Journal of the Anus Rectum and Colon最新文献

{"title":"Pre-Stenting Inflammatory Burden Index (IBI) as a Predictor of Survival and Postoperative Complications in Patients with Obstructive Colorectal Cancer.","authors":"Ryuichiro Sato, Masaya Oikawa, Tetsuya Kakita, Tomoya Abe, Naoya Akazawa, Haruka Okano, Kei Ito, Takashi Tsuchiya","doi":"10.23922/jarc.2025-045","DOIUrl":"10.23922/jarc.2025-045","url":null,"abstract":"<p><strong>Objectives: </strong>Growing evidence suggests that cancer prognosis is influenced by the host's immune-inflammatory environment. The inflammatory burden index (IBI) is a newly established, potent inflammation-based marker easily calculated from laboratory findings. We evaluated the prognostic significance of IBI in patients with nonmetastatic obstructive colorectal cancer (OCRC) who underwent curative surgery following insertion of a self-expandable metallic stent as a bridge to curative surgery.</p><p><strong>Methods: </strong>Eighty-six patients with pathological stages I-III OCRC were retrospectively analyzed to investigate the association between IBI and short- and long-term results.</p><p><strong>Results: </strong>This study included 50 males and 36 females. The median age was 71.5 years, and the median follow-up time was 43 months. There were 34 postoperative complications, including 17 infectious complications. Sixty-three patients were classified as pre-stenting IBI-high using a cutoff of 0.9. Multivariate analyses revealed that high IBI was independently correlated with poorer disease-free survival (DFS) [hazard ratio (HR) = 4.10, 95% confidence interval (CI) 1.37-12.28, P = 0.012] and overall survival (OS) (HR = 9.32, 95% CI 1.15-75.63, P = 0.037). Moreover, patients with a high IBI had significantly more postoperative (P = 0.013) and infectious complications (P = 0.034). The preoperative IBI values had no prognostic significance.</p><p><strong>Conclusions: </strong>A high pre-stenting IBI was independently associated with poor DFS and OS. Additionally, it serves as a robust predictor of postoperative and infectious complications. Given that IBI can be easily derived from routine laboratory tests, its clinical utility is readily applicable in daily practice.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"406-414"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432933","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}

{"title":"Risk Factors for Conversion to an Open Surgery during Laparoscopic Surgery for Patients with Colon Cancer with Body Mass Index ≥25 kg/m².","authors":"Yuki Tsuchiya, Kiichi Sugimoto, Shuko Nojiri, Yutaka Kojima, Kazuhiro Sakamoto, Yoshiaki Fujii, Hiroaki Takeshita, Takashi Taketa, Tomonori Akagi, Kentaro Nakajima, Takatoshi Nakamura, Yoshinori Kagawa, Shinobu Ohnuma, Masafumi Inomata, Seiichiro Yamamoto, Takeshi Naitoh","doi":"10.23922/jarc.2025-005","DOIUrl":"10.23922/jarc.2025-005","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to identify factors associated with conversion to an open procedure during laparoscopic colectomy in patients with body mass index (BMI) ≥25 kg/m². The effects of conversion on long-term outcomes were evaluated.</p><p><strong>Methods: </strong>In a multicenter cohort study conducted under the auspices of the Japan Society of Laparoscopic Colorectal Surgery, clinicopathological data were examined for 887 patients with BMI ≥25 kg/m² who underwent laparoscopic surgery for colon cancer. Risk factors for conversion to an open procedure were estimated using a logistic model after parameter selection using a least absolute shrinkage and selection operator (lasso) model. Long-term outcomes were compared after inverse probability weighting (IPW) estimation.</p><p><strong>Results: </strong>Among the 887 patients who underwent laparoscopic colectomy, 31 patients (3.5%) required conversion to an open procedure. In multivariate analysis, preoperative BMI ≥27.5 kg/m², comorbidity-hypertension, blood loss, and simultaneous resection of adjacent organs were independent factors for conversion. After IPW estimation, there were no significant differences in recurrence-free, cancer-specific and overall survival between the conversion (+) and (-) groups.</p><p><strong>Conclusions: </strong>In obese patients with the factors identified in this study, surgeons should consider the possibility of conversion to open surgery. Long-term outcomes in patients with BMI ≥25 kg/m² did not differ between patients who underwent conversion and those who did not. Therefore, conversion to an open procedure was not detrimental in Japanese patients with BMI ≥25 kg/m².</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"428-436"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433085","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}

{"title":"Postoperative Gut Microbiota Changes after Colorectal Cancer Surgery: A Comparative Study Based on Resection Sites.","authors":"Yutaka Hattori, Tadashi Fujii, Takumi Tochio, Tsutomu Kumamoto, Junichiro Hiro, Hiroshi Matsuoka, Koji Masumori, Kohei Funasaka, Eizaburo Ohno, Yoshiki Hirooka, Koichi Suda, Koki Otsuka","doi":"10.23922/jarc.2025-048","DOIUrl":"10.23922/jarc.2025-048","url":null,"abstract":"<p><strong>Objectives: </strong>Colorectal cancer (CRC) is a major global health concern, and surgical resection remains its primary treatment. However, the impact of different surgical procedures on gut microbiota and their influence on postoperative outcomes remain unclear. This study investigated changes in the gut microbiota following three types of CRC resections: right-sided colectomy (RSC), left-sided colectomy (LSC), and low anterior resection (LAR).</p><p><strong>Methods: </strong>Fecal samples were collected from 34 patients with CRC who underwent curative resection at Fujita Health University Hospital between April 2022 and December 2023. Bacterial profiling was performed using 16S rRNA gene amplicon sequencing. The results were compared with data from 85 healthy controls.</p><p><strong>Results: </strong>Significant alterations in gut microbiota composition were observed in surgical groups compared to the healthy control (Ctrl) group. The RSC group exhibited the greatest reduction in alpha diversity, likely because of ileocecal valve loss. Beta-diversity analysis revealed distinct microbial profiles between the Ctrl group and the surgical groups, with notable alterations in key bacterial species. The RSC group exhibited significant reduction in beneficial bacteria, including <i>Faecalibacterium prausnitzii</i> and <i>Bifidobacterium</i> spp., alongside increase in <i>Escherichia coli</i>, suggesting a shift toward a pro-inflammatory environment. In contrast, the LSC and LAR groups exhibited enrichment of <i>Akkermansia muciniphila</i>, which may promote gut barrier integrity and immune modulation.</p><p><strong>Conclusions: </strong>CRC resection induces site-specific changes in gut microbiota composition. These microbial alterations may affect postoperative inflammation, metabolism, and cancer recurrence risk. Further studies are necessary to explore microbiome-targeted strategies for improving postoperative outcomes in cases of CRC.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"447-454"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432912","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}

{"title":"Prognostic Impact of C-reactive Protein-albumin-lymphocyte Index in Elderly Patients with Colorectal Cancer.","authors":"Yasunobu Kobayashi, Yasuhiro Takano, Saya Matsukida, Teruyuki Takishima, Hironori Kanno, Nobuyoshi Hanyu, Ken Eto","doi":"10.23922/jarc.2025-017","DOIUrl":"10.23922/jarc.2025-017","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the prognostic impact of the C-reactive protein-albumin-lymphocyte index in older patients with colorectal cancer and to evaluate the superiority of this new system.</p><p><strong>Methods: </strong>Of the patients who received initial treatment for colorectal cancer at our hospital between 2014 and 2021 (n=269), older patients aged ≥65 years who had undergone curative resection for colorectal cancer during the study period were included. We retrospectively investigated the relationship between the preoperative C-reactive protein-albumin-lymphocyte index and overall and recurrence-free survival rates. Univariate and multivariate analyses were performed to identify the independent prognostic factors after curative resection in older patients with colorectal cancer.</p><p><strong>Results: </strong>One-hundred-seventy-eight patients underwent initial curative resection during the study period. The median survival times for patients with C-reactive protein-albumin-lymphocyte (CALLY) indices <1.2 and ≥1.2 were 42.6 and 68.3 months, respectively (<i>p</i>=0.01). Multivariate analysis identified the following independent risk factors associated with poor prognosis: age ≥75 years (hazard ratio 1.64, 95% confidence interval 1.03-2.62, <i>p</i>=0.03), T stage 3 or 4 (hazard ratio 1.66, 95% confidence interval 1.06-2.61, <i>p</i>=0.02), laparotomy surgical approach (hazard ratio 2.09, 95% confidence interval 1.29-3.38, <i>p</i><0.01), and C-reactive protein-albumin-lymphocyte index <1.2 (hazard ratio 1.75, 95% confidence interval 1.05-2.92, <i>p</i>=0.03).</p><p><strong>Conclusions: </strong>Our study suggests that the CALLY index is an independent prognostic factor in older patients with colorectal cancer and may facilitate multidisciplinary decision-making.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"398-405"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433055","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}

{"title":"Solitary Fibrous Tumor of the Mesentery of the Small Intestine: A Rare Case Report.","authors":"Go Ito, Katsuya Hattori, Yasunori Ota, Junko Mukohyama, Naoki Sakuyama, Dai Shida","doi":"10.23922/jarc.2025-049","DOIUrl":"10.23922/jarc.2025-049","url":null,"abstract":"<p><p>Solitary fibrous tumors (SFTs) are rare spindle cell neoplasms of mesenchymal origin, most commonly originating from the pleura. The discovery of the NAB2-STAT6 gene fusion has enabled more accurate diagnosis, particularly in extrapleural locations. We report a rare case of a 50-year-old woman presenting with localized abdominal pain, who showed a 46-mm heterogeneous mass in the left abdomen on contrast-enhanced CT; laparoscopic exploration identified a pedunculated tumor arising from the jejunal mesentery, located 50 cm distal to the ligament of Treitz. Segmental resection of 15 cm of the jejunum with the associated mesentery was performed. The tumor measured 55 × 45 × 30 mm and was confined to the mesentery, with no invasion of the bowel wall. Histopathological examination revealed proliferation of spindle cells within a collagenous stroma, and immunohistochemistry confirmed strong nuclear STAT6 and cytoplasmic CD34 positivity, while c-Kit, DOG1, Desmin, and S-100 were negative, establishing the diagnosis of SFT. The patient's abdominal pain resolved completely following resection. This case highlights the diagnostic challenges of mesenteric SFTs and underscores the importance of complete surgical resection with intact borders and immunohistochemical analysis in securing an accurate diagnosis and favorable outcome.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"472-478"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433065","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}

{"title":"The Preoperative C-reactive Protein/Albumin Ratio of Immune-inflammation Index Is an Independent Prognostic Factor of Advanced Colorectal Cancer in Older Patients (≥ 65 years).","authors":"Naohiro Yoshida, Haruki Yonemori, Yoshiki Miyamoto, Ai Nishihira, Takahiro Shigaki, Kenji Fujiyoshi, Kenichi Koushi, Takefumi Yoshida, Tomoya Sudo, Toru Hisaka, Nobuya Ishibashi, Fumihiko Fujita","doi":"10.23922/jarc.2024-103","DOIUrl":"10.23922/jarc.2024-103","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the characteristics of colorectal cancer (CRC) in older patients (≥ 65 years) and the immune-inflammation indexes.</p><p><strong>Methods: </strong>This study included 149 patients aged ≥ 65 years with advanced colorectal cancer, who underwent radical surgery (R0 resection). Four immune-inflammation indexes (C-reactive protein-to-albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-lymphocyte ratio (NLR)) were calculated. We analyzed the association between immune-inflammation indexes and clinicopathological features or prognosis.</p><p><strong>Results: </strong>Tumor depth and lymph node metastasis were independent prognostic factors for recurrence-free survival (RFS) in multivariate analysis (p=0.03, hazard ratio [HR] 2.095, 95% confidence interval (CI) 1.225-3.982 and p=0.008, HR 2.209, 95% CI 1.225-3.982, respectively). Lymphatic invasion and CAR were also independent prognostic factors for overall survival (OS) in multivariate analysis (p=0.04, HR 2.197, 95% CI 1.042-4.632 and p=0.04, HR 2.174, 95% CI 1.032-4.58, respectively). Lymphatic invasion and CAR were independent prognostic factors for cancer specific survival (CSS) in the multivariate analysis (p=0.03, HR 3.004, 95% CI 1.11-8.13 and p=0.03, HR 3.087, 95% CI 1.135-8.394, respectively).</p><p><strong>Conclusions: </strong>CAR is a useful immune-inflammation index for predicting the prognosis after radical resection for advanced CRC in older patients.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 4","pages":"437-446"},"PeriodicalIF":1.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433026","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}

{"title":"Investigation of Peritoneal Lavage Cytology before and after Tumor Resection as a Prognostic Factor in Colorectal Cancer.","authors":"Masayasu Kawasaki, Masao Kameyama, Hirotoshi Kobayashi, Kenjiro Kotake, Kotaro Maeda, Takeshi Suto, Hideki Ueno, Koji Komori, Heita Ozawa, Keiji Koda, Masayuki Ohue, Kenichi Sugihara","doi":"10.23922/jarc.2024-106","DOIUrl":"10.23922/jarc.2024-106","url":null,"abstract":"<p><strong>Objectives: </strong>There is no consensus on the significance of peritoneal lavage cytology for the prognosis of patients with colorectal cancer. In this prospective multicenter study, we aimed to determine whether positive peritoneal lavage cytology results predict poor patient outcomes and to clarify if the appropriate timing of cytology is before or after tumor resection.</p><p><strong>Methods: </strong>Patients diagnosed with pathological stage II or III colorectal cancer between 2013 and 2017 were enrolled in this study. Peritoneal lavage cytology was performed twice, before and after the tumor resection, and the results were analyzed to determine their effect on prognosis and peritoneal recurrence.</p><p><strong>Results: </strong>We analyzed 1378 patients, and 54 (3.9%) had positive cytology results. Furthermore, 30 patients were positive before tumor resection, 13 after tumor resection, and 11 for both markers. The 5-year relapse-free survival rates (5yRFS) with positive and negative cytology before tumor resection in patients with pStage II were 44.4 and 81.7%, respectively (p=0.0014). The 5-year overall survival rates (5yOS) were 57.1 and 91.6%, respectively (p=0.0046). In Stage III, the 5yRFS and 5yOS between patients with positive and negative cytology did not differ. Patients with positive and negative cytology before tumor resection in pStage II had peritoneal recurrence rates of 11.1 and 1.66%, respectively (p=0.034). These rates were 12.5 and 2.51%, respectively, in patients with pStage III (p=0.011).</p><p><strong>Conclusions: </strong>A positive cytology result before tumor resection is a prognostic factor in Stage II colorectal cancer and is instrumental in predicting peritoneal recurrence in Stages II and III colorectal cancer.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 3","pages":"310-320"},"PeriodicalIF":1.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755159","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}

{"title":"Can Mesenchymal Stem Cell-derived Exosomes Pave the Way Towards Regenerative Medicine Therapeutics in Perianal Fistula with Crohn's Disease?","authors":"Lan Wang, Fang Cheng","doi":"10.23922/jarc.2025-032","DOIUrl":"10.23922/jarc.2025-032","url":null,"abstract":"","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 3","pages":"368-369"},"PeriodicalIF":1.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755156","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}

{"title":"The Relationship between the Psoas Muscle Mass Index and Postoperative Complications in Crohn's Disease: A Retrospective Cohort Study.","authors":"Maho Sasaki, Tatsunari Fukuoka, Masatsune Shibutani, Hiroaki Kasashima, Kiyoshi Maeda","doi":"10.23922/jarc.2024-104","DOIUrl":"10.23922/jarc.2024-104","url":null,"abstract":"<p><strong>Objectives: </strong>Sarcopenia is generally defined based on the age-related muscle mass and weakness. However, it has been reported that patients with Crohn's disease, who develop severe inflammation of the gastrointestinal tract, are more likely to develop sarcopenia. We retrospectively investigated the effect of the iliopsoas muscle area, which is an indicator of sarcopenia, on postoperative complications in patients with Crohn's disease.</p><p><strong>Methods: </strong>We included 98 patients with Crohn's disease who underwent surgery in our department between January 2016 and December 2021, and performed retrospectively analyzed. The psoas muscle index (PMI) was calculated as the average of the left and right iliopsoas muscles (L3, cm²) / height². We divided patients into the low PMI (men <2.33 cm²/m², women <1.85 cm²/m²) and normal PMI groups and compared their preoperative and intraoperative factors and postoperative outcomes.</p><p><strong>Results: </strong>The median age of the 98 patients was 37.0 (17-77) years. Complications were noted in 40 patients (40.8%), including 10 (10.2%) with anastomotic leakage. There were 26 (26.5%) patients with a low PMI. The incidence of all postoperative complications, grade ≥2 complications, anastomotic leakage and surgical site infection (SSI) were significantly higher in the low-PMI group than in the normal-PMI group. According to a multivariate analysis, low PMI (p=0.04) was only independent predictor for grade 2 or above postoperative complications.</p><p><strong>Conclusions: </strong>A low PMI is associated with postoperative complications, especially anastomotic leakage, in patients with Crohn's disease.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 3","pages":"330-338"},"PeriodicalIF":1.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755244","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}

{"title":"Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer.","authors":"Ken Inoue, Naohisa Yoshida, Reo Kobayashi, Ryohei Hirose, Naoto Iwai, Osamu Dohi, Takaaki Murakami, Yutaka Inada, Tomohiro Arita, Yukiko Morinaga, Eiichi Konishi, Yoshito Itoh","doi":"10.23922/jarc.2024-105","DOIUrl":"10.23922/jarc.2024-105","url":null,"abstract":"<p><strong>Objectives: </strong>Pure well-differentiated adenocarcinoma (PWDA) could be a safe factor against lymph node metastasis (LNM) and recurrence in patients with T1 colorectal cancer. We investigated the utility and endoscopic features of PWDA to determine its predictive ability.</p><p><strong>Methods: </strong>We analyzed the LNM and recurrence rates, along with various clinicopathological factors, including PWDA, in 315 patients with T1 colorectal cancer who underwent surgical resection at our center. PWDA was defined as a lesion consisting of well-differentiated adenocarcinoma only. Three pathologists evaluated the consistency of the PWDA diagnosis and performed inter- and intraobserver assessments of PWDA and lymphatic invasion. Endoscopic features of PWDA was also examined.</p><p><strong>Results: </strong>The LNM, recurrence, and PWDA rates in patients with T1 colorectal cancer were 9.5%, 2.9%, and 31.1%, respectively. Significant differences were observed in T1b (100% vs. 82.8%; p = 0.014) and non-PWDA (100% vs. 65.6%; p < 0.001) between patients with and without LNM. Multivariate analyses showed that non-PWDA was an independent risk factor for LNM (odds ratio [OR], 12.09; 95% confidence interval [CI], 1.59-92.0; p = 0.016). Furthermore, significant differences in venous invasion (44.4% vs. 19.6%; p < 0.001), and non-PWDA (100% vs. 68.0%; p < 0.001) were observed between patients with and without recurrence. The agreement among three pathologists on the diagnosis of PWDA was acceptable (kappa value > 0.5). Surface redness (p < 0.001), a rugged surface (p < 0.01), fold convergence (p < 0.001), and an impression of fullness (p = 0.031) were significantly related with PWDA.</p><p><strong>Conclusions: </strong>PWDA can predict safety against LNM and recurrence in patients with T1 colorectal cancer.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"9 3","pages":"302-309"},"PeriodicalIF":1.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755243","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}