1.Non-operative Management of Rectal Cancer with Adjuvant Chemotherapy after Chemoradiotherapy (NORMANDY): Prospective Study
Hyebin LEE ; Hyung Ook KIM ; Jason Joon Bock LEE ; In-Gu DO ; Heon-Ju KWON ; Mi Sung KIM ; Soo-Kyung PARK ; Hyo-Joon YANG ; Yoon Suk JUNG ; Jung Ho PARK ; Dong-Il PARK ; Kyung Uk JUNG ; Eo Jin KIM ; Dong-Hoe KOO ; Hungdai KIM ; Ho-Kyung CHUN ;
Cancer Research and Treatment 2026;58(2):573-580
Purpose:
Non-operative management (NOM) has emerged as a promising organ-preserving strategy for patients with rectal cancer who achieve a clinical complete response (cCR) after neoadjuvant chemoradiotherapy (CRT). However, no standardized treatment protocol has been established for watch-and-wait strategies.
Materials and Methods:
This prospective study evaluated oncological outcomes of NOM combined with 4 months of adjuvant capecitabine. Patients with resectable rectal cancer (≤ 8 cm from the anal verge, cT2-4 or N+) underwent CRT (50-54 Gy in 25-27 fractions with capecitabine). Eight weeks post-CRT, a multidisciplinary team assessed cCR. Patients achieving cCR received six cycles of capecitabine (2 weeks on/1 week off) and were actively monitored.
Results:
Among 89 patients receiving CRT (2018-2023), 17 (19.1%) achieved cCR and were included. The median age was 65 years, and 64.7% were male. Eleven (64.7%) completed all six cycles of adjuvant therapy. After a median follow-up of 31.4 months, 11 patients (64.7%) remained disease-free. Local regrowth occurred in six patients (35.3%) with 2- and 4-year rates of 34.5% and 47.6%, respectively. Five underwent radical surgery, and one received transanal excision with systemic chemotherapy. At the time of assessment, 15 patients (88.2%) showed no evidence of disease, while two (11.8%) received palliative chemotherapy. All patients were alive.
Conclusion
NOM with adjuvant capecitabine showed promising oncological outcomes, offering an alternative to passive watch-and-wait approaches. Further refinement through multidisciplinary strategies is warranted.
2.Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk BAE ; Kyeong Eui KIM ; Chang-Woo KIM ; Ji-Hoon KIM ; Woon Kyung JEONG ; Yoon-Suk LEE ; Seong Kyu BAEK ; Suk-Hwan LEE ; Jun-Gi KIM
Annals of Coloproctology 2025;41(2):154-161
Purpose:
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods:
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results:
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
3.Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk BAE ; Kyeong Eui KIM ; Chang-Woo KIM ; Ji-Hoon KIM ; Woon Kyung JEONG ; Yoon-Suk LEE ; Seong Kyu BAEK ; Suk-Hwan LEE ; Jun-Gi KIM
Annals of Coloproctology 2025;41(2):154-161
Purpose:
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods:
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results:
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
4.Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk BAE ; Kyeong Eui KIM ; Chang-Woo KIM ; Ji-Hoon KIM ; Woon Kyung JEONG ; Yoon-Suk LEE ; Seong Kyu BAEK ; Suk-Hwan LEE ; Jun-Gi KIM
Annals of Coloproctology 2025;41(2):154-161
Purpose:
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods:
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results:
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
5.Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk BAE ; Kyeong Eui KIM ; Chang-Woo KIM ; Ji-Hoon KIM ; Woon Kyung JEONG ; Yoon-Suk LEE ; Seong Kyu BAEK ; Suk-Hwan LEE ; Jun-Gi KIM
Annals of Coloproctology 2025;41(2):154-161
Purpose:
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods:
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results:
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
6.Re-do laparoscopic common bile duct exploration for recurrent common bile duct stones: a single-center retrospective cohort study
In Ho LEE ; Seung Jae LEE ; Ju Ik MOON ; Sang Eok LEE ; Nak Song SUNG ; Seong Uk KWON ; In Eui BAE ; Seung Jae RHO ; Sung Gon KIM ; Min Kyu KIM ; Dae Sung YOON ; Won Jun CHOI ; In Seok CHOI
Annals of Surgical Treatment and Research 2025;108(5):310-316
Purpose:
Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones.
Methods:
This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded.
Results:
Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057).
Conclusion
Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.
7.Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk BAE ; Kyeong Eui KIM ; Chang-Woo KIM ; Ji-Hoon KIM ; Woon Kyung JEONG ; Yoon-Suk LEE ; Seong Kyu BAEK ; Suk-Hwan LEE ; Jun-Gi KIM
Annals of Coloproctology 2025;41(2):154-161
Purpose:
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods:
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results:
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
8.Re-do laparoscopic common bile duct exploration for recurrent common bile duct stones: a single-center retrospective cohort study
In Ho LEE ; Seung Jae LEE ; Ju Ik MOON ; Sang Eok LEE ; Nak Song SUNG ; Seong Uk KWON ; In Eui BAE ; Seung Jae RHO ; Sung Gon KIM ; Min Kyu KIM ; Dae Sung YOON ; Won Jun CHOI ; In Seok CHOI
Annals of Surgical Treatment and Research 2025;108(5):310-316
Purpose:
Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones.
Methods:
This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded.
Results:
Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057).
Conclusion
Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.
9.Re-do laparoscopic common bile duct exploration for recurrent common bile duct stones: a single-center retrospective cohort study
In Ho LEE ; Seung Jae LEE ; Ju Ik MOON ; Sang Eok LEE ; Nak Song SUNG ; Seong Uk KWON ; In Eui BAE ; Seung Jae RHO ; Sung Gon KIM ; Min Kyu KIM ; Dae Sung YOON ; Won Jun CHOI ; In Seok CHOI
Annals of Surgical Treatment and Research 2025;108(5):310-316
Purpose:
Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones.
Methods:
This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded.
Results:
Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057).
Conclusion
Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.
10.Decisional Trade-offs in Localized Prostate Cancer: A Prospective Cross-Sectional Study of Radical Prostatectomy, Radiation Therapy, and Active Surveillance
Hyunho HAN ; Youngdeuk CHOI ; Woong Kyu HAN ; Jihee JUNG ; Ayoung YOO ; Hyunji YOON ; Siyeong LEE ; Changhwa HYUN ; Woong Sub KOOM ; Ik Jae LEE ; Chan Woo WEE ; Jeongmi LEE ; Jae Young JEONG ; Hyung Ho LEE ; Young Ae KIM ; Jung Eun KIM ; Songhee EUN ; Sung Uk LEE ; Jinha JEONG ; Moonsoo RA
Journal of Urologic Oncology 2025;23(2):112-118
Purpose:
To evaluate patient‐reported experiences of 3 primary treatments for localized or locally advanced prostate cancer—radical prostatectomy (RP), radiation therapy (RT), and active surveillance (AS)—based on cross‐sectional data from a prospective registry, and to explore how these findings can inform a structured shared decision making (SDM) framework.
Materials and Methods:
Men with clinical stage cT3aN0M0 or lower were enrolled. Those who underwent RP or RT were surveyed 6–24 months posttreatment; men on AS had 6–60 months of follow‐up. All participants completed the EORTC QLQ‐PR25 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Prostate Cancer Module), capturing urinary, bowel, hormonal, and sexual function. The Kruskal‐Wallis test evaluated group differences, with significance set at p<0.05.
Results:
Among 542 patients, 435 underwent RP, 73 received RT (43% with androgen deprivation therapy), and 34 were on AS. RP patients reported higher rates of urinary incontinence and sexual dysfunction, whereas RT patients had more severe urinary irritative and bowel symptoms. AS generally preserved baseline sexual function but still involved some urinary complaints and anxiety regarding disease progression. These findings underscore the distinct trade‐offs among the 3 management strategies, emphasizing the importance of individualized SDM that accounts for functional priorities and patient values.
Conclusion
Each treatment modality poses unique impacts on quality of life. Incorporating these patient‐reported data into SDM discussions can improve alignment between clinical recommendations and patient preferences, potentially reducing decisional regret and enhancing long‐term outcomes.

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