Annals of Coloproctology

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Original Articles

Colorectal cancer

Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?: Olga Maynovskaia, Evgeny Rybakov, Stanislav Chernyshov, Evgeniy Khomyakov, Sergey Achkasov; Ann Coloproctol. 2023;39(6):484-492. Published online December 26, 2023; DOI: https://doi.org/10.3393/ac.2023.00087.0012

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Purpose
Submucosa-limited (pathological T1, pT1) colorectal cancers (CRCs) pose a continuing challenge in the choice of treatment options, which range from local excision to radical surgery. The aim of this study was to evaluate the morphometric and morphologic risk factors associated with regional lymph node metastasis (LNM) in pT1 CRC.
Methods
We performed a histological review of patients who underwent oncological resection between 2016 and 2022. Tumor grade, budding, poorly differentiated clusters (PDCs), cancer gland rupture, lymphovascular invasion (LVI), and presence of deep submucosal invasion (DSI), as well as width, length, total area, and area of DSI, were evaluated as potential risk factors for LNM.
Results
A total of 264 cases of colon and rectal carcinomas with invasion into the submucosal layer (pT1) were identified. LNM was found in 46 of the 264 cases (17.4%). All morphometric parameters, as well as DSI (P=0.330), showed no significant association with LNM. High grade adenocarcinoma (P=0.050), budding (P=0.056), and PDCs (P<0.001) were associated with LNM. In the multivariate analysis, LVI presence remained the only significant independent risk factor (odds ratio, 15.7; 95% confidence interval, 8.5–94.9; P<0.001).
Conclusion
The DSI of T1 CRC, as well as other morphometric parameters of submucosal tumor spread, held no predictive value in terms of LNM. LVI was the only independent risk factor of LNM.

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IMMUNOREACT 8: Immune markers of local tumor spread in patients undergoing transanal excision for clinically N0 rectal cancer
Giulia Becherucci, Cesare Ruffolo, Melania Scarpa, Federico Scognamiglio, Astghik Stepanyan, Isacco Maretto, Andromachi Kotsafti, Ottavia De Simoni, Pierluigi Pilati, Boris Franzato, Antonio Scapinello, Francesca Bergamo, Marco Massani, Tommaso Stecca, An
Surgery.2025; 178: 108902. CrossRef
Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer
Pin-Chun Chen, Yi-Kai Kao, Po-Wen Yang, Chia-Hung Chen, Chih-I Chen
Scientific Reports.2025;[Epub] CrossRef
Management strategies for pT1 rectal cancer following local excision: Insights from a national survey by the AIRO gastrointestinal study group
Elena Galofaro, Paola De Franco, Federico Barbaro, Roberta Menghi, Silvia Pecere, Angela Romano, Silvia Di Franco, Rita Marina Niespolo, Mariantonietta Gambacorta, Giuditta Chiloiro
Journal of Radiation Research and Applied Sciences.2025; 18(4): 101955. CrossRef
The results of randomized controlled trial comparing effectiveness of transanal endoscopic microsurgery versus endoscopic submucosal dissection
Evgeny Rybakov, Stanislav Chernyshov, Aleksey Likutov, Evgeny Khomiakov, Oleg Yugai, Mikhail Alekseev, Olga Maynovskaia, Mikhail Tarasov, Sergei Achkasov
Surgical Endoscopy.2025;[Epub] CrossRef
Problems and prospects of using morphological risk factors for lymph node metastasis in T1 colorectal cancer (review)
O. A. Mainovskaya
Koloproktologia.2025; 24(4): 177. CrossRef

Colorectal cancer

Stratification of rate of lymph node metastasis according to risk factors and oncologic outcomes in patients who underwent radical resection for rectal neuroendocrine tumors: Myung Jae Jin, Sung Sil Park, Dong-Eun Lee, Sung Chan Park, Dong Woon Lee, Kiho You, Hee Jin Chang, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):467-473. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2022.00913.0130

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Abstract PDF Supplementary Material

Purpose
Most predictive factors for lymph node metastasis in rectal neuroendocrine tumors (NETs) have been based on local and endoscopic resection. We aimed to evaluate the risk factors for lymph node metastasis in patients who underwent radical resection for rectal NETs and stratify the risk of lymph node metastasis.
Methods
Sixty-four patients who underwent radical resection for rectal NETs between January 2001 and January 2018 were included. We investigated the risk factors of lymph node metastasis using clinicopathologic data. We also performed a risk stratification for lymph node metastases using the number of previously known risk factors. For oncologic outcomes, the 5-year overall survival and recurrence-free survival were evaluated in both groups.
Results
Among the patients who underwent radical surgery, 32 (50.0%) had lymph node metastasis and 32 (50.0%) had non–lymph node metastasis. In the multivariable analysis, only the male sex was identified as a risk factor for lymph node metastasis (odds ratio, 3.695; 95% confidence interval, 1.128–12.105; P=0.031). When there were 2 or more known risk factors, the lymph node metastasis rate was significantly higher than when there were one or no risk factors (odds ratio, 3.667; 95% confidence interval, 1.023–13.143; P=0.046). There was also no statistical difference between the 2 groups in 5-year overall survival (P=0.431) and 5-year recurrence-free survival (P=0.144).
Conclusion
We found that the rate of lymph node metastasis increased significantly when the number of known risk factors is 2 or more.

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Lateral pelvic lymph nodes dissection of rectal neuroendocrine neoplasms: A prospective case-series and literature review
Yueyang Zhang, Yi Yang, Changyuan Gao, Hong Zhao, Haitao Zhou
Surgery.2024; 176(5): 1360. CrossRef

Case Report

Rare disease & stoma

A small, low-grade rectal neuroendocrine tumor with lateral pelvic lymph node metastasis: a case report: Seonhui Shin, Young-In Maeng, Seyun Jung, Chun-Seok Yang; Ann Coloproctol. 2022;38(4):327-331. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00899.0128

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Abstract PDF

Rectal neuroendocrine tumors (NETs) are typically small lesions that are confined to the submucosa and have favorable behavior at the time of diagnosis. Local endoscopic or surgical resection is recommended because lymph node metastasis is very rare. In this report, we present the case of a 36-year-old male presenting with an incidentally found rectal mass during screening colonoscopy. Pathologic examination of the primary tumor revealed a 9-mm grade 1 NET with submucosal invasion and no significant aggressive factors except for central ulceration. However, radiologic studies revealed a suspected 2.6-cm mesorectal lymph node metastasis and multiple left internal iliac lymph node metastases. We performed laparoscopic intersphincteric resection with left lateral pelvic lymph node dissection. The final pathologic report revealed a metastatic lymph node with low grade, low mitotic count, and low Ki-67 index. We describe an overview of lymph node metastasis of rectal NETs focusing on lateral pelvic lymph node metastasis.

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Risk factors for and prognostic impact of lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a single-center retrospective analysis of 214 cases with radical resection
Tsubasa Sakurai, Y. Hiyoshi, N. Daitoku, S. Matsui, T. Mukai, T. Nagasaki, T. Yamaguchi, T. Akiyoshi, H. Kawachi, Y. Fukunaga
Surgery Today.2025; 55(2): 144. CrossRef
Construction and evaluation of the prediction model for advanced disease in well-differentiated colorectal neuroendocrine neoplasms less than 2 cm in diameter
Hongda Yin, Yanan Chen, Wei Zhao, Fuqiang Zhao, Zhijun Huang, Aimin Yue, Zhijie Wang
Heliyon.2025; 11(1): e41197. CrossRef
Primary small rectal neuroendocrine tumor with pelvic lateral lymph nodes metastasis: A case report and review of literature
Lihong Li, Ziyue Chen, Dajian Zhu, Qianbao Lv, Tianpeng Zhang, Jinsong Lai
International Journal of Surgery Case Reports.2025; 127: 110963. CrossRef
Risk factors for lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a systematic review and meta-analysis
Ziyue Chen, Dajian Zhu
Frontiers in Oncology.2025;[Epub] CrossRef
Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
Jae Won Shin, Eun-Jung Lee, Sung Sil Park, Kyung Su Han, Chang Gyun Kim, Hee Chul Chang, Won Youn Kim, Eui Chul Jeong, Dong Hyun Choi
Annals of Coloproctology.2025; 41(3): 221. CrossRef
Successfully Resected Isolated Lateral Lymph Node Recurrence in a Patient with T1 Lower Rectal Cancer: Case Report and Literature Review
Kazuma Rifu, Koji Koinuma, Hisanaga Horie, Katsusuke Mori, Daishi Naoi, Mineyuki Tojo, Yuko Homma, Satoshi Murahashi, Atsushi Kihara, Toshiki Mimura, Joji Kitayama, Naohiro Sata
Journal of the Anus, Rectum and Colon.2024; 8(3): 259. CrossRef
Clinical application of endoscopic ultrasonography in the management of rectal neuroendocrine tumors
Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
International Journal of Gastrointestinal Intervention.2023; 12(3): 105. CrossRef
Multiple rectal neuroendocrine tumors: An analysis of 15 cases and literature review
Shu Pang, Ye Zong, Kun Zhang, Haiying Zhao, Yongjun Wang, Junxiong Wang, Chuntao Liu, Yongdong Wu, Peng Li
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Association Between c-Met and Lymphangiogenic Factors in Patients With Colorectal Cancer: Han Jo Kim, Moo-Jun Baek, Dong Hyun Kang, Sang-Cheol Lee, Sang Byung Bae, Kyu Taek Lee, Namsu Lee, Hyungjoo Kim, Dongjun Jeong, Tae Sung Ahn, Moon Soo Lee, Dae Sik Hong, Jong-Ho Won; Ann Coloproctol. 2018;34(2):88-93. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.10.10

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Abstract PDF

Purpose
Animal models show a strong relationship between lymphangiogenesis and lymph node metastasis. However, the clinical significance of lymphangiogenesis in patients with colorectal cancer (CRC) remains uncertain. This study aimed to evaluate the association between c-Met and lymphangiogenic factors and to elucidate the prognostic significance of c-Met in patients with CRC.
Methods
A total of 379 tissue samples were obtained from surgically resected specimens from patients with CRC at Soonchunhyang University Cheonan Hospital between January 2002 and December 2010. The expressions of c-Met, vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGF receptor (VEGFR)-3, and podoplanin were examined using immunohistochemistry. The expression of c-Met and clinical factors were analyzed.
Results
Of the 379 tissues, 301 (79.4%) had c-Met expression. High expression of c-Met in tumor cells was significantly associated with high expression of VEGF-C (P < 0.001) and VEGFR-3 (P = 0.001). However, no statistically significant association with podoplanin (P = 0.587) or VEGF-D (P = 0.096) was found. Of the 103 evaluable patients, expression of c-Met in tumor cells was significantly associated with advanced clinical stage (P = 0.020), positive lymph node status (P = 0.038), and high expression of VEGF-C (P = 0.020). However, no statistically significant association with podoplanin (P = 0.518), VEGFR-3 (P = 0.085), VEGF-D (P = 0.203), or overall survival (P = 0.360) was found.
Conclusion
Our results provide indirect evidence for an association and possible regulatory link of c-Met with the lymphangiogenic markers, but c-Met expression in patients with CRC is not a prognostic indicator for overall survival.

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Expression Profile of Microenvironmental Factors in the Interface Zone of Colorectal Cancer: Histological-Stromal Biomarkers and Cancer Cell-Cancer-Associated Fibroblast-Related Proteins Combined for the Assessment of Tumor Progression
Ricella Souza da Silva, Eduardo M. Queiroga, Cynthia de Toledo Osório, Karin S. Cunha, Fabiana P. Neves, Julieth P. Andrade, Eliane P. Dias
Pathobiology.2024; 91(2): 99. CrossRef
Recent progress in the imaging of c‐Met aberrant cancers with positron emission tomography
Giuseppe Floresta, Vincenzo Abbate
Medicinal Research Reviews.2022; 42(4): 1588. CrossRef
Involvement of Met receptor pathway in aggressive behavior of colorectal cancer cells induced by parathyroid hormone-related peptide
María Belén Novoa Díaz, Pedro Carriere, Graciela Gigola, Ariel Osvaldo Zwenger, Natalia Calvo, Claudia Gentili
World Journal of Gastroenterology.2022; 28(26): 3177. CrossRef
The potential therapeutic and prognostic impacts of the c‐MET/HGF signaling pathway in colorectal cancer
Seyed Mostafa Parizadeh, Reza Jafarzadeh‐Esfehani, Danial Fazilat‐Panah, Seyed Mahdi Hassanian, Soodabeh Shahidsales, Majid Khazaei, Seyed Mohammad Reza Parizadeh, Majid Ghayour‐Mobarhan, Gordon A. Ferns, Amir Avan
IUBMB Life.2019; 71(7): 802. CrossRef

Case Report

TisN0M1 Sigmoid Colon Cancer: A Case Report: Kyung Ha Lee, Jin Su Kim, Kwang Sik Cheon, In Sang Song, Dae Young Kang, Ji Yeon Kim; Ann Coloproctol. 2014;30(3):141-146. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.141

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Abstract PDF

Distant metastasis of a colon carcinoma in situ has not yet been reported. We experienced a case of a sigmoid colon carcinoma in situ with common hepatic lymph node metastasis. After the first operation, we diagnosed dual intramucosal adenocarcinomas of the sigmoid colon without any regional lymph node metastasis. After the second operation, a metastatic adenocarcinoma was found in the common hepatic lymph nodes. We suggest that metastasis in cases of a colonic carcinoma in situ is rare, but possible. The parallel progression model of tumors can explain this early metastasis.

Citations

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Lymph node metastasis in a patient with carcinoma in situ rectal cancer: A case report
San-Ha Kim, Gi-Bong Chae, Seung-Koo Lee, Seung-Joo Nam
Molecular and Clinical Oncology.2025; 23(4): 1. CrossRef
Potential for Metastasis and Recurrence in Colorectal Carcinoma In Situ: A Retrospective Analysis of 1069 Patients
Seijong Kim, Jung Kyong Shin, Yoonah Park, Jung Wook Huh, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Yong Beom Cho
Clinical Colorectal Cancer.2024; 23(3): 245. CrossRef
Rectal intramucosal carcinoma with lymph node metastasis and tumor deposit
Wenhao Chen, Liang Kang, Yan Huang, Zhao Ding
Asian Journal of Surgery.2022; 45(9): 1719. CrossRef
Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
Taichi Horino, Yukiharu Hiyoshi, Yuji Miyamoto, Naoya Yoshida, Hideo Baba
Surgical Case Reports.2020;[Epub] CrossRef
Recurrence, death risk, and related factors in patients with stage 0 colorectal cancer
Ming-Hao Hsieh, Pei-Tseng Kung, Wen-Yin Kuo, Tao-Wei Ke, Wen-Chen Tsai
Medicine.2020; 99(36): e21688. CrossRef
Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef
Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer
Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang
Clinical Endoscopy.2017; 50(1): 91. CrossRef
Lymph node pooling: a feasible and efficient method of lymph node molecular staging in colorectal carcinoma
Natalia Rakislova, Carla Montironi, Iban Aldecoa, Eva Fernandez, Josep Antoni Bombi, Mireya Jimeno, Francesc Balaguer, Maria Pellise, Antoni Castells, Miriam Cuatrecasas
Journal of Translational Medicine.2017;[Epub] CrossRef
Inter- and intra-tumor profiling of multi-regional colon cancer and metastasis
Akihiro Kogita, Yasumasa Yoshioka, Kazuko Sakai, Yosuke Togashi, Shunsuke Sogabe, Takuya Nakai, Kiyotaka Okuno, Kazuto Nishio
Biochemical and Biophysical Research Communications.2015; 458(1): 52. CrossRef

Original Articles

Outcomes after a Hepatic Resection for Multiple Hepatic Metastases from Colorectal Cancer.: Choi, Pyong Wha , Kim, Hee Cheol , Jung, Sang Hun , Kim, Dae Dong , Park, In Ja , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(2):100-106.; DOI: https://doi.org/10.3393/jksc.2008.24.2.100

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PURPOSE
Surgical resection is still considered as the gold standard in patients with hepatic metastases from colorectal cancer. The impact of the number of hepatic metastases is a controversial issue. We aimed to evaluate the outcomes and the prognostic factors after hepatic resection in multiple hepatic metastases from colorectal cancer. METHODS: Between June 1989 and October 2005, 42 patients underwent hepatic resections for three or more hepatic metastases from colorectal cancer. Disease-free survival analyses were performed on patients grouped as a function of the following factors: age, sex, preoperative serum CEA level, primary tumor site, nodal status, intrahepatic distribution, diameter of the liver lesion, their number, and the resection margin. RESULTS: Of the 42 patients, 29 (69.0%) developed recurrence (16 in the liver alone, 5 in the liver and another distant site, 8 in a distant site alone) during a median follow-up of 24 months. The overall 1-, 2-, and 5-year survival rates were 89.1%, 58.6%, and 31.8%, respectively. The 1-year and 2-year disease-free survival rates were 38.1 and 29.4%, respectively. There was no postoperative mortality and the morbidity rate was 11.9%. The disease-free survival rate was independently associated with the resection margin of the metastatic tumor (P=0.017). The 1-year disease- free survival rates in patients with more than a 5-mm resection margin and with less than a 5-mm resection margin were 72.7%, and 25.8%, respectively.
CONCLUSIONS
If technically feasible, an aggressive hepatic resection should be performed for the treatment of multiple hepatic metastases from colorectal cancer. The surgical resection margin may govern the outcomes in patients with surgically curable hepatic metastases from colorectal cancer.

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Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer
Sung Woo Ahn, Ahn Soo Na, Jae Do Yang, Hong Pil Hwang, Hee Chul Yu, Baik Hwan Cho
Korean Journal of Hepato-Biliary-Pancreatic Surgery.2011; 15(3): 146. CrossRef
Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases
Jung Wook Huh, Chol Kyoon Cho, Hyeong Rok Kim, Young Jin Kim
Journal of Gastrointestinal Surgery.2010; 14(8): 1258. CrossRef

c-Met Expression in Colorectal Carcinoma and Adenomas: Correlation with Clinicopathologic Parameters.: Kim, Jin , Kim, Jung Yun , Lee, Won Jin , Cho, Seong Jin , Min, Byoung Wook , Um, Jun Won , Cho, Min Young , Suh, Sung Ock , Moon, Hong Young , Hwang, Cheung Wung; J Korean Soc Coloproctol. 2004;20(4):205-210.

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Abstract PDF: PURPOSE
Hepatocyte growth factor (HGF) stimulates proliferation, migration, and morphogenesis of epithelial cells by specifically binding to its receptor c-met. Abnomalities of the c-met oncogene have been studied in cancers of many organs including thyroid, lung, pancreas, and stomach. However, little is known about the clinical significance of c-met oncogene abnormalities in colorectal carcinomas. In this study, we investigated over- expression of the c-met protein in colorectal adenomas and adenocarcinomas, and analyzed the clinicopathologic significance of this over-expression.
METHODS
Expression of the c-met protein localized in colorectal adenoma and adenocarcinoma tissues was analyzed by using immunohistochemistry. The results were compared with clinicopathologic parameters to find clinical correlation.
RESULTS
c-met protein was detected in 42.5% (17/40) of colorectal cancers and in 10.0% (4/40) of colorectal adenomas (P= 0.001). In colorectal cancer, the proportion of expression of c-met protein was 0% (0/40) in stage I, 47.6% (10/40) in stage II, 53.8% (7/40) in stage III and, 0% (0/40) in stage IV. c-met protein expression was 18.8% (3/40) in tumors with invasion into the muscularis propria (MP), and 58.3% (14/40) in tumors with invasion beyond the MP. The depth of tumor invasion was a statistically significant factor (P=0.022) for c-met expression.
CONCLUSIONS
The c-met protein expression was related to the depth of invasion of colorectal cancer and showed a significant difference in its rate of expression between adenoma and adenocarcinomas.

Clinical Comparison of Hepatic Resection and Radiofrequency Ablation of Hepatic Metastases from Colorectal Cancer.: Kang, Sin Jae , Park, Chi Min , Jeong, Keuk Won , Park, Sung Bae , Yun, Seong Hyeon , Chang, Weon Young , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2004;20(3):163-168.

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Abstract PDF: PURPOSE
The aim of this study was to compare the clinical characteristics between hepatic resection and radiofrequency ablation (RFA) in hepatic metastases of colorectal cancer.
METHODS
Among 183 patients who were diagnosed as having colorectal cancer with hepatic metastases from May 1999 to Dec. 2002, excluding 56 patients who did not undergo a hepatic resection or RFA due to multiple hepatic metastases or other distant metastases, 127 patients who were treated with a pure hepatic resection (N=68), pure RFA (N=35), or a hepatic resection with RFA (N=24) synchronous or metachronous were reviewed in this study. The study included metastatic hepatic tumor size, number, distribution, disease-free survival rate, and overall survival rate.
RESULTS
The mean hepatic tumor sizes in the resection group, the RFA group, and the resection with RFA group were 3.3 cm, 3.0 cm, and 2.5 cm, respectively, but the differences in the sizes had no statistical significance (P>0.1). In the view of the number of hepatic metastases, single metastases were the most prevalent kind in the resection group and the RFA group (64.7% and 60.0%) while multiple metastases were the most prevalent kind in the resection with RFA (20/24, 83.3%). In the resection and the RFA groups, a unilobar distribution was the most common (88.2% and 68.6%), but a bilobar distribution was the most common (87.5%) in the resection with RFA group. The disease-free survival rates were 42.2% (resection group), 30.7% (RFA group), and 22.2% (resection with RFA group) in the third year (P=0.65). The overall survival rates were 70.9% (resection group), 68.4% (RFA group), and 62.9% (resection with RFA group) in the third year (P=0.19).
CONCLUSIONS
There were no significant statistical differences in the disease-free survival and the overall survival rates between the three groups. Radiofrequency ablation (RFA) is considered as not only a complementary but also an alternative treatment tool to hepatic resection in the treatment of hepatic metastases of colorectal cancer and has a similar survival rate.

Prognostic Significance of p53, nm23 and VEGF Expression in Primary and Hepatic Colorectal Cancer Metastases Following Surgical Resection.: Kim, Nam Kyu , Park, Jae Kun , Lee, Kang Young , Kim, Ho geun , Sohn, Seung Kook , Min, Jin Sik; J Korean Soc Coloproctol. 2002;18(2):121-127.

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Abstract PDF: PURPOSE
The aim of this study is to analyze a correlation between related molecular markers and prognosis after curative resection for primary and hepatic metastasis for colorectal cancer.
METHODS
A total 63 patients who have been resected curatively for primary and metastatic colorectal cancer between 1989 and 2000. All patients were completely followed up and recurrence and survival rates were analyzed. All paraffin embedded tumor tissues in primary and metastatic tumors were used for microtissue array and immunohistochemical staining of p53, nm23 and VEGF.
RESULTS
Mean follow up period was 30.9 months. Recurrence was noted in 39/63 (61.9%) and 5 year survival rates was 27.7%. 5 year survival rates according to protein expression in primary tumor: p53+/-: 24.6% vs 27.3%, nm 23 +/-: 17.6% vs 38.9%, VEGF +/-: 38.8% vs 21.6% (P=0.16, 0.06, 0.9, respectively). 5 year survival rates according to protein expression in metastatic tumor, p53 +/-: 18% vs 59.2%, nm 23 +/-; 38.2% vs 15.8%, VEGF +/-: 38.8% vs 21.6% (P=0.03, 0.35, 0.96, respectively). A patients recurred within 1 year after surgery (group I, N=23) were compared with patients who recurred 1 year after (group II, N=16). nm23 expression in primary tumor in each group of patients: ; 15/23 (65.2%), : 4/16 (25 %), : 8/23 (34.8%), : 12/16 (75%), respectively (P= 0.013). But, p53, VEGF expression in primary tumor showed no statistical significance. nm23 expression in metastatic tumor revealed no statistical significance between two group of patients.
CONCLUSIONS
p53 expression in metastatic tumor and nm 23 expression in primary tumor can predict poor prognosis after curative resection for primary and metastatic colorectal cancer. Molecular marker expression in primary and hepatic colorectal cancer can give us a reliable prognostic values.

Prognostic Factors after Hepatic Resection for Metastatic Colorectal Cancer.: Kim, Hee Cheol , Kim, Chang Nam , Hong, Hyoun Kee , Lee, Dong Hee , Yu, Chang Sik , Lee, Je Hwan , Kim, Tae Won , Kim, Jin Cheon; J Korean Soc Coloproctol. 2000;16(2):87-92.

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Abstract PDF: Metastases to the liver from carcinoma of the colon and rectum occur as many as 80% of cases. As resection of metastases is proven to enhance survival and to reduce hepatic recurrence, the criteria for selection of patients and surgery type appear to be indispensable. Purpose: The aim of this study was to assess the prognostic factors after hepatic resection for metastatic colorectal cancer and propose the optimal surgical principles for resection of metastatic colorectal cancer. Methods: Sixty-three patients who underwent initial hepatic resection for liver metastases from colorectal cancer between 1989 and 1998 were analyzed regarding clinical and pathologic parameters. Results: Overall 5-year survival rate was 32%. Preoperative serum CEA level and resection margin of metastatic tumors were found to be significant predictors for poor long-term outcome. Resection margin of greater than 5 mm was closely associated with better survival. In multivariate analysis, resection margin alone was an independent prognostic factor.
Conclusions
Preoperative serum CEA level and surgical resection margin may affect the outcome for the patients who underwent hepatic resection for metastatic colorectal cancer. Surgical resection margin must be kept enough to avoid re-recurrence or metastasis during hepatic resection for metastatic colorectal cancer.

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