1.Is Colonoscopy Alone Adequate for Surveillance in Stage I Colorectal Cancer?
Seijong KIM ; Jung Kyong SHIN ; Yoonah PARK ; Jung Wook HUH ; Hee Cheol KIM ; Seong Hyeon YUN ; Woo Yong LEE ; Yong Beom CHO
Cancer Research and Treatment 2025;57(2):507-518
Purpose:
While colonoscopy is the standard surveillance tool for stage I colorectal cancer according to National Comprehensive Cancer Network guidelines, its effectiveness in detecting recurrence is debated. This study evaluates recurrence risk factors and patterns in stage I colorectal cancer to inform comprehensive surveillance strategies.
Materials and Methods:
A retrospective analysis of 2,248 stage I colorectal cancer patients who underwent radical surgery at Samsung Medical Center (2007-2018) was conducted. Exclusions were based on familial history, prior recurrences, preoperative treatments, and inadequate data. Surveillance included colonoscopy, laboratory tests, and computed tomography (CT) scans.
Results:
Stage I colorectal cancer patients showed favorable 5-year disease-free survival (98.3% colon, 94.6% rectum). Among a total of 1,467 colon cancer patients, 26 (1.76%) experienced recurrence. Of the 781 rectal cancer patients, 47 (6.02%) experienced recurrence. Elevated preoperative carcinoembryonic antigen levels and perineural invasion were significant recurrence risk factors in colon cancer, while tumor budding was significant in rectal cancer. Distant metastasis was the main recurrence pattern in colon cancer (92.3%), while rectal cancer showed predominantly local recurrence (50%). Colonoscopy alone detected recurrences in a small fraction of cases (3.7% in colon, 14.9% in rectum).
Conclusion
Although recurrence in stage I colorectal cancer is rare, relying solely on colonoscopy for surveillance may miss distant metastases or locoregional recurrence outside the colorectum. For high-risk patients, we recommend considering regular CT scans alongside colonoscopy. This targeted approach may enable earlier recurrence detection and improve outcomes in this subset while avoiding unnecessary scans for the low-risk majority.
2.Is Colonoscopy Alone Adequate for Surveillance in Stage I Colorectal Cancer?
Seijong KIM ; Jung Kyong SHIN ; Yoonah PARK ; Jung Wook HUH ; Hee Cheol KIM ; Seong Hyeon YUN ; Woo Yong LEE ; Yong Beom CHO
Cancer Research and Treatment 2025;57(2):507-518
Purpose:
While colonoscopy is the standard surveillance tool for stage I colorectal cancer according to National Comprehensive Cancer Network guidelines, its effectiveness in detecting recurrence is debated. This study evaluates recurrence risk factors and patterns in stage I colorectal cancer to inform comprehensive surveillance strategies.
Materials and Methods:
A retrospective analysis of 2,248 stage I colorectal cancer patients who underwent radical surgery at Samsung Medical Center (2007-2018) was conducted. Exclusions were based on familial history, prior recurrences, preoperative treatments, and inadequate data. Surveillance included colonoscopy, laboratory tests, and computed tomography (CT) scans.
Results:
Stage I colorectal cancer patients showed favorable 5-year disease-free survival (98.3% colon, 94.6% rectum). Among a total of 1,467 colon cancer patients, 26 (1.76%) experienced recurrence. Of the 781 rectal cancer patients, 47 (6.02%) experienced recurrence. Elevated preoperative carcinoembryonic antigen levels and perineural invasion were significant recurrence risk factors in colon cancer, while tumor budding was significant in rectal cancer. Distant metastasis was the main recurrence pattern in colon cancer (92.3%), while rectal cancer showed predominantly local recurrence (50%). Colonoscopy alone detected recurrences in a small fraction of cases (3.7% in colon, 14.9% in rectum).
Conclusion
Although recurrence in stage I colorectal cancer is rare, relying solely on colonoscopy for surveillance may miss distant metastases or locoregional recurrence outside the colorectum. For high-risk patients, we recommend considering regular CT scans alongside colonoscopy. This targeted approach may enable earlier recurrence detection and improve outcomes in this subset while avoiding unnecessary scans for the low-risk majority.
3.Is Colonoscopy Alone Adequate for Surveillance in Stage I Colorectal Cancer?
Seijong KIM ; Jung Kyong SHIN ; Yoonah PARK ; Jung Wook HUH ; Hee Cheol KIM ; Seong Hyeon YUN ; Woo Yong LEE ; Yong Beom CHO
Cancer Research and Treatment 2025;57(2):507-518
Purpose:
While colonoscopy is the standard surveillance tool for stage I colorectal cancer according to National Comprehensive Cancer Network guidelines, its effectiveness in detecting recurrence is debated. This study evaluates recurrence risk factors and patterns in stage I colorectal cancer to inform comprehensive surveillance strategies.
Materials and Methods:
A retrospective analysis of 2,248 stage I colorectal cancer patients who underwent radical surgery at Samsung Medical Center (2007-2018) was conducted. Exclusions were based on familial history, prior recurrences, preoperative treatments, and inadequate data. Surveillance included colonoscopy, laboratory tests, and computed tomography (CT) scans.
Results:
Stage I colorectal cancer patients showed favorable 5-year disease-free survival (98.3% colon, 94.6% rectum). Among a total of 1,467 colon cancer patients, 26 (1.76%) experienced recurrence. Of the 781 rectal cancer patients, 47 (6.02%) experienced recurrence. Elevated preoperative carcinoembryonic antigen levels and perineural invasion were significant recurrence risk factors in colon cancer, while tumor budding was significant in rectal cancer. Distant metastasis was the main recurrence pattern in colon cancer (92.3%), while rectal cancer showed predominantly local recurrence (50%). Colonoscopy alone detected recurrences in a small fraction of cases (3.7% in colon, 14.9% in rectum).
Conclusion
Although recurrence in stage I colorectal cancer is rare, relying solely on colonoscopy for surveillance may miss distant metastases or locoregional recurrence outside the colorectum. For high-risk patients, we recommend considering regular CT scans alongside colonoscopy. This targeted approach may enable earlier recurrence detection and improve outcomes in this subset while avoiding unnecessary scans for the low-risk majority.
4.Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4
Siyoung KIM ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Sung Woo HUH
Annals of Occupational and Environmental Medicine 2024;36(1):e20-
Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population. Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products. Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage. This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.
5.Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4
Sung Woo HUH ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Keon Woo KIM
Annals of Occupational and Environmental Medicine 2024;36(1):e12-
Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs. Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage. The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females. This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.
6.Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4
Siyoung KIM ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Sung Woo HUH
Annals of Occupational and Environmental Medicine 2024;36(1):e20-
Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population. Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products. Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage. This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.
7.Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4
Sung Woo HUH ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Keon Woo KIM
Annals of Occupational and Environmental Medicine 2024;36(1):e12-
Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs. Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage. The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females. This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.
8.Relationship between the use of hair products and urine benzophenone-3: the Korean National Environmental Health Survey (KoNEHS) cycle 4
Siyoung KIM ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Sung Woo HUH
Annals of Occupational and Environmental Medicine 2024;36(1):e20-
Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population. Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products. Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage. This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.
9.Relationship between crustacean consumption and serum perfluoroalkyl substances (PFAS): the Korean National Environmental Health Survey (KoNEHS) cycle 4
Sung Woo HUH ; Seong-yong CHO ; Seongyong YOON ; Daehwan KIM ; Hyun Woo PARK ; Jisoo KANG ; Keon Woo KIM
Annals of Occupational and Environmental Medicine 2024;36(1):e12-
Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs. Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage. The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females. This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.
10.Learning curve for single-port robot-assisted colectomy
Moon Suk CHOI ; Seong Hyeon YUN ; Sung Chul LEE ; Jung Kyong SHIN ; Yoon Ah PARK ; Jungwook HUH ; Yong Beom CHO ; Hee Cheol KIM ; Woo Yong LEE
Annals of Coloproctology 2024;40(1):44-51
Purpose:
Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery.
Methods:
We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3.
Results:
The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection.
Conclusion
In our experience, the learning curve for SPR colectomy was achieved after the 18th case.

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