Journal of the Korean Society of Coloproctology最新文献

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Recurrent renal leiomyosarcoma mimicking a colonic submucosal tumor: a case report. 模拟结肠粘膜下肿瘤的复发性肾平滑肌肉瘤1例报告。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.270
Yun Jeung Kim, Hee Seok Moon, Eaum Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Ji Yeon Kim, Dae Young Kang
{"title":"Recurrent renal leiomyosarcoma mimicking a colonic submucosal tumor: a case report.","authors":"Yun Jeung Kim,&nbsp;Hee Seok Moon,&nbsp;Eaum Seok Lee,&nbsp;Jae Kyu Sung,&nbsp;Hyun Yong Jeong,&nbsp;Ji Yeon Kim,&nbsp;Dae Young Kang","doi":"10.3393/jksc.2011.27.5.270","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.270","url":null,"abstract":"<p><p>A primary leiomyosarcoma of the kidney is a rare, but highly aggressive, neoplasm, accounting for only 0.1% of all invasive renal tumors. Local or systemic recurrence is common, but a leiomyosarcoma is difficult to diagnose preoperatively. We recently encountered an interesting case of an unusual recurrence of a renal leiomyosarcoma. A 57-year-old woman visited our hospital complaining of lower abdominal pain. Four years previously, she had undergone a left nephrectomy. She had a primary leiomyosarcoma of the kidney that had been misdiagnosed as a renal cell carcinoma. Colonoscopy revealed the presence of a lesion similar to a submucosal tumor in the descending colon. Postoperative pathologic examination confirmed that the mass was a recurrent leiomyosarcoma. We report this unusual case and present a review of the literature.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/29/jksc-27-270.PMC3218133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30268466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Laparoscopic versus open appendectomy for appendicitis in elderly patients. 老年阑尾炎患者腹腔镜阑尾切除术与开放式阑尾切除术的比较。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.241
Hyun Nam Baek, Yong Hwan Jung, Yong Hee Hwang
{"title":"Laparoscopic versus open appendectomy for appendicitis in elderly patients.","authors":"Hyun Nam Baek,&nbsp;Yong Hwan Jung,&nbsp;Yong Hee Hwang","doi":"10.3393/jksc.2011.27.5.241","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.241","url":null,"abstract":"<p><strong>Purpose: </strong>The appendectomy is the most common emergent surgical procedure in elderly patients. The increasing number of elderly persons has been accompanied by an increase in the number of cases of acute appendicitis in the elderly. In order to understand the clinical significance of a laparoscopic appendectomy for elderly patients with appendicitis, we investigated the results of a laparoscopic appendectomy for treating patients over 60 years of age with appendicitis and compared them with the results for an open technique.</p><p><strong>Methods: </strong>We studied retrospectively patients over 60 years of age who underwent an appendectomy with either a laparoscopic (LA) or open (OA) technique for appendicitis between July 2007 and December 2009. There were 30 patients in the LA group and 47 patients in the OA group. The demographic data, operative time, length of the hospital stay, bowel movement, pain control, cost, complications and pre-existing disease were assessed.</p><p><strong>Results: </strong>There were no significant differences between the LA and the OA groups with respect to pre-existing diseases, gender, age, American Society of Anesthesiologists (ASA) score and the number of cases of complicated appendicitis, operative time, length of hospital stay, and times of analgesics use. However, the proportion of early gas out (within POD #2) was significantly greater in the LA group (80% vs. 57%, P < 0.05), and postoperative complications were significantly lower in the LA group (7% vs. 32%, P < 0.01). The costs for the two groups were not significantly different.</p><p><strong>Conclusion: </strong>A laparoscopic appendectomy is a safe and effective procedure in elderly patients and is not associated with any increase in morbidity. It can be recommended for routine use in treating elderly patients with appendicitis.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/0f/jksc-27-241.PMC3218128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 20
Correlation between Liver Metastases and the Level of PRL-3 mRNA Expression in Patients with Primary Colorectal Cancer. 原发性结直肠癌患者肝转移与PRL-3 mRNA表达水平的相关性
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.231
Nam Won Kim, Chong Woo Chu, Tae Sung Ahn, Chang Jin Kim, Dong Jun Jung, Myoung Won Son, Sang Ho Bae, Moon Soo Lee, Chang Ho Kim, Moo Jun Baek
{"title":"Correlation between Liver Metastases and the Level of PRL-3 mRNA Expression in Patients with Primary Colorectal Cancer.","authors":"Nam Won Kim,&nbsp;Chong Woo Chu,&nbsp;Tae Sung Ahn,&nbsp;Chang Jin Kim,&nbsp;Dong Jun Jung,&nbsp;Myoung Won Son,&nbsp;Sang Ho Bae,&nbsp;Moon Soo Lee,&nbsp;Chang Ho Kim,&nbsp;Moo Jun Baek","doi":"10.3393/jksc.2011.27.5.231","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.231","url":null,"abstract":"<p><strong>Purpose: </strong>Phosphatase of regenerating liver-3 (PRL-3) has been associated with metastasis promotion. However, clinical applications of this association have not yet been clearly demonstrated. In this study, we evaluated the relation of PRL-3 mRNA level in primary colorectal cancer to the corresponding stage and to other clinicopathologic factors.</p><p><strong>Methods: </strong>Two hundred forty-five patients with histologically-proven colorectal cancer underwent surgery between January 2004 and December 2006. RNA was extracted and cDNA was prepared by using reverse transcription. Quantification of PRL-3 was done using a real-time polymerase chain reaction.</p><p><strong>Results: </strong>Eighty-six cases with well-preserved specimens were enrolled: 53 males and 33 females. The mean age was 63.4 years. According to tumour node metastasis (TNM) stage of the American Joint Committee on Cancer (AJCC), stage I was 11 cases, stage II was 38 cases, stage III was 23 cases, and stage IV was 14 cases. Among stage IV cases, one case was combined with liver and lung metastases, and one case was combined with liver metastases and peritoneal dissemination. The remaining stage IV patients were combined with only liver metastases. There was a significant correlation in PRL-3 mRNA expression between primary colorectal cancer and corresponding tumor stage. PRL-3 mRNA expression was increased in the liver metastases cases. Lymphatic and vascular invasion were significantly related with PRL-3 mRNA levels.</p><p><strong>Conclusion: </strong>Advanced stage prediction may be obtained by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Especially, the risk of liver metastases may be predicted by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Further study is required to confirm these preliminary results.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/86/jksc-27-231.PMC3218126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Prognostic Significance of Lymph Node Ratio in Stage III Rectal Cancer. 淋巴结比例在III期直肠癌中的预后意义。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.252
Jin Yong Shin, Kwan Hee Hong
{"title":"Prognostic Significance of Lymph Node Ratio in Stage III Rectal Cancer.","authors":"Jin Yong Shin,&nbsp;Kwan Hee Hong","doi":"10.3393/jksc.2011.27.5.252","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.252","url":null,"abstract":"<p><strong>Purpose: </strong>Although nodal metastasis is the most powerful prognostic factor in rectal cancer, marked heterogeneity exists within stage III rectal cancer. Recent studies of rectal cancer have shown a prognostic superiority of the lymph node ratio (LNR) compared with N stage. The purpose of this study was to investigate the prognostic value of the LNR in the era of the 7th edition of the TNM classification.</p><p><strong>Methods: </strong>We included 190 patients who underwent a curative resection for rectal cancer with nodal metastasis. The patients were divided into four groups on the basis of statistically calculated cut-off values as 0.21, 0.32, and 0.61.</p><p><strong>Results: </strong>The LNR was an independent risk factor for overall survival (OS; P = 0.008) and for systemic recurrence-free survival (SRFS; P = 0.002). However, the LNR was not a predictive factor for local recurrence. When the N stage of the sixth TNM staging system was separately analyzed as a covariate, the LNR was also found to be a predictive factor for both OS and SRFS (P = 0.012 and P = 0.004, respectively). A LNR value of 0.21 offered the best cut off to separate patients into two prognostic groups.</p><p><strong>Conclusion: </strong>The defined cut-off values of the LNR were an independent risk factor for OS and distant metastasis-free survival in patients with rectal cancer, irrespective of the sixth or the seventh version of the TNM classification, and the LNR should be considered as a prognostic variable in any future staging system.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/56/jksc-27-252.PMC3218130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1? 慢性肛裂的慢性性与内皮素-1有关系吗?
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.221
Won-Kyung Kang
{"title":"Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?","authors":"Won-Kyung Kang","doi":"10.3393/jksc.2011.27.5.221","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.221","url":null,"abstract":"","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/7a/jksc-27-221.PMC3218122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Lymph node ratio for nodal staging in colorectal cancer - a promising, but premature tool. 结直肠癌淋巴结分期的淋巴结比例-一个有前途但不成熟的工具。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.224
Kang Young Lee
{"title":"Lymph node ratio for nodal staging in colorectal cancer - a promising, but premature tool.","authors":"Kang Young Lee","doi":"10.3393/jksc.2011.27.5.224","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.224","url":null,"abstract":"See Article on Page 252-265 \u0000 \u0000Accurate tumor staging is an essential step for the management of colorectal cancer patients. Precise tumor staging has a pivotal role not only for the prediction of the patient's prognosis, but also for the selection of patients for adjuvant therapy. The Tumor-node-metastasis (TNM) staging system based on pathologic findings is the most popular staging system in clinical practice. \u0000 \u0000Among several prognosticators in TNM staging, the presence of regional lymph-node metastasis is the most potent indicator of the patient's prognosis in cases of colorectal cancer. In the current staging system, nodal stage is classified by the number of metastatic lymph nodes. In addition, several studies have reported that the number of retrieved lymph nodes also has prognostic power because a sufficient number of lymph nodes should be examined for accurate staging. For that reason, in the American Joint Committee on Cancer (AJCC) 7th edition recommends that at least 10-14 lymph nodes in radical colon and rectum resections should be examined for reliable nodal staging [1]. \u0000 \u0000The number of retrieved lymph nodes could be affected by the extent of surgery and the pertinacity of the pathologist, but the location of tumor, the application of preoperative radiotherapy, and patient factors, including body mass index, could also be contributing factors. Moreover, in cases of preoperative chemoradiation therapy, the proportion of those with fewer than 12 examined lymph nodes may be increased. Since a prerequisite for the current nodal staging is the examination of over 10-14 regional lymph nodes, nodal staging in stage III colorectal cancer, which is solely based on the number of metastatic lymph nodes, would be inaccurate in certain circumstances. \u0000 \u0000Recently, the metastatic lymph-node ratio has been suggested as an alternative tool for nodal staging in stage III colorectal cancer [2-4]. Also, after preoperative chemoradiation therapy in rectal cancer patients, the lymph-node ratio has reportedly been able to provide better stratification of patients' prognoses than ypN staging [5]. A recent series of publications support the lymph-node ratio's being a successful substitute for the current nodal staging in overcoming the limitation of the numeric counting system in cases of colorectal cancer. However, there are still several problems in the studies regarding the lymph-node ratio. \u0000 \u0000The biggest hurdle in nodal staging with the lymph-node ratio may be that there is no consensus on a point of reference for stratification. Even though the lymph-node ratio has shown very nice stratification of patients' prognoses in cases of stage III colorectal cancer, not all studies adapted the same point of reference. Standardization of the point of reference would be an essential step toward use of the lymph-node ratio in staging. There is no doubt that precise lymph-node staging would be an essential step toward providing accurate prognoses for colorectal ","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/0f/jksc-27-224.PMC3218124.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The synchronous prevalence of colorectal neoplasms in patients with stomach cancer. 胃癌患者结直肠肿瘤的同步患病率。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.246
Sang Su Lee, Woon Tae Jung, Cha Young Kim, Chang Yoon Ha, Hyun Ju Min, Hyun Jin Kim, Tae Hyo Kim
{"title":"The synchronous prevalence of colorectal neoplasms in patients with stomach cancer.","authors":"Sang Su Lee,&nbsp;Woon Tae Jung,&nbsp;Cha Young Kim,&nbsp;Chang Yoon Ha,&nbsp;Hyun Ju Min,&nbsp;Hyun Jin Kim,&nbsp;Tae Hyo Kim","doi":"10.3393/jksc.2011.27.5.246","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.246","url":null,"abstract":"<p><strong>Purpose: </strong>The association between stomach cancer and colorectal cancer is controversial. The purpose of this study was to determine the synchronous prevalence of colorectal neoplasms in patients with stomach cancer.</p><p><strong>Methods: </strong>A total of 123 patients with stomach cancer (86 male) and 246 consecutive, age- and sex-matched persons without stomach cancer were analyzed from July 2005 to June 2010. All of them underwent colonoscopy within 6 months after undergoing gastroscopy.</p><p><strong>Results: </strong>The prevalence of colorectal neoplasms was significantly higher in the stomach cancer group (35.8%) than in the control group (17.9%) (P < 0.001). Colorectal neoplasms were more prevalent in the patients with stomach cancer (odds ratio [OR], 3.10; 95% confidence interval [CI], 1.71 to 5.63). In particular, the difference in the prevalence of colorectal neoplasms was more prominent in the patients above 50 years old (OR, 3.54; 95% CI, 1.80 to 6.98).</p><p><strong>Conclusion: </strong>The results showed that the synchronous prevalence of colorectal neoplasms was higher in patients with stomach cancer than in those without stomach cancer. Therefore, patients with stomach cancer should be regarded as a high-risk group for colorectal neoplasms, and colonoscopy should be recommended for screening.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/38/jksc-27-246.PMC3218129.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1? 慢性肛裂的慢性性与内皮素-1有关系吗?
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.237
Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Seung Kyu Jeong, Hyung Kyu Yang
{"title":"Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?","authors":"Cheong Ho Lim,&nbsp;Hyeon Keun Shin,&nbsp;Wook Ho Kang,&nbsp;Seung Kyu Jeong,&nbsp;Hyung Kyu Yang","doi":"10.3393/jksc.2011.27.5.237","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.237","url":null,"abstract":"<p><strong>Purpose: </strong>Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity.</p><p><strong>Methods: </strong>The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject's serum and to compare the results with those for the control groups.</p><p><strong>Results: </strong>Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 ± 0.78 pg/mL for male subjects and 1.16 ± 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 ± 0.44 pg/mL in group 1, 1.46 ± 0.83 pg/mL in group 2, and 1.20 ± 0.56 pg/mL in group 3 (P = 0.14).</p><p><strong>Conclusion: </strong>Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/ea/jksc-27-237.PMC3218127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Colorectal cancer with multiple metastases: is palliative surgery needed? 结直肠癌多发转移:是否需要姑息性手术?
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.226
Hong-Jo Choi, Jin Yong Shin
{"title":"Colorectal cancer with multiple metastases: is palliative surgery needed?","authors":"Hong-Jo Choi,&nbsp;Jin Yong Shin","doi":"10.3393/jksc.2011.27.5.226","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.226","url":null,"abstract":"<p><p>In patients with symptomatic incurable metastatic colorectal cancer (mCRC), the goal of resection of the primary lesion is to palliate cancer-related morbidity, including obstruction, bleeding, or perforation. In patients with asymptomatic primary tumors and incurable metastatic disease, however, the necessity of primary tumor resection is less clear. Although several retrospective analyses suggest survival benefit in patients who undergo resection of the primary tumor, applying this older evidence to modern patients is out of date for several reasons. Modern chemotherapy regimens incorporating the novel cytotoxic agents oxaliplatin and irinotecan, as well as the target agents bevacizumab and cetuximab, have improved median survival from less than 1 year with the only available single-agent 5-fluorouracil until the mid-1990s to over 2 years. In addition to significant prolongation of overall survival, combinations of novel chemotherapeutic and target agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring surgical resection. Resection of an asymptomatic primary tumor risks surgical complications and may postpone the administration of chemotherapy that may offer both systemic and local control. In conclusion, the morbidity and the mortality of unnecessary surgery or surgery that does not improve quality of life or survival in patients with mCRC of a limited life expectancy should be carefully evaluated. With the availability of effective combinations of chemotherapy and target agents, systemic therapy for the treatment of life-threatening metastases would be a preferable treatment strategy for unresectable asymptomatic patients with mCRC.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/ce/jksc-27-226.PMC3218125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30271127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Clinical Significance of Lymph Node Ratio in Stage III Colorectal Cancer. 结直肠癌III期淋巴结比例的临床意义。
Journal of the Korean Society of Coloproctology Pub Date : 2011-10-01 Epub Date: 2011-10-31 DOI: 10.3393/jksc.2011.27.5.260
Yo Han Park, Jae Im Lee, Jong Kyung Park, Hang Ju Jo, Won Kyung Kang, Chang Hyeok An
{"title":"Clinical Significance of Lymph Node Ratio in Stage III Colorectal Cancer.","authors":"Yo Han Park,&nbsp;Jae Im Lee,&nbsp;Jong Kyung Park,&nbsp;Hang Ju Jo,&nbsp;Won Kyung Kang,&nbsp;Chang Hyeok An","doi":"10.3393/jksc.2011.27.5.260","DOIUrl":"https://doi.org/10.3393/jksc.2011.27.5.260","url":null,"abstract":"<p><strong>Purpose: </strong>Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer.</p><p><strong>Methods: </strong>We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR.</p><p><strong>Results: </strong>There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR ≤ 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 ≥ LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor.</p><p><strong>Conclusions: </strong>LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/1f/jksc-27-260.PMC3218131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30268464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
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