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Visceral Surgery > Colon Cancer > Flashcards

Colon Cancer Flashcards

1
Q

Rectum

A

15cm

7cm are intra-peritoneal

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2
Q

Anus

A

4.2cm ( 3-5.3cm)

Anatomical anus :
up to marginal line

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3
Q

Chances of synchronous lesion on colonoscopy

A

6-8%

If not performed before, 3 months after Surgery

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4
Q

CEA

A

most likely correlated with advanced disease, but absent in 50% of cases

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5
Q

% that have metastatis at presentation

A

20

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6
Q

PET CT

A

not routinely recommended

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7
Q

Tumor in Caecum, Ascending Colon

A

Right hemicolectomy
High ligation of :
- ileocolic
- right colic

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8
Q

Tumor in Transversum

A

Right or left extended

- including middle colic artery

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9
Q

Sigmoid cancer

A
  • Left hemicolectomy

Sigmoid colectomy

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10
Q

Number of lymph nodes for correct staging

A

12

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11
Q

Node positive (Stage) Colon

A 
III
adjuvant therapy (FOLFOX 6 months)
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12
Q

Surveillance post operative for T3 or greater

A

CEA

  • every 3 months for the first 2 years
  • every 6 months for the following 3 years
  • CT yearly
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13
Q

Surveillance post operative

A

at 1 year or within 6 months if incomplete pre op

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14
Q

Colon : Adjuvant therapy for

A

Stage III or Stage II with risk factors:

  • poorly differentiated
  • lymphovascular invasion
  • bowel perforation
  • inadequate tumor margins
  • T4 lesions
  • low nodal count
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15
Q

T1

A

submucosa

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16
Q

T2

A

muscularis propria

17
Q

T4

A

neighbouring organs

18
Q

T4a

A

perforates visceral peritoneum

19
Q

T4b

A

infiltrates or adheres directly other organs

20
Q

N1

A

1-3 pericolic LN

21
Q

N2

A

4 or more pericolic LN

22
Q

N3

A

LN in central vascular structures

23
Q

M1

A

Remote metastasis

  • Liver
  • LN
  • Peritoneum
  • Lungs
  • Skelet
  • Adrenal glands
  • Brain
24
Q

Stadium AJCC

A

Stage I : T1 or T2, N0 M0
Stage II : > T3 and N0 M0
Stage III : N+
Stage IV : M+

25
Q

T3

A

Through muscularis mucosa into pericolorectal tissues

26
Q

Liver first

A 
If liver metastasis
Neo adjuvant chemotherapy
Liver resection
\+/- Chemotherapy
Colon resection
27
Q

Rectum : Neo Adjuvant Rx Chemo

A

II-III
cT3-T4 N0, M0
cT1-4 N1-2

28
Q

Rectum : Adjuvant Chemo

A

cT3-T4 N0, M0

cT1-4 N1-2

29
Q

Rectum Stadium I

A

pT1-2, N0, M0

no adjuvant or neo-adjuvant

30
Q

Stadium IV

A

Operation + palliatve Chemo

31
Q

Safety Margins

A

4-5 cm

For low risk deep tumors 3cm

Visceral Surgery (32 decks)

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