scholarly journals Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer

2018 ◽  
Vol 19 (9) ◽  
pp. 2577 ◽  
Author(s):  
Stephan Paschke ◽  
Sakhavat Jafarov ◽  
Ludger Staib ◽  
Ernst-Dietrich Kreuser ◽  
Catharina Maulbecker-Armstrong ◽  
...  

Colon cancer (CC) and rectal cancer (RC) are synonymously called colorectal cancer (CRC). Based on our experience in basic and clinical research as well as routine work in the field, the term CRC should be abandoned. We analyzed the available data from the literature and results from our multicenter Research Group Oncology of Gastrointestinal Tumors termed FOGT to confirm or reject this hypothesis. Anatomically, the risk of developing RC is four times higher than CC, while physical activity helps to prevent CC but not RC. Obvious differences exist in molecular carcinogenesis, pathology, surgical topography and procedures, and multimodal treatment. Therefore, we conclude that CC is not the same as RC. The term “CRC” should no longer be used as a single entity in basic and clinical research as well as other areas of classification.

2018 ◽  
Vol 17 (4) ◽  
pp. 88-98 ◽  
Author(s):  
S. Jafarov ◽  
K. H. Link

Introduction.Colon and rectal cancer (CC, RC) are different entities from a clinical and tumor biological point of view. Up to now, both, CC and RC, are synonymously called  “Colorectal Cancer” (CRC). With our experience in basic and clinical research and routine  work in this field we now have come to the opinion, that the term “CRC” should definitely be questioned, and if justified, be abandoned.Materials/Methods.We analyzed the actual available data from the literature and our own  results from the Ulm based study group FOGT to proof or reject our hypothesis.Results.The following evident differences were recognized: Anatomically, the risk to  develop RC is 4× higher than for CC. Molecular changes in carcinogenesis in CC are different from RC. Physical activity helps to prevent CC, not RC. Pathologically there are differences between RC and CC. In addition, there are also major clinical differences  between CC and RC, such as in surgical topography and– procedures, multimodal treatment  (MMT) approaches (RC in MMT is less sensitive to chemotherapy than CC), and prognostic  factors for the spontaneous course and for success of MMT (e.g. TS or DPD ). Discussion. CC ´sand RC´s definitely are different in parameters of causal and formal carcinogenesis, effectivity of primary prevention by physical activity, conventional and  molecular pathology.According to our findings we can demand from the preclinical point of  view that CC and RC are two different tumor entities in terms of various representative  biological characteristics.CC and RC are also differing substantially in many clinical features, as outlined in a separate paper from our group.Conclusion.“CRC” should no longer be used in basic and clinical research and other fields  of cancer classification as a single disease entity. CC is not the same as RC. CC might even be divided into right and left CC.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maximilian Richter ◽  
Lena Sonnow ◽  
Amir Mehdizadeh-Shrifi ◽  
Axel Richter ◽  
Rainer Koch ◽  
...  

Abstract Objectives To evaluate how the certification of specialised Oncology Centres in Germany affects the relative survival of patients with colorectal cancer (CRC) by means of national and international comparison. Methods Between 2007 and 2013, 675 patients with colorectal cancer, treated at the Hildesheim Hospital, an academic teaching hospital of the Hannover Medical School (MHH), were included. A follow-up of the entire patient group was performed until 2014. To obtain international data, a SEER-database search was done. The relative survival of 148,957 patients was compared to our data after 12, 36 and 60 months. For national survival data, we compared our rates with 41,988 patients of the Munich Cancer Registry (MCR). Results Relative survival at our institution tends to be higher in advanced tumour stages compared to national and international cancer registry data. Nationally we found only little variation in survival rates for low stages CRC (UICC I and II), colon, and rectal cancer. There were notable variations regarding relative survival rates for advanced CRC tumour stages (UICC IV). These variations were even more distinct for rectal cancer after 12, 36 and 60 months (Hildesheim Hospital: 89.9, 40.3, 30.1%; Munich Cancer Registry (MCR): 65.4, 28.7, 16.6%). The international comparison of CRC showed significantly higher relative survival rates for patients with advanced tumour stages after 12 months at our institution (77 vs. 54.9% for UICC IV; raw p<0.001). Conclusions Our findings suggest that patients with advanced tumour stages of CRC and especially rectal cancer benefit most from a multidisciplinary and guidelines-oriented treatment at Certified Oncology Centres. For a better evaluation of cancer treatment and improved national and international comparison, the creation of a centralised national cancer registry is necessary.


2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification


2019 ◽  
Author(s):  
Maurits P. Engbersen ◽  
Max J. Lahaye ◽  
Regina G.H. Beets-Tan

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification


2020 ◽  
Author(s):  
Christina E Bailey ◽  
Eduardo Vilar ◽  
Y. Nancy You

Colorectal cancer (CRC) is the third most common and lethal cancer in men and women in the United States. At presentation, a significant proportion of patients with CRC are able to undergo resection with curative intent, but up to 50% of these patients will develop recurrent disease. Fortunately, recurrence rates for both colon and rectal cancer have improved with the introduction of multimodality therapies, which include chemotherapy, chemoradiation therapy, and radiation therapy. These therapies are adjuncts to surgery and can be administered before (i.e. neoadjuvant) or after (i.e. adjuvant) surgery. This review summarizes the current evidence for the use of adjuvant and neoadjuvant therapies in colon and rectal cancer. This review contains 2 figures, 7 tables, and 77 references. Keywords: Colon cancer, rectal cancer, neoadjuvant therapy, adjuvant therapy, total neoadjuvant therapy, induction chemotherapy in rectal cancer, chemoradiation, organ preservation, non-operative management


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13585-13585
Author(s):  
J. C. Marin Marmolejo ◽  
C. R. Villegas Mejia ◽  
J. P. Cardona Arcila ◽  
E. Mulett Vasquez ◽  
M. Osorio Chica ◽  
...  

13585 Background: According to the TNM classification, the prognosis of patients suffering from colon and rectal cancer has been defined taking into account the number of nodes reported positively. Objective: This work is intending to establish a relation between the number of positive nodes and the number of dissected nodes, relating it with the overall survival. Methods: 5500 medical records of patients were reviewed. 771 out of these corresponded to gastrointestinal cancer (14%) from which 351(6.38%) corresponded to colorectal cancer. From this group, 291 patients (82.9%) underwent a surgery. A relation between the number of positive nodes and the number of dissected nodes was established and called proportion of positivity (positive nodes/ dissected nodes × 100) and this was in turn related to a five year overall survival. Two groups were analyzed: proportion of positivity > than 50% and proportion of positivity < than 50%. Results: A report of 209 patients showing nodes was obtained (59.5%), with a means of 10.4 (rank 0–31) of dissected nodes per patient and a means of positive nodes of 2.4 (rank 0–22). Comparing the two groups the statistic significance starts to be obvious from the 18 months and the difference between the two groups continues increasing until the five years. The survival to five years for the group with the proportion > than 50% was 39% (IC 95%:13.4–64.5) compared to the survival for the group with a proportion < than 50% that was 75.7% (IC 95%:67.6–83.7) p<0.05. Conclusions: The proposal shows that not only is the absolute number of positive dissected nodes as only prognostic indicator (TNM) but also that before nodes dissections with low number of them, it is possible to establish a reliable prognostic relationship by calculating the proportion of positivity. The above said does not consider that the nodal dissection can be less than recommended, on the contrary obtaining the biggest number of nodes will mean bigger equivalence of the proposal and a bigger possibility to detect positive nodes. No significant financial relationships to disclose.


2008 ◽  
Vol 19 (9) ◽  
pp. 939-953 ◽  
Author(s):  
Regan A. Howard ◽  
D. Michal Freedman ◽  
Yikyung Park ◽  
Albert Hollenbeck ◽  
Arthur Schatzkin ◽  
...  

2021 ◽  
Vol 9 (1) ◽  
pp. 256
Author(s):  
Yasser Mohammad Abd-Elshafy ◽  
Islam Mohammad Mohammad ◽  
Hazem Nour Abdelatif Ashry ◽  
Mohammad Abdullah Zaitoun

Because of the initial case study results suggesting high recurrence rates at port sites, adoption of the laparoscopic approach for colorectal cancer treatment was slow. Surgical resection remains the cornerstone and most important facet in management of colon cancer. The use of minimally invasive approach in colorectal surgery has been reported by several authors in the literature. Some difficult about the use of laparoscopic surgery for colorectal cancer still raises, particularly with the technique’s complexity, learning curve and longer duration. Scientific literature published from January 2010 to April 2020 was reviewed. Phase III randomized clinical trials were included. Analysis of the scientific literatures confirmed that for the curative treatment of colon and rectal cancer, laparoscopy is not inferior to open surgery with respect to overall survival, disease-free survival and rate of recurrence. Laparoscopic resection can be considered an option for the curative treatment of colon and rectal cancer; but must take into consideration surgeon experience, tumour stage and potential contraindications; and that laparoscopic resection for rectal cancer be performed only by appropriately trained surgeons.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035556
Author(s):  
Heigo Reima ◽  
Jaan Soplepmann ◽  
Anneli Elme ◽  
Mari Lõhmus ◽  
Rena Tiigi ◽  
...  

ObjectivesLarge disparities in colorectal cancer (CRC) management and survival have been observed across Europe. Despite recent increases, the survival deficit of Estonian patients with CRC persists, particularly for rectal cancer. The aim of this study was to examine diagnostic, staging and treatment patterns of CRC in Estonia, comparing clinical data from 1997 and 2011.DesignNationwide population-based retrospective study.SettingEstonia.ParticipantsAll incident cases of colon and rectal cancer diagnosed in 1997 and 2011 identified from the Estonian Cancer Registry. Clinical data gathered from medical records.Outcome measuresDifferences in diagnostic, staging and treatment patterns; 5-year relative survival ratios.ResultsThe number of colon cancer cases was 337 in 1997 and 498 in 2011; for rectal cancer, the respective numbers were 209 and 349. From 1997 to 2011, large increases were seen in the use of colonoscopy and lung and liver imaging. Radical resection rate increased from 48% to 59%, but emergency surgeries showed a rise from 18% to 26% in colon and from 7% to 14% in rectal cancer. The proportion of radically operated patients with ≥12 lymph nodes examined pathologically increased from 2% to 58% in colon cancer and from 2% to 50% in rectal cancer. The use of neoadjuvant radiotherapy increased from 6% to 39% among stage II and from 20% to 50% among patients with stage III rectal cancer. The use of adjuvant chemotherapy in stage III colon cancer increased from 42% to 63%. The 5-year RSR increased from 50% to 58% in colon cancer and from 37% to 64% in patients with rectal cancer.ConclusionsMajor improvements were seen in the diagnostics, staging and treatment of CRC in Estonia contributing to better outcomes. Increase in emergency surgeries highlights possible shortcomings in timely diagnosis and treatment.


Sign in / Sign up

Export Citation Format

Share Document