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  • Original Article | 2021-12-01
    95 46

    Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction

    Eun Ju Choe , Yong Kang Lee , Han Ho Jeon , Jong Won Choi , Byung Kyu Park , Sun Young Won , Jeong Hun Seo , Chun Kyon Lee , Yong Suk Cho

    Journal of Digestive Cancer Reports 2021; 9(2): 43-49

    Abstract : Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes.
    Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence.
    Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-tosurgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridgeto- surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-tosurgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024).
    Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

  • Review Article | 2021-12-01
    101 44

    Recent Advance in the Management of Dysplasia in the Ulcerative Colitis

    Dong-Hoon Yang

    Journal of Digestive Cancer Reports 2021; 9(2): 50-56

    Abstract : In patients having long-standing ulcerative colitis (UC), the risk of colorectal cancer (CRC) increased compared with general population. Dysplasia is a precancerous lesion of colitic patients, and traditionally total proctocolectomy was considered as a standard therapy to prevent colorectal cancer in UC patients. However, even with ileal pouch-anal anastomosis (IPAA), patients who underwent total proctocolectomy may experience early and late postoperative complications, such as ileus, bleeding, pouchitis, and so on. In addition, the bowel movement after proctocolectomy with IPAA reaches a median of seven times per day, and a considerable proportion of patients require daytime and nighttime pads. Change in the strategy for managing dysplasia started from two early studies, which suggested polypectomy for polypoid dysplasia to prevent CRC in colitic patients. After that, many studies supported that polypectomy should be the first option for the management of polypoid dysplasia. Moreover, recent studies suggested the feasibility of endoscopic submucosal dissection as a therapeutic option for non-polypoid dysplasia, although long term, large studies should be followed.

  • Review Article | 2021-12-01
    90 48

    직장 유암종 질병 분류 코드 변경과 임상적 의의

    김은수

    Journal of Digestive Cancer Reports 2021; 9(2): 57-59

    Abstract : Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

  • Review Article | 2021-12-01
    82 33

    소장의 전암성 병변

    김수환, 김지원

    Journal of Digestive Cancer Reports 2021; 9(2): 60-67

    Abstract : Tumors of the small intestine are rare and generally asymptomatic or with nonspecific symptoms. The small intestine is difficult to approach using conventional endoscopy, and early diagnosis of the small intestinal tumors is difficult. Therefore, many of the small intestinal tumors are diagnosed at an advanced stage, which makes the prognosis poor. Premalignant lesions of the small intestine or known risk factors of small bowel cancer are sporadic adenoma, adenoma associated with familial adenomatous polyposis, hamartomatous polyp associated with Peutz- Jeghers syndrome, Crohn’s disease, and celiac disease. Therefore, it is necessary to recognize that the small bowel cancer can occur in these patients with premalignant lesions or risk factors of small bowel cancer. To reduce the possibility of small bowel cancer or to detect at an earlier stage, attention should be paid to screening and surveillance of these patients with premalignant lesions or risk factors of the small bowel cancer.

  • Cancer Image of the Issue | 2021-12-01
    67 36

    Multiple Rectal Neuroendocrine Tumor

    So Jung Han , Jun Yong Kim , Jae Jun Park

    Journal of Digestive Cancer Reports 2021; 9(2): 68-70
  • Research Trend | 2021-12-01
    83 33

    Immune Checkpoint Inhibitors in Advanced Colorectal Cancer

    Jaekyung Cheon

    Journal of Digestive Cancer Reports 2021; 9(2): 71-74
  • Education Series | 2021-12-01
    74 42

    An Unusual Cause of Acute Pancreatitis

    Jung Wan Choe

    Journal of Digestive Cancer Reports 2021; 9(2): 75-77

Journal Info

JDCR
Vol.9 No.2
December 1, 2021
eISSN : 2765-6713
pISSN : 2288-1581
Frequency: Semiannual

open access

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Journal of Digestive Cancer Reports

eISSN 2765-6713
pISSN 2288-1581