Colon cancer

Question 1

T3 colon cancer is defined by

Answer 1

tumor invades muscularis propria

Question 2

Standard of care for T3/T4 tumor:

Answer 2

preoperative chemoradiation then curative surgical resection then by further chemotherapy. doesn’t matter if there IS or ISN’T regional lymph node involvement see improved survival rates

Question 3

Differences between rectal versus colon cancer

Answer 3

sphincter preservation is important consideration as it means no need for permanet colostomy.

Question 4

Failure of tx of rectal cancer has higher morbidity and worse outcome because of

Answer 4

pelvic location

Question 5

What intervention helps to significantly down stage primary tumor of rectal cancer?

Answer 5

neoadjuvant chemo and radiation therapy. Needs to be done prior to resection Then can have post op chemotherapy allows for higher rates of sphincter preservation and local control.

Question 6

how many pts with colorectal cancer have metastatic dx at diagnosis?

Answer 6

20%

Question 7

common sites of colorectal metastasis are:

Answer 7

liver, lung, peritoneum and lymph nodes

Question 8

prognosis for colon cancer with liver only metastasis?

Answer 8

can be cured with surgical resection if only liver and no evidence of hepatic artery, major bile duct and main portal vein or celiac or aortic lymph node dx and <70% of liver

Need to have post surgery subsequent chemotherapy to maximize cure rates (30%) and 5 year survival is 50%

Question 9

what happens if someone has colon cancer and lung lesions or metachronous liver metastasis (found after colorectal surgery)

Answer 9

they can be resected too with curative intent

Question 10

what is done for follow up of colorectal cancer?

Answer 10

need CEA testing, colonoscopy and abdominal imaging to monitor for dx recurrence.

Question 11

colon cancer screening for pts who have increased risk:

Answer 11