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14. Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

Author

Son, Gyung Mo, Lee, In Young, Lee, Yoon Suk, Kye, Bong-Hyeon, Cho, Hyeon-Min, Jang, Je-Ho, Kim, Chang-Nam, Lee, Kil Yeon, Lee, Suk-Hwan, and Kim, Jun-Gi

Subjects
Lymph node excision, Colonic neoplasms, Laparoscopy, RC799-869, Review, Diseases of the digestive system. Gastroenterology, Colectomy, Mesocolon
Abstract

Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

Published
2021

42. Quality of Life Following Adjuvant FOLFOX Chemotherapy in Colon Cancer: Results from the Prospective SIMPLE Trial

Author

Kang, Byung Mo, primary, Kim, Hyung Jin, additional, Kye, Bong-Hyeon, additional, Lee, Sang Chul, additional, Lee, Kil Yeon, additional, Park, Sun Jin, additional, Lee, Suk-Hwan, additional, Lim, Sang Woo, additional, Kim, Ji Hoon, additional, Lee, Jinkwon, additional, Kim, Min Ki, additional, Kim, Jun-Gi, additional, and Lee, Yoon Suk, additional

Published
2020
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46. Tumor budding as a risk factor of lymph node metastasis in submucosal invasive T1 colorectal carcinoma: a retrospective study

Author

Kye Bong-Hyeon, Jung Ji-Han, Kim Hyung-Jin, Kang Se-Goo, Cho Hyeon-Min, and Kim Jun-Gi

Subjects
Lymph node metastasis, T1 colorectal cancer, Tumor budding, Surgery, RD1-811
Abstract

Abstract Background This study was designed to identify risk factors for lymph node metastasis of early stage colorectal cancer, which was confirmed to a carcinoma that invaded the submucosa after radical resection. Methods In total, 55 patients revealing submucosal invasive colorectal carcinoma on pathology who underwent curative radical resection at the Department of Surgery, St. Vincent’s Hospital, The Catholic University of Korea from January 2007 to September 2010 were evaluated retrospectively. Tumor size, depth of submucosal invasion, histologic grade, lymphovascular invasion, tumor budding, and microacinar structure were reviewed by a single pathologist. Student t-test for continuous variables and Chi-square test for categorical variables were used for comparing the clinicopathological features between two groups (whether lymph node involvement existed or not). Continuous variables are expressed as the mean ± standard error while statistical significance is accepted at P Results The mean age of 55 patients (34 males and 21 females) was 61.2 ± 9.6 years (range, 43–83). Histologically, eight (14.5%) patients had metastatic lymph node. In the univariate analysis, tumor budding (P = 0.047) was the only factor that was significantly associated with lymph node metastasis. Also, the tumor budding had a sensitivity of 83.3%, a specificity of 60.5%, and a negative predictive value of 0.958 for lymph node metastasis in submucosal invasive T1 colorectal cancer. Conclusions The tumor budding seems to have a high sensitivity (83.3%), acceptable specificity (60.5%), and a high negative predictive value (0.958). A close examination of pathologic finding including tumor budding should be performed in order to manage early CRC properly.

Published
2012
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47. The effect of laparoscopic surgery in stage II and III right-sided colon cancer: a retrospective study

Author

Kye Bong-Hyeon, Kim Jun-Gi, Cho Hyeon-Min, Lee Jung, Kim Hyung-Jin, Suh Young-Jin, and Chun Chung-Soo

Subjects
Laparoscopic surgery, Learning curve, Long-term outcome, Right sided colon cancer, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background This retrospective study compared the clinicopathological results among three groups divided by time sequence to evaluate the impact of introducing laparoscopic surgery on long-term oncological outcomes for right-sided colon cancer. Methods From April 1986 to December 2006, 200 patients who underwent elective surgery with stage II and III right-sided colon cancer were analyzed. The period for group I referred back to the time when laparoscopic approach had not yet been introduced. The period for group II was designated as the time when first laparoscopic approach for right colectomy was carried out until we overcame its learning curve. The period for group III was the period after overcoming this learning curve. Results When groups I and II, and groups II and III were compared, overall survival (OS) did not differ significantly whereas disease-free survival (DFS) in groups I and III were statistically higher than in group II (P = 0.042 and P = 0.050). In group III, laparoscopic surgery had a tendency to provide better long-term OS ( P = 0.2036) and DFS ( P = 0.2356) than open surgery. Also, the incidence of local recurrence in group III (2.6%) was significantly lower than that in groups II (7.4%) and I (12.1%) ( P = 0.013). Conclusions Institutions should standardize their techniques and then provide fellowship training for newcomers of laparoscopic colon cancer surgery. This technique once mastered will become the gold standard approach to colon surgery as it is both safe and feasible considering the oncological and technical aspects.

Published
2012
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