Colorectal carcinoma

Question 1

Presentation colorectal carcinoma

Answer 1

Abdo mass, perforation, haemorrhage, fistula
For right sided: weight loss, anaemia, abdo pain
For left: rectal bleeding/mucus, bowel obstruction, tenesmus

Question 2

Tests colorectal cancer

Answer 2

FBCs for anaemia
Colonoscopy or CT
Faecal occult blood in screening

Question 3

Risk factors colorectal cancer

Answer 3

Polyps
FAP and HNPCC
diet/smoking/alcohol

Question 4

Treatment colorectal cancer

Answer 4

Surgical removal
Radiotherapy in palliative or pre/post-op rectal
Folfox chemo for stage 3 disease (fluorouracil, folinic acid, oxaliplatin)

Question 5

Colorectal Cancer TNM staging

Answer 5

T1 invading submucosa, T2 muscularis propria, T3 subserosa, T4 adjacent structures
N0 no node spread, N1 1-3 local nodes, N2 >3 nodes
M0 no metastases, M1 distant metastases

Question 6

Colorectal Cancer overall staging

Answer 6

Stage 1 is T1 or T2/N0/M0
Stage 2 is T3 or T4/N0/M0
Stage 3 is N1 or N2/M0
Stage 4 is M1

Question 7

Surgical options colorectal cancer

Answer 7

Right hemicolectomy if cancer in caecum, ascending or proximal transverse colon
Left hemicolectomy if cancer in distal or descending colon
High anterior resection for sigmoid cancer
Total mesorectal excision, TME, (anterior resection) for upper rectal cancer
Low TME for lower rectal cancer
Abdomino-perineal excision of rectum for anal verge cancer

Question 8

Gastric cancer histology

Answer 8

Signet ring cells