Overview of the management of primary colon cancer
- Miguel A Rodriguez-Bigas, MD
Miguel A Rodriguez-Bigas, MD
- Professor of Surgery
- MD Anderson Cancer Center
- Axel Grothey, MD
Axel Grothey, MD
- Mayo Clinic College of Medicine
- Section Editors
- Kenneth K Tanabe, MD
Kenneth K Tanabe, MD
- Section Editor — Gastrointestinal Malignancies
- Professor of Surgery
- Harvard Medical School
- Richard M Goldberg, MD
Richard M Goldberg, MD
- Section Editor — Gastrointestinal Cancer
- Director of the West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center
- Professor of Medicine
- Laurence S. & Jean J. DeLynn Chair of Oncology
Colorectal cancer is the third most common cancer affecting both males and females in the United States; approximately 70 percent of cases arise in the colon . Globally, colorectal cancer is the third most commonly diagnosed cancer in males and the second in females; however, the incidence varies markedly . Country-specific incidence rates are available through the World Health Organization (WHO) GLOBOCAN database.
This topic review will provide an overview of the management and prognosis of primary colon cancer. Epidemiology, risk factors, clinical presentation, and diagnosis are addressed in detail elsewhere. (See "Colorectal cancer: Epidemiology, risk factors, and protective factors" and "Clinical presentation, diagnosis, and staging of colorectal cancer".)
The diagnosis of a colon cancer is usually made by colonoscopy. (See "Clinical presentation, diagnosis, and staging of colorectal cancer".)
"Staging" a cancer provides a standard framework for describing disease extent. The stage of a colon cancer has three components, primary tumor (T), status of the regional nodes (N), and distant metastasis (M), which together are combined to form stage groupings, from I to IV. Stage groupings permit the stratification of prognosis, which is useful for the selection of treatment. The T, N, and M categories for colon cancer are assigned based upon:
●Whether there are signs of cancer spread on physical examination or radiographic imaging tests
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- THE CLINICAL STAGING EVALUATION
- Radiographic imaging
- Tumor markers
- Family history
- MANAGEMENT OF LOCALIZED DISEASE
- Surgical resection
- - Elderly patients
- - Management of carcinoma in a polyp
- - Locally advanced primary lesions
- Neoadjuvant chemoradiotherapy or chemotherapy
- Adjuvant chemotherapy
- - Side effects
- Benefit of postoperative RT
- METASTATIC DISEASE
- POSTTREATMENT SURVEILLANCE
- GENETIC ISSUES
- MANAGEMENT OF LOCALLY RECURRENT DISEASE
- INFORMATION FOR PATIENTS