Colorectal CA Flashcards
Colorectal cancer precursor
Adenomatous polyp, sessile type
**Villous adenomas (most are sessile) has increased malignant risk
Primary therapy and prevention once noted to have polyposis coli
Total colectomy with ileoanal anastomosis
Diagnostic clues for Lynch syndrome (hereditary nonpolyposis colon cancer)
>/= 1 case of colon ca diagnosed = 50y/o in the family >/= 2 generations had colorectal ca >/= 3 relatives with colon ca, 1 of which is 1st degree relative of the other 2
Difference of polyposis coli and Lynch syndrome in terms of location of polyps
Polyposis coli: evenly distributed from cecum to anus
Lynch syndrome: proximal large colon
Type of inflammatory bowel disease with increased risk of colorectal ca
Ulcerative colitis
Most effective chemopreventive agents for colonic adenomas and carcinomas
NSAIDs and aspirin
Location of colon cancer when it usually presents as anemia
Cecum and ascending colon (right colon)
Location of colon cancer when it usually presents as obstruction
Transverse and descending colon (left colon)
Most frequent visceral site of metastasis of colon ca
Liver
Colon cancer staging
T1: until submucosa
T2: until muscularis
T3: through muscularis
T4: invades adjacent organs
N1: 1-3 LN
N2: >/= 4 LN
Stage I: T1-T2
Stage II: T3-T4
Stage III: +N
Stage IV: +M
Optimal treatment for colorectal ca
Total resection of tumor
Sensitive marker for tumor recurrence
CEA
Recommended surgery for rectal ca
Total mesorectal excision
Standard adjuvant chemo for colorectal ca
FOLFOX (Folinic acid + 5-FU + Oxaliplatin)
Alternative: FOLFIRI (Folinic acid + 5-FU + Irinotecan)
Effective treatment for advanced colorectal ca
Monoclonal antibodies: Cetuximab, panitumumab, bevacizumab
