Colorectal cancer Flashcards
What histology in the GI tract cancers?
Oral: squamous
GI/colon/rectum: adenocarcinoma
Anus: squamous
How does tumor grow in left and right colon?
Left: inwards
Right: outwards
RF for coloncancer?
FAP
HNPCC
Villous, large polyps
UC, CD
Prognosis in colonca?
Good, not very aggressive ca
Screening tests?
gFOBT and FIT
Sigmoidoscopy
Colonoscopy
When do you do colonoscopy
after age 50, every 10 years
Single best test for diagnosis?
Colonoscopy
What histology in coloncancer?
90% adenocarcinoma
Where does colorectal ca metastatize?
LIVER
lungs
Which tumor marker in colon ca?
CEA
What would CEA > 5 ng/ml represent?
WORSE prognosis
What is CEA used for?
Prognostic factor
What is cTNM?
Staging done before operation (metastasis)
What is pTNM?
Staging done after operation = most important
What is yTNM?
Staging done after neoadjuvant tx
Curative tx of colon ca?
SURGERY
When is radiotx used in colon cancer?
Never
CHemotx treatment is different in what way between rectal and colon ca?
Colon: only adjuvant
Rectal: neoadjuvant and adjuvant
How is surgical tx of colon ca done?
Resection margin at least 5 cm
Removal of at LEAST 12 lymph nodes
How is surgical tx of rectal ca done?
Neoadjuvant chemotx –> mesorectal excision
Remove at LEAST 12 lymph nodes
What is traditional chemotx in colon ca?
FOLFOX!!!
What is FOLFOX?
Oxaliplatin
5 FU
Leucovorine
If there is metastatic disease of colon ca, in which ways may we treat it?
Curative (only liver): Chemotx + liver surgery
Palliative (multiple organs): Only chemotx
What targeted therapy is used in colorectal ca??
Cetuximab (+ FOLFOX)
Bevacizumab = leukemia, GIST
