Colorectal cancer surgical resection

Surgical intervention is a potential treatment option in patients with complications such as fistulae or abscesses, or in patients with medically refractory disease. Ulcerative colitis is curable with performance of a total colectomy. Patients with UC may opt to have a colectomy to reduce the chance of developing colorectal cancer. Patients with CD may have affected areas of intestine resected. Unfortunately, CD may recur following surgical resection. Repeated surgeries may lead to significant malabsorption of nutrients and drugs consistent with development of short-bowel syndrome. 

Individuals with stage I to III colorectal cancer should undergo a complete surgical resection of the tumor mass with removal of regional lymph nodes as a curative approach for... 

An important demonstration of the efficacy of a MAb in minimal residual disease was achieved usiug MAb 17-lA (directed against the EGP-2 or EpCAM antigen as described previously) in patients with stage III colorectal cancer. Following surgical resection, MAb therapy reduced the overall death rate by 32% and the rate of recurrence by 23% [122]. 

Colorectal cancer (CRC) is the third most common cause of cancer-related death in women and men in the United States (4). Although surgical resection is the primary therapy for CRC, prognosis remains poor and not all patients are candidates for surgery. The current therapeutic options for patients with metastatic CRC (mCRC) are 5-fluorouracil (5-FU) based therapy regimens in combination with irinotecan (CPT-11) or oxaliplatin (5,6). 

Adjuvant therapy differs for colon and rectal cancer because their natural history and recurrence patterns differ. Rectal cancer is more difficult to resect with wide margins, so local recurrences are more frequent than with colon cancer. Adjuvant RT plus chemotherapy is considered standard for stage 11 or 111 rectal cancer. Adjuvant chemotherapy is standard for stage 111 colon cancer and can be considered for high-risk stage II colon cancer. Adjuvant therapy is not indicated for stage I colorectal cancer because most patients are cured by surgical resection alone. 

Treatment modalities for colorectal cancer include surgery, XRT, chemotherapy, immunotherapy, and new targeted molecular therapies. Surgery is the most important and deflnitive procedure associated with cure radiation therapy can be used to improve curability following surgical resection and to reduce symptoms and complications... 

Complete surgical resection of discrete hepatic, pulmonary, abdominal, or brain metastases in patients with colorectal cancer, if possible, may offer selected patients an opportunity to experience extended DPS. Patients who have from one to three small nodules isolated to the liver, lungs, or abdomen have the most favorable outcome. Up to 25% of patients will present with hepatic metastases at time of diagnosis, and 60% of patients with colorectal cancer wfll develop hepatic metastases sometime during the course of their disease. 

The liver is the most frequent site of metastases as a result of the portal circulation and up to 60%-80% of patients with a history of colorectal carcinoma, pancreas carcinoma, breast cancer or other tumor types will develop metastases within the liver during the follow-up period [1]. There is no doubt that surgical resection of these metastases is the only potential curative option for these patients and is therefore considered as gold standard. However, due to anatomic or technical reasons or simple inoperability. 

Tumors not suitable for surgical resection for cure (HCC, colorectal cancer metastases approved by the regulatory authorities, metastases from other primaries can be treated accordingly with intention-to-treat but as yet without sufficient study basis)... 

The liver is the most frequent site of metastases, primarily due to the spread of cancer cells through the portal circulation. Approximately 60% of patients diagnosed with colorectal carcinoma will eventually experience liver disease as the predominant site. As with hepatocellular carcinoma (HCC), surgical resection of colorectal metastases offers the only chance for cure. However, this option is only available to a small percentage of patients. Many patients with other primaries such as breast, lung, and neuroendocrine will develop liver metastases during the course of the dis-... 

Bozzetti F, Cozzaglio L, Boracchi P, et al (1993) Comparing surgical resection of limited hepatic metastases from colorectal cancer to non-operative treatment. Eur J Surg Oncol 19 162-167... 

Iwatsuki S, Esquivel C, Gordon RD, et al (1986) Liver resection for metastatic colorectal cancer. Surgery 100 804-810 Jaeck D (2003) The significance of hepatic pedicle lymph node metastases in surgical management of colorectal liver metastases and of other liver malignancies. Ann Surg Oncol 10 1007-1011... 

Patt YZ, McBride CM, Ames FC, et al (1987) Adjuvant perioperative hepatic arterial mitomycin C and floxuridine combined with surgical resection of metastatic colorectal cancer in the liver. Cancer 59 867-873 Pawlik TM, Izzo F, Cohen DS, et al (2003) Combined resection and radiofrequency ablation for advanced hepatic malignancies results in 172 patients. Ann Surg Oncol. 10 1059-1069... 

Rivoire M, De Cian F, Meeus P, et al (2002) Combination of neoadjuvant chemotherapy with cryotherapy and surgical resection for the treatment of unresectable liver metastases from colorectal carcinoma. Cancer 95 2283-2292... 

Colorectal cancer is primarily treated by surgical resection, and early detection is critical for successful treatment [1], A fecal occult blood test is widely used as the easiest way of screening for colorectal cancer [2], Patients with positive findings need to be diagnosed by subsequent endoscopy in... 

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