Publications by authors named "Yih-Jong Chern"

Introduction: Natural killer (NK) cell activity (NKA) is downregulated in patients with colorectal cancer (CRC), and its dysfunction is possibly associated with increased risk of recurrence. However, its role in prognosis of CRC remains unclear. Prior research has shown that surgical stress can suppress NKA.

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  • * Patients with EOCRC tend to have more aggressive forms of cancer and are diagnosed at later stages compared to those with late-onset CRC (LOCRC), reporting more severe symptoms like rectal bleeding and abdominal pain.
  • * Despite similar surgical outcomes, the 5-year survival rate for stage IV EOCRC patients is notably lower than that for late-onset cases, highlighting the urgent need for better awareness and early detection efforts in younger populations.
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  • The study investigates the long-term outcomes of laparoscopic versus open surgery for colorectal cancer in obese patients (BMI ≥ 30 kg/m²) using data from 2009-2019, aiming to find better surgical options.
  • Laparoscopic surgery showed longer operation times and higher complication rates, while open surgery had more wound infections and readmissions; however, laparoscopic surgery was linked to worse long-term survival and recurrence rates, especially in certain patient subgroups.
  • The authors conclude that laparoscopic colorectal surgery in obese patients has significant risks despite short-term benefits, recommending caution for specific groups like older patients and those with advanced cancer stages.
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In this study, we introduce a novel method for stoma closure, aiming to reduce wound infection rates. This method involves creating the common channel of both limbs of a loop stoma extracorporeally, which is particularly beneficial during laparoscopic stoma closure surgery by potentially avoiding contamination of the wound. We applied this technique in 23 patients undergoing laparoscopic stoma reversal surgery, comprising both loop colostomy and ileostomy cases.

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Context: The association between colorectal cancer (CRC) and new-onset diabetes mellitus remains unclear.

Objective: To examine the association between CRC and the risk of subsequent diabetes mellitus and to further investigate the impact of chemotherapy on diabetes mellitus risk in CRC.

Design: A nationwide cohort study.

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Background: Studies on prognostic factors for patients undergoing surgery to treat solitary liver metastases originating from colorectal cancer (CRC) are limited. This study aimed to analyze significant prognostic factors associated with tumor recurrence and long-term survival after liver resection for solitary colorectal liver metastasis.

Methods: Data from 230 patients with solitary liver metastases from CRC who received liver resection between 2010 and 2019 were retrospectively analyzed.

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Purpose: Low anterior resection syndrome (LARS) has had many impacts on the lives of patients and substantial differences in emotional and social functions. The aim of this study was to investigate the correlation analysis of different personality traits in rectal cancer patients with LARS after undergoing curative surgery.

Methods: This study was designed as a prospective cohort study.

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Background: Although diabetes is a poor prognostic factor for colorectal cancer (CRC), whether diabetes severity provides an additional predictive value for CRC prognosis remains unclear. The study aimed to investigate the prognostic differences after curative CRC resection among patients with different diabetic severities.

Methods: This population-based retrospective cohort study analyzed data registered between 2007 and 2015 in the Cancer Registry Database, which is linked to the National Health Insurance Research Database and National Death Registry.

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Abdominal computed tomography (CT) is a frequently used imaging modality for evaluating gastrointestinal diseases. The detection of colorectal cancer is often realized using CT before a more invasive colonoscopy. When a CT exam is performed for indications other than colorectal evaluation, the tortuous structure of the long, tubular colon makes it difficult to analyze the colon carefully and thoroughly.

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Background: Evidence regarding postoperative CEA for predicting long-term outcomes of colorectal cancer remains controversial, especially in patients with normal postoperative CEA.

Objective: To investigate the risk difference among different postoperative CEA trajectories in patients with normal postoperative CEA after curative colorectal cancer resection.

Design: This cohort study was conducted at a comprehensive cancer center and included data retrieved from a prospectively collected database between January 2006 and December 2018.

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Background: To summarize the chemo-radio effect of metformin in rectal cancers with neoadjuvant chemoradiotherapy on pathological response, tumor regression grade (TRG), and T/N downstaging.

Methods: PubMed, MEDLINE, Embase, and Cochrane Database of collected reviews were searched up to June 30, 2022. This study conducted systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) sheet.

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Purpose: The standard initial treatment for metastatic colorectal cancer (mCRC) remains debated. This study investigated whether upfront primary tumor resection (PTR) or upfront systemic therapy (ST) provides better survival outcomes for patients with mCRC.

Methods: The PubMed, Embase, Cochrane Library, and ClinicalTrials.

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Article Synopsis
  • The study examined the effectiveness, safety, and mid-term outcomes of using short-course radiotherapy (SCRT) combined with oxaliplatin-based chemotherapy in patients with locally advanced rectal cancer (LARC).
  • Out of 64 patients treated, a significant number responded well to the treatment, with a high rate of sphincter preservation observed during surgeries and minimal severe complications.
  • After about 32 months of follow-up, most patients showed good overall survival and disease-free rates, indicating that this treatment approach is both safe and effective for downstaging tumors in LARC.
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  • The main treatment for metastatic colorectal cancer involves chemotherapy and targeted therapies, especially with anti-EGFR drugs for patients with normal RAS and BRAF genes.
  • A study of 111 patients revealed that while skin reactions are common with anti-EGFR treatments, they don't significantly predict treatment success or overall survival.
  • Gender differences in skin reactions were noted, with males experiencing higher rates of severe acne, but overall, factors like age and tumor site did not impact patient outcomes significantly.
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  • The study examines the effects of high versus low ligation of the inferior mesenteric artery during surgery for sigmoid colon or rectal cancer, focusing on surgical outcomes and recovery.
  • It involved a retrospective analysis of 894 patients who underwent anterior resection between December 2016 and December 2019, which was then narrowed down to 245 matched patients per group.
  • The results indicate that low ligation is associated with significantly lower rates of anastomotic leakage and overall complications compared to high ligation, suggesting it may be the safer option for surgical treatment.
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Background: Because of the progression of minimally invasive surgery skills and obesity in colorectal surgery, we aimed to evaluate the short-term outcomes of colorectal cancer resections in patients with generalized obesity at a single teaching hospital with mature surgical techniques and training programs.

Methods: A total of 537 patients were diagnosed with CRC and had a body mass index ≥30 kg/m between January 2009 and December 2019 at a single institution. 265 patients underwent open surgery and 272 patients underwent laparoscopic surgery.

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Inflammatory reactions play a crucial role in cancer progression and may contribute to systemic inflammation. In routine clinical practice, some inflammatory biomarkers can be utilized as valuable predictors for colorectal cancer (CRC). This study aims to determine the usefulness of a novel cancer-inflammation prognostic index (CIPI) marker derived from calculating carcinoembryonic antigen (CEA) multiplied by the neutrophil-to-lymphocyte ratio (NLR) values established for non-metastatic CRCs.

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AIM: The ERAS protocol consists of multiple items that aim to improve the outcomes of patients receiving surgery. Adhering to the protocol is difficult. We wondered whether surgeons practicing the ERAS protocol in a group would improve patient outcomes.

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Background/aims: Exacerbating factors of ulcerative colitis (UC) are multiple and complex with individual influence. We aimed to evaluate the efficacy of disease control by searching and restricting inflammation trigger factors of UC relapse individually in daily clinical practice.

Methods: Both patients with UC history or new diagnosis were asked to avoid dairy products at first doctor visit.

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It is controversial whether patients who achieve clinical complete remission (cCR) of rectal cancer should be treated with the "watch and wait" (W&W) or radical resection (RR) strategy. Our study aimed to compare the survival outcomes and ostomy rate of the W&W and RR strategies. Between January 2008 and December 2015, we investigated 26 patients who achieved pathologic complete remission after undergoing RR and 36 patients who adopted the W&W strategy because of cCR.

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Studies have reported positive short-term and histopathological results of transanal total mesorectal excision (TaTME) for mid-low rectal cancer. The long-term oncological outcomes are diverse, and concerns regarding the high local recurrence (LR) rate of TaTME have recently increased. We retrospectively analyzed 298 consecutive patients who underwent Laparoscopic TME (LapTME) or TaTME between January 2015 and December 2019.

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Background: Few studies have evaluated the feasibility and safety of intracorporeal anastomosis (IA) for left hemicolectomy. Here, we aimed to investigate the potential advantages and disadvantages of laparoscopic left hemicolectomy with IA and compare the short- and medium-term outcomes between IA and extracorporeal anastomosis (EA).

Methods: We retrospectively analyzed 133 consecutive patients who underwent laparoscopic left hemicolectomies from July 2016 to September 2019 and categorized them into the IA and EA groups.

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This study aimed to explore the safety and efficacy of neoadjuvant SCRT and tegafur−uracil/leucovorin plus oxaliplatin (TEGAFOX) for LARC in comparison to those of the modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX-6) regimen. We retrospectively evaluated 15 and 22 patients with LARC who underwent SCRT, followed by consolidation chemotherapy with TEGAFOX and mFOLFOX-6 before surgery, respectively, between January 2015 and December 2019. The primary endpoint was the tumor response rate.

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Neoadjuvant short course radiotherapy (SCRT) followed by consolidation chemotherapy (CCT) is an alternative treatment for locally advanced rectal cancer (LARC). We performed this systematic review and meta-analysis to explore the tumor response and oncological outcomes of this new approach compared to conventional chemoradiotherapy (CRT). An online search of the PubMed, Embase, and Cochrane Library databases was performed.

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