Conclusion
A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.

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Nalini Kanta Ghosh, Ashok Kumar
Annals of Coloproctology.2024; 40(Suppl 1): S1. CrossRef
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Shinji Yamamoto, Keiji Yonezawa, Naoki Fukata, Koji Takeshita, Makoto Kodama, Tetsuro Yamana, Shigeru Kiryu, Yukinori Okada
Medicine.2023; 102(14): e33281. CrossRef
Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management
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Vasilis Taliadoros, Henna Rafique, Shahnawaz Rasheed, Paris Tekkis, Christos Kontovounisios
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Adjuvant chemoradiotherapy does not improve outcomes in patients with fistula-associated anal adenocarcinoma undergoing abdominoperineal resection
Min Wang, Yu Xiang, Yunshan Wang, Jiayi Zhang, Haoran Zhao, Can Wang, Lichao Qiao, Bolin Yang
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Effects of Intraoperative Insufflation With Warmed, Humidified CO₂ during Abdominal Surgery: A Review: Ju Yong Cheong, Anil Keshava, Paul Witting, Christopher John Young; Ann Coloproctol. 2018;34(3):125-137. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.26

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13 Citations

Abstract PDF

Purpose
During a laparotomy, the peritoneum is exposed to the cold, dry ambient air of the operating room (20°C, 0%–5% relative humidity). The aim of this review is to determine whether the use of humidified and/or warmed CO₂ in the intraperitoneal environment during open or laparoscopic operations influences postoperative outcomes.
Methods
A review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, OVID MEDLINE, Cochrane Central Register of Controlled Trials and Embase databases were searched for articles published between 1980 and 2016 (October). Comparative studies on humans or nonhuman animals that involved randomized controlled trials (RCTs) or prospective cohort studies were included. Both laparotomy and laparoscopic studies were included. The primary outcomes identified were peritoneal inflammation, core body temperature, and postoperative pain.
Results
The literature search identified 37 articles for analysis, including 30 RCTs, 7 prospective cohort studies, 23 human studies, and 14 animal studies. Four studies found that compared with warmed/humidified CO₂, cold, dry CO₂ resulted in significant peritoneal injury, with greater lymphocytic infiltration, higher proinflammatory cytokine levels and peritoneal adhesion formation. Seven of 15 human RCTs reported a significantly higher core body temperature in the warmed, humidified CO₂ group than in the cold, dry CO₂ group. Seven human RCTs found lower postoperative pain with the use of humidified, warmed CO₂.
Conclusion
While evidence supporting the benefits of using humidified and warmed CO₂ can be found in the literature, a large human RCT is required to validate these findings.

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