• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.141-146
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• 2023

Colorectal cancer is the third most common cancer worldwide. The occurrence of colon cancer can be prevented by removing precursor lesions. Several countries are making efforts to prevent the occurrence of colon cancer via screening programs. Korea is also following suite by screening individuals < 50 years of age. Currently, the incidence of colon cancer among the young is increasing globally, and Korea has a high colon cancer incidence rate among individuals in their 20s and 40s. Therefore, it may be necessary to start the screening individuals < 50 years of age to detect the cancer's manifestation early. Moreover, advanced adenomas associated with poor prognosis can be detected early, the overall screening rate can be increased, and death from colon cancer at a young age can be prevented. Although the period of colorectal cancer screening has been expanded, the overall colorectal cancer screening rate has not. Additionally, increasing the screening rate among individuals > 50 years could reduce the mortality rate at a lower cost. Although the incidence of colon cancer is increasing in younger individuals, the evidence to conclude that screening at the age of < 50 years has a meaningful impact on the incidence and survival rates of colon cancer remains insufficient. Therefore, rather than following the trend and performing screening early, an approach that actively selects cases where tests for colorectal cancer diagnosis are required is warranted.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.52-60
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• 2012

Purpose: This study is to determine knowledge about early detection and risk perception of cancer according to taking cancer screening tests in the general population. Methods: The participants were 151 people aged 40 years or older. A questionnaire consisted of knowledge about early detection (warning signs, cancer screening methods, general knowledge for early detection), cancer risk perception and history of cancer screening during past 2 years. Results: The percentages of correct answers were 64.7% in knowledge about warning signs, 73.7% in knowledge of cancer screening tests and 80.1% in general knowledge for early detection. Participants had the highest knowledge about screening methods for stomach cancer and the lowest for liver and colon cancer. The level of risk perception was medium. The participants who participated in cancer screening showed lower risk perception than those who did not. There was no significant relationship between knowledge and performance of cancer screening. The primary reason for not participating in cancer screening was patient's perception of their own health. Conclusion: These results suggest that cancer risk perception can affect the performance of cancer screening and we need to study how to handle this problem. Additionally screening programs should focus on liver cancer and colon cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.753-756
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• 2015

Background: Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Much previous research has indicated that it increases in cases of systemic inflammation or cardiametabolic incident. However, information on the relation of RDW with solid tumors causing systemic inflammation is limited. In the present research, we examined the relation of RDW with malignant and benign lesions of the colon. Materials and Methods: 115 patients with colon polyps (group 1), and 30 with colon cancer (group 2) who were diagnosed histopathologically in our clinic between January 2010-January 2013 were scanned retrospectively. Patients with anemia, hematologic diseases and active inflammation were excluded. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relations with the malignant and benign lesions of the colon were examined. Results: Both groups were similar in age and gender distribution. RDW values of patients with colon cancer were significantly higher than the patients with colon polyp (p=0,01). No significant differences were detected between the two groups in terms of MCV and Plt values (p>0,05). Conclusions: RDW can be used as an early warning biomarker for solid colon tumors. Further prospective research is required on the relations of cheap and easily measured RDW parameters with colon malignancies.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2319-2321
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• 2014

Our aim was to determine GSTT1 expression levels in left colon tumors and paired normal tissue in order to identify specific alterations in GSTT1 mRNA levels. Alterations in GSTT1 expression in twenty-four left-sided colon tumors and paired cancer free tissue were determined by qRT-PCR. Significant fold changes were determined with t-test. When compared with cancer free tissue, left colon cancers showed a significant decrease in GSTT1 expression. However, GSTT1 mRNA levels among different grades increased gradually in correlation with tumor grade. Our results suggest that downregulation of GSTT1 in left-sided colon cancers is an early event and is reversed with cancer progression, probably due to cellular defense mechanisms as a response to changes in the microenvironment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10501-10504
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• 2015

Background: Colon cancer is the second most common cancer in developed countries. Activated platelets play a key role in inflammation and atherothrombosis, with mean platelet volume (MPV) is an early marker of platelet activation. The aim of the study was to clarify the relevance of MPV in patients with colon cancer. Materials and Methods: We measured MPV levels in 128 patients with colon cancer before and after surgery, and 128 controls matched for age, gender, body mass index (BMI) and smoking status. The odds ratios (ORs) and 95% confidence intervals (CIs) for colon cancer were calculated using multivariate logistic regression analyses across MPV quartiles. Results: Patients with colon cancer had higher MPV compared with controls. Surgical tumor resection resulted in a significant decrease in MPV levels (11.4 fL vs 10.7 fL; p<0.001). A positive correlation between MPV and tumor-nodule-metastases (TNM) stage was found. Furthermore, after adjusting for other risk factors, the ORs (95%CIs) for colon cancer according to MPV quartiles were 1.000, 2.238 (1.014-4.943), 3.410 (1.528-7.613), and 5.379 (2.372-12.198), respectively. Conclusions: The findings show that patients with colon cancer have higher MPV levels compared with controls, and these are reduced after surgery. In addition, MPV was found to be independently associated with the presence of colon cancer. Further studies are warranted to assess the utility of MPV as a novel diagnostic screening tool for colon cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2191-2194
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• 2014

Background: Fluorouracil-based regimens have been widely accepted and recommended in the guidelines for treating patients with early or advanced staged colon cancer, although results are controversial. Here we performed a systemic analysis to evaluate the impact of S-1 based regimens on response and survival of patients with colon cancer. Methods: Clinical studies evaluating the impact of S-1 based regimens on response and survival of patients with colon cancer were identified using a predefined search strategy. Summary response rates (RRs) to treatment were calculated. Results: Six clinical studies which including 227 patients with advanced colorectal cancer were considered eligible for inclusion. Two studies were conducted using combination of S-1 and Oxaliplatin, and four studies featured S-1 and irinotecan. Systemic analysis showed that, in all patients, pooled RRs was 43.17%. Major adverse effects were hematological toxicities, gastrointestinal disturbance, neurosensory toxicity. No treatment related death occurred. Conclusion: This systemic analysis suggests that S-1 based regimens, both with oxaliplatin or irinotean are associated with acceptable response and toxicity in patients with colon cancer.

• Journal of Digestive Cancer Research
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• v.12 no.2
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• pp.90-101
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• 2024

The incidence of colon cancer in South Korea has recently been the highest among gastrointestinal cancers. Early diagnosis is critical, and image-enhanced endoscopy (IEE) is a key diagnostic method. Colon tumors primarily include serrated polyps, adenomatous polyps, and colon cancer. Early endoscopic techniques relied on simple visual inspection for diagnosis, with tumor size and shape being the primary considerations. Low-resolution images made these methods ineffective for detecting small or early-stage lesions. IEE now enables detailed examination using high-resolution images and various color and structure analyses. Techniques like narrow band imaging (NBI) allow precise observation of vascular patterns and surface structures. Hyperplastic polyps often appear similar in color to the surrounding mucosa, with no visible vascular pattern. Sessile serrated lesions have a cloudy surface with distinct boundaries and irregular patterns, often with black spots in the crypts. Adenomatous polyps are darker brown, with a visible white epithelial network and various pit patterns. Magnified images help differentiate between low- and high-grade dysplasia, with low-grade showing regular patterns and high-grade showing increased irregularities. The NBI International Colorectal Endoscopic classification identifies malignant colon tumors as brown or dark brown with disorganized vascular patterns. The Japan NBI Expert Team classification includes loose vascular areas and disrupted thick vessels. The Workgroup serrAted polypS and Polyposis classification aids in differentiating between hyperplastic polyps and sessile serrated lesions/adenomas when deciding whether to resect polyps larger than 5 mm. Suspected high-grade dysplasia warrants endoscopic submucosal dissection and follow-up. Future advancements in IEE are expected to further enhance early detection and diagnostic accuracy.

• The Korean Journal of Nuclear Medicine
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• v.15 no.2
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• pp.1-9
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• 1981

Bone scans with $^{99m}Tc-MDP$ (methylene diphosphonate) were obtained and analysed in 574 patients with biopsy-proven malignancy, who visited Seoul National University Hospital from April, 1979 to June, 1931. Clinical staging was done in all patients without bone scan information and compared with bone scan to determine the predictive value of bone scanning. 1. Primary site of the maligancies were lung in 152, breast in 97, stomach in 43, colon in 15, esophagus in 9, liver and pancreas in 11, kidney in 14, bladder in 27, prostate in 22, thyroid in 20, skin in 11, bone in 9, head and neck in 36, ovary and uterus in 17, hematopoietic and lymphoretic ular system in 33, nervous system in 10, and others in 9 cases. Primary site was not defined in 39 cases. 2. Bone scans were positive in 186 cases (32.4%), which, included 48 cases (31.6%) of lung cancer, 27 cases (27.8%) of breast cancer, 12 cases(28%) of stomach cancer, 6 cases(40%) of colon cancer, 6 cases(43%) of kidney tumor, 4 cases(15%) of bladder cancer, 14 cases(64%) of prostate cancer, 3 cases(15%) of thyroid cancer and 66 other cases. 3. Bone scans were suspicious in 64 cases (11.2%) which included 29 cases (19.1%) of lung cancer, 10 cases (10.3%) of breast cancer, 4 cases (9.3%) of stomach cancer, one case (7%) of colon cancer, 3 cases(11%) of bladder cancer, 2 cases(10%) of thyroid cancer and 15 other cases. 4. Out of 121 cases with early stage of malignancy (which included 20 cases of lung cancer in stage I, II, 38 cases of breast cancer, 13 cases of stomach cancer, 8 cases of kidney tumor, 14 cases of thyroid cancer in stage $I{\sim}III$, and 6 cases of colon cancer, 14 cases of bladder cancer, 8 cases of prostate cancer in stage $A{\sim}C$, bone scans were positive in 5 cases (4.1%) which included 3 cases of lung cancer one case of breast cancer and one case of prostate cancer, and considered as further advanced stage. Out of 121 cases with early stage of malgnancy, bone scans were suspicious in 21 cases (17.4%) which inlcuded 9 cases of lung cancer, 4 cases of breast cancer, 2 cases of stomach cancer, one case of colon cancer, 3 cases of bladder cancer, and 2 cases of thyroid cancer. From these results, we concluded bone scan was useful in detecting bone metastasis in patients of early stage of malignancy, determining prognosis and establishing therapentic plan.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5141-5144
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• 2013

Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

• Annals of Surgical Treatment and Research
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• v.96 no.2
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• pp.78-85
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• 2019

Purpose: Insistence that total regression of primary tumor would not represent long-term oncologic outcomes has been raised. Therefore, this study aimed to evaluate the outcomes of these patients after preoperative chemoradiotherapy (PCRT) and radical surgery and to evaluate the associated risk factors. Methods: We included 189 patients with rectal cancer who showed total regression of the primary tumor after PCRT, followed by radical resection, between 2001 and 2012. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the results were compared with 77 patients with Tis rectal cancer who received only radical resection. Factors associated with RFS were evaluated using Cox regression analysis. Results: Sphincter-saving resection was performed for 146 patients (77.2%). Adjuvant chemotherapy was administered to 168 patients (88.9%). During the follow-up period, recurrence occurred in 17 patients (9%). The 5-year RFS was 91.3%, which was significantly lower than that of patients with Tis rectal cancer without PCRT (P = 0.005). In univariate analysis, preoperative CEA and histologic differentiation were associated with RFS. However, no factors were found to be associated with RFS. Conclusion: RFS was lower in patients with total regression of primary rectal cancer after PCRT than in those with Tis rectal cancer without PCRT, and it would not be considered as the same entity with early rectal cancer or "disappeared tumor" status.