Annals of Coloproctology

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Special issue, Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology

Has the COVID-19 Pandemic Caused Upshifting in Colorectal Cancer Stage?: Ji Ha Lim, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin; Ann Coloproctol. 2021;37(4):253-258. Published online August 9, 2021; DOI: https://doi.org/10.3393/ac.2021.00269.0038

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22 Citations

Purpose
Coronavirus disease 2019 (COVID-19) has affected many parts of daily life and healthcare, including cancer screening and diagnosis. The purpose of this study was to determine whether there was an upshift in the colorectal cancer stage at diagnosis due to delays related to the COVID-19 outbreak.
Methods
From January to June of each year from 2017 to 2020, a total of 3,229 patients who were first diagnosed with colorectal cancer were retrospectively reviewed. Those enrolled from 2017 to 2019 were classified as the ‘pre-COVID’ group, and those enrolled in 2020 were classified as the ‘COVID’ group. The primary outcome was the rate of stage IV disease at the time of diagnosis.
Results
There was no statistically significant difference in the proportion of stage IV patients between the pre-COVID and COVID groups (P=0.19). The median preoperative carcinoembryonic antigen level in the COVID group was higher than in the pre-COVID group in all stages (all P<0.05). In stage I, II patients who underwent radical surgery, the lymphatic invasion was more presented in COVID patients (P=0.009).
Conclusion
We did not find significant stage upshifting in colorectal cancer during the COVID-19 outbreak. However, there were more initially unresectable stage IV colorectal cancer patients with a low conversion rate to resectable status, and more patients had factors related to poor prognosis. These results may become more apparent over time, so it is vital not to neglect cancer screening to not delay the diagnosis during the COVID-19 epidemic.

Citations

Citations to this article as recorded by

The impact of extended invitation intervals on stage distribution of screen‐detected and interval cancer within the Dutch colorectal cancer screening program
Maria‐Alexandra Katsara, Danica van den Berg, Manon C. W. Spaander, Adriana J. van Vuuren, Evelien Dekker, Folkert J. van Kemenade, Iris D. Nagtegaal, Monique E. van Leerdam, Iris Lansdorp‐Vogelaar, Esther Toes‐Zoutendijk
International Journal of Cancer.2025; 157(2): 298. CrossRef
The COVID-19 pandemic and clinical characteristics of colorectal cancer: a multicenter retrospective study
Yoon Dae Han, Sung Uk Bae, Woo Ram Kim, Dae Ro Lim, Chang Woo Kim
Scientific Reports.2025;[Epub] CrossRef
Impact of the COVID-19 pandemic on the diagnosis, tumor characteristics, and survival outcomes of colorectal cancer: a retrospective cohort study
Enver Yarikkaya, Merve Cin, Sena Ecin-Demezoglu, Beste Noyan-Mod, Mert Mahsuni Sevinc, Yakup Bozkaya, Nevra Dursun-Kepkep
Annals of Saudi Medicine.2025; 45(3): 169. CrossRef
The impact of COVID-19 on patients diagnosed with melanoma, breast, and colorectal cancer
Danielle Hanuschak, Mallori DePiero, Melissa DeMoraes, Shamoore Bailly, Muni Rubens, Paul Lindeman, Michael Zinner, Geoffrey Young
The American Journal of Surgery.2024; 229: 36. CrossRef
The global pandemic's second deadly hit: cancer care
Emma Bradley, Magge Deepa
The American Journal of Surgery.2024; 229: 34. CrossRef
Trends in the Stage Distribution of Colorectal Cancer During the COVID-19 Pandemic in Japan: A Nationwide Hospital-claims Data Analysis
Masato Ota, Kohei Taniguchi, Mitsuhiro Asakuma, Sang-Woong Lee, Yuri Ito
Journal of Epidemiology.2024; 34(7): 356. CrossRef
Inadvertent laparoscopic lavage of perforated colon cancer: a systematic review
Mahir Gachabayov, Agon Kajmolli, Luis Quintero, Daniel M. Felsenreich, Dorin E. Popa, Dejan Ignjatovic, Roberto Bergamaschi
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Impact of the Sars-Cov-2 outbreak on the initial clinical presentation of new solid cancer diagnoses: a systematic review and meta-analysis
Simon Marty, Guillaume Lamé, Etienne Guével, Sonia Priou, Gilles Chatellier, Christophe Tournigand, Emmanuelle Kempf
BMC Cancer.2024;[Epub] CrossRef
Measuring the impact of COVID-19 on cancer survival using an interrupted time series analysis
Pascal Lambert, Katie Galloway, Allison Feely, Oliver Bucher, Piotr Czaykowski, Pamela Hebbard, Julian O Kim, Marshall Pitz, Harminder Singh, Maclean Thiessen, Kathleen M Decker
JNCI Cancer Spectrum.2024;[Epub] CrossRef
Decreased Positive Fecal Occult Blood Tests and Delayed Medical Presentation for Colorectal Cancer during the Initial COVID-19 Pandemic Period: A Single-center Experience
Tadataka Takagi, Fumikazu Koyama, Hiroyuki Kuge, Yosuke Iwasa, Takeshi Takei, Tomomi Sadamitsu, Kosuke Fujimoto, Suzuka Harada, Takashi Tamura, Goki Ejiri, Chihiro Yoshikawa, Masayuki Sho
Journal of the Anus, Rectum and Colon.2024; 8(3): 188. CrossRef
Impact of COVID-19 Pandemic on the Clinical and Pathologic Characteristics of Colorectal Cancer: A Retrospective Multicenter Study in South Korea
Jae Hyun Kang, Il Tae Son, Sang Nam Yoon, Jin Soo Ihm, Byung Mo Kang, Jong Kim
Cancer Management and Research.2024; Volume 16: 1131. CrossRef
The COVID-19 pandemic's impact on prostate cancer screening and diagnosis in Korea
Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha
Kosin Medical Journal.2023; 38(3): 193. CrossRef
Measuring the impact of the COVID‐19 pandemic on colorectal cancer presentation: a retrospective comparative study
Kirsten Fullard, Daniel Steffens, Michael Solomon, Joo‐Shik Shin, Cherry Koh
ANZ Journal of Surgery.2023; 93(12): 2951. 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
Colorectal Surgery in the COVID-19 Era: A Systematic Review and Meta-Analysis
Nikolaos Pararas, Anastasia Pikouli, Dimitrios Papaconstantinou, Georgios Bagias, Constantinos Nastos, Andreas Pikoulis, Dionysios Dellaportas, Panagis Lykoudis, Emmanouil Pikoulis
Cancers.2022; 14(5): 1229. CrossRef
Short-Term Impact of Temporary Shutdown of a University-Affiliated Hospital on Patients With Colorectal Cancer During the Coronavirus Disease 2019 Pandemic
Youn Young Park, Jaeim Lee, Kil-yong Lee, Seong Taek Oh
Journal of Korean Medical Science.2022;[Epub] CrossRef
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
The effect of the COVID-19 pandemic on the outcomes of surgically treated colorectal diseases: a retrospective cohort study
Gülten Çiçek Okuyan, Melih Yıldırım
Annals of Surgical Treatment and Research.2022; 103(2): 104. CrossRef
Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic
Sami Akbulut, Abdirahman Sakulen Hargura, Ibrahim Umar Garzali, Ali Aloun, Cemil Colak
World Journal of Clinical Cases.2022; 10(26): 9228. 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
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
No evidence of delay in colorectal cancer diagnosis during the COVID-19 pandemic in Gwangju and Jeonnam, Korea
Hye-Yeon Kim, Min-Gyeong Kim, Mi-Ran Kang, Jeong-Ho Yang, Min-Ho Shin, Sun-Seog Kweon
Epidemiology and Health.2022; 44: e2022092. 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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8 Citations

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.

Citations

Citations to this article as recorded by

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,Prognosis and adjuvant therapy

Identification of Risk Factors Associated With Stage III Disease in Nonmetastatic Colon Cancer: Results From a Prospective National Cohort Study: Jakob Lykke, Ole Roikjaer, Per Jess, Jacob Rosenberg, On behalf of the Danish Colorectal Cancer Group; Ann Coloproctol. 2020;36(5):316-322. Published online February 18, 2020; DOI: https://doi.org/10.3393/ac.2019.03.03

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5 Web of Science
5 Citations

Abstract PDF

Purpose
This study aimed to identify possible patient- and tumor-related factors associated with risk of TNM stage III disease in nonmetastatic colon cancer.
Methods
The associations between stage III disease and age, sex, lymph node yield, pathological tumor (pT) stage, tumor subsite, type of surgery, and priority of surgery were assessed in a nationwide cohort of 13,766 patients treated with curative resection of colon cancer. Each level of age, lymph node yield, and pT stage was compared to the preceding level.
Results
Age, lymph node yield, pT stage, tumor subsite, and priority of surgery were associated with stage III disease. Odds ratios (95% confidence interval [CI]) were as follows: age < 65/65–75 years: 1.28 (95% CI, 1.15–1.43) and 65–75/ > 75 years: 1.22 (95% CI, 1.13–1.32); lymph node yield 0–5/6–11: 0.60 (95% CI, 0.50–0.72), lymph node yield 6–11/12–17: 0.84 (95% CI, 0.76–0.93), and lymph node yield 12–17/ ≥ 18: 0.97 (95% CI, 0.89–1.05); pT1/pT2: 0.74 (95% CI, 0.57–0.95), pT2/pT3: 0.35 (95% CI, 0.30–0.40), and pT3/pT4: 0.49 (95% CI, 0.47–0.54). Only tumors of the transverse colon were independently associated with lower risk of stage III disease than tumors in the sigmoid colon (sigmoid colon: 1, transverse colon: 0.84 [95% CI, 0.73–0.96]; elective surgery: 1, acute surgery: 1.43 [95% CI, 1.29–1.60]).
Conclusion
In this study, stage III disease in colon cancer was significantly associated with age, lymph node yield, pT stage, tumor subsite, and priority of surgery but was not associated with right-sided location compared with stage I and II cancers.

Citations

Citations to this article as recorded by

Association of the pathomics-collagen signature with lymph node metastasis in colorectal cancer: a retrospective multicenter study
Wei Jiang, Huaiming Wang, Xiaoyu Dong, Yandong Zhao, Chenyan Long, Dexin Chen, Botao Yan, Jiaxin Cheng, Zexi Lin, Shuangmu Zhuo, Hui Wang, Jun Yan
Journal of Translational Medicine.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
Deep learning-based pathology signature could reveal lymph node status and act as a novel prognostic marker across multiple cancer types
Siteng Chen, Jinxi Xiang, Xiyue Wang, Jun Zhang, Sen Yang, Wei Yang, Junhua Zheng, Xiao Han
British Journal of Cancer.2023; 129(1): 46. 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
Deep learning can predict lymph node status directly from histology in colorectal cancer
Lennard Kiehl, Sara Kuntz, Julia Höhn, Tanja Jutzi, Eva Krieghoff-Henning, Jakob N. Kather, Tim Holland-Letz, Annette Kopp-Schneider, Jenny Chang-Claude, Alexander Brobeil, Christof von Kalle, Stefan Fröhling, Elizabeth Alwers, Hermann Brenner, Michael Ho
European Journal of Cancer.2021; 157: 464. CrossRef

Perioperative Serum Carcinoembryonic Antigen Ratio Is a Prognostic Indicator in Patients With Stage II Colorectal Cancer: Jinsun Woo, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keun Ho Yang, Byung-Noe Bae, Ki Hwan Kim; Ann Coloproctol. 2018;34(1):4-10. Published online February 28, 2018; DOI: https://doi.org/10.3393/ac.2018.34.1.4

6,029 View
79 Download
6 Web of Science
3 Citations

Abstract PDF

Purpose

The aim of this study was to evaluate whether the perioperative carcinoembryonic antigen (CEA) ratio could be used as a determinant for adjuvant therapy after curative surgery in stage II colorectal cancer.

Methods

Data for 119 patients with stage II colorectal cancer who underwent radical surgery between 2010 and 2013 were collected. The perioperative CEA ratio was defined as the postoperative/preoperative serum CEA level, and the patients were grouped according to their perioperative CEA ratios: high ratio (≥0.5) and low ratio (<0.5). Overall survival rates were calculated, and their prognostic significances were analyzed.

Results

The overall survival rates of the high and the low perioperative CEA groups were 68.2% and 86.8%, respectively (P = 0.033). In patients with normal preoperative CEA levels (<5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (71.7% vs. 100.0%, P = 0.007). In patients with high preoperative CEA levels (≥5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (33.3% vs. 75.0%, P = 0.036). In the multivariate analysis, perioperative CEA ratio (P = 0.046), age (P = 0.034), and venous invasion (P = 0.015) were independent prognostic factors for survival.

Conclusion

The perioperative CEA ratio is a prognostic indicator for stage II colorectal cancer. Patients with normal preoperative serum CEA levels might also be considered for adjuvant therapy if their perioperative CEA ratios are higher than 0.5.

Citations

Citations to this article as recorded by

Tumor regression and immunity in combination therapy with anti-CEA chimeric antigen receptor T cells and anti-CEA-IL2 immunocytokine
Seung E. Cha, Maciej Kujawski, Paul J. Yazaki, Christine Brown, John E. Shively
OncoImmunology.2021;[Epub] CrossRef
Prognostic Impact of Pretreatment Elevated and Normalized Carcinoembryonic Antigen Levels After Neoadjuvant Chemoradiotherapy in Resected Locally Advanced Rectal Cancer Patients
Jianyuan Song, Zhuhong Chen, Daxin Huang, Benhua Xu
Cancer Management and Research.2021; Volume 13: 3713. CrossRef
Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer
Thomas A. Odeny, Nicole Farha, Hannah Hildebrandand, Jessica Allen, Wilfred Vazquez, Maximillian Martinez, Ravi Kumar Paluri, Anup Kasi
Journal of Clinical Medicine.2020; 9(12): 3848. CrossRef

Does T3 Subdivision Correlate with Nodal or Distant Metastasis in Colorectal Cancer?: Hong Yeol Yoo, Rumi Shin, Heon-Kyun Ha, Heung-Kwon Oh, Seung-Yong Jeong, Kyu Joo Park, Gyeong Hoon Kang, Woo Ho Kim, Jae-Gahb Park; J Korean Soc Coloproctol. 2012;28(3):160-164. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.160

4,847 View
35 Download
10 Citations

Abstract PDF

Purpose

We analyzed the clinical data of T3 colorectal cancer patients to assess whether T3 subdivision correlates with node (N) or metastasis (M) staging and stage-independent factors.

Methods

Five hundred fifty-five patients who underwent surgery for primary colorectal cancer from January 2003 to December 2009 were analyzed for T3 subdivision. T3 subdivision was determined by the depth of invasion beyond the outer border of the proper muscle (T3a, <1 mm; T3b, 1 to 5 mm; T3c, >5 to 15 mm; T3d, >15 mm). We investigated the correlation between T3 subdivision and N, M staging and stage-independent prognostic factors including angiolymphatic invasion (ALI), venous invasion (VI) and perineural invasion (PNI).

Results

The tumors of the 555 patients were subclassified as T3a in 86 patients (15.5%), T3b in 209 patients (37.7%), T3c in 210 patients (37.8%) and T3d in 50 patients (9.0%). The nodal metastasis rates were 39.5% for T3a, 56.5% for T3b, 75.7% for T3c and 74.0% for T3d. The distant metastasis rates were 7.0% for T3a 9.1% for T3b, 27.1% for T3c and 40.0% for T3d. Both N and M staging correlated with T3 subdivision (Spearman's rho = 0.288, 0.276, respectively; P < 0.001). Other stage-independent prognostic factors correlated well with T3 subdivision (Spearman's rho = 0.250, P < 0.001 for ALI; rho = 0.146, P < 0.001 for VI; rho = 0.271, P < 0.001 for PNI).

Conclusion

Subdivision of T3 colorectal cancer correlates with nodal and metastasis staging. Moreover, it correlates with other prognostic factors for colorectal cancer.

Citations

Citations to this article as recorded by

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International Journal of Clinical Oncology.2022; 27(9): 1428. CrossRef
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Xue Ding, Danqi Sun, Qiuchen Guo, Yeting Li, Hao Chen, Xiaoxiao Dai, Guohua Fan, Yongyou Wu, Guangqiang Chen, Yonggang Li
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European Journal of Cancer.2018; 104: 47. CrossRef
Extramural extension as indicator for postoperative adjuvant chemotherapy in Stage IIA (pT3N0) colon cancer
Yoshito Akagi, Kazuo Shirouzu, Tetsushi Kinugasa
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T3 Subdivision Correlation with Nodal or Distant Metastasis in Colorectal Cancer; Is It Practically Useful?
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