BOOK
Treatment of Colorectal Cancer, An Issue of Surgical Oncology Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Surgical Oncology Clinics of North America is devoted to the treatment of Colorectal Cancer. Editors Nancy Baxter, MD and Marcus Burnstein, MD have assembled some of the top experts in the field to review this important topic.Articles in this issue include: Colonoscopy: What are we missing?; Imaging in rectal cancer: MRI vs. ERUS; Local Excision for Rectal Cancer; Controversies in Neo-adjuvant treatment for rectal cancer; Management of the complete response; Controversies in laparoscopy for CRC; Colon resection – is standard technique adequate?; Quality Assurance in CRC surgery; Controversies in Abdomino-perineal resection; Functional Consequences of CRC management; Timing of adjuvant therapy for CRC; and Management of Stage IV disease.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Treatment of Colorectal Cancer\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | v | ||
| Surgical Oncology Clinics Of North America\r | viii | ||
| Foreword \r | ix | ||
| Preface\r | xi | ||
| Colonoscopy | 1 | ||
| Key points | 1 | ||
| Introduction | 1 | ||
| Biology | 1 | ||
| Aims of colonoscopy | 2 | ||
| Colonoscopy and cancer prevention | 2 | ||
| Miss rates | 3 | ||
| Adenoma detection rates | 3 | ||
| Why are adenomas missed? | 4 | ||
| Serrated polyp detection | 4 | ||
| High-risk colons | 5 | ||
| Avoiding the missed lesion | 6 | ||
| Technique | 6 | ||
| Pattern Recognition | 6 | ||
| Bowel Preparation | 6 | ||
| Instrumental and Technical Measures | 7 | ||
| Reinforcements | 7 | ||
| Summary | 7 | ||
| References | 7 | ||
| Quality Assurance in Colon and Rectal Cancer Surgery | 11 | ||
| Key points | 11 | ||
| Introduction | 11 | ||
| Technical quality factors in colorectal cancer surgery | 11 | ||
| Colon Cancer | 11 | ||
| Lymphadenectomy and vessel ligation | 11 | ||
| En bloc resection for T4 lesions | 12 | ||
| Synchronous cancers | 12 | ||
| Prophylactic oophorectomy | 12 | ||
| Laparoscopy | 12 | ||
| Adjuvant chemotherapy | 12 | ||
| Rectal Cancer | 13 | ||
| Staging | 13 | ||
| Neoadjuvant chemoradiation | 13 | ||
| Local excision | 13 | ||
| Vascular ligation | 13 | ||
| Total mesorectal excision | 13 | ||
| Margins | 14 | ||
| Lymphadenectomy | 14 | ||
| Technique for abdominoperineal resection | 14 | ||
| Laparoscopy | 14 | ||
| System quality factors in colorectal cancer surgery | 14 | ||
| Appropriate prophylactic antibiotic use | 15 | ||
| Venous thromboembolism prevention | 16 | ||
| The impact of postoperative complications | 17 | ||
| Summary | 18 | ||
| References | 18 | ||
| Colon Resection | 25 | ||
| Key points | 25 | ||
| Introduction | 25 | ||
| Current surgical practice for colonic resection | 26 | ||
| What is the evidence to support current colonic cancer surgical practice? | 26 | ||
| How can we improve oncological outcomes in colon cancer surgery? | 28 | ||
| CME and CVL: background and supportive evidence | 28 | ||
| Which lymph nodes do colonic tumors spread to? | 29 | ||
| How does improved lymph node yield equate to improved survival? | 30 | ||
| Summary | 31 | ||
| References | 32 | ||
| Controversies in Laparoscopy for Colon and Rectal Cancer | 35 | ||
| Key points | 35 | ||
| Introduction | 35 | ||
| Colon cancer | 36 | ||
| Operative and Short-Term Outcomes | 36 | ||
| Long-Term Oncologic Outcomes | 37 | ||
| Rectal cancer | 38 | ||
| Short-Term Outcomes | 38 | ||
| Long-Term Outcomes | 40 | ||
| Conversion rates | 40 | ||
| Lymph node harvest | 41 | ||
| Cost-effectiveness of laparoscopy | 41 | ||
| Obesity and laparoscopy | 41 | ||
| Laparoscopy in the elderly patient | 41 | ||
| Pelvic nerves | 42 | ||
| Learning curve for laparoscopy | 42 | ||
| Single-incision laparoscopic colectomy | 43 | ||
| Robotic surgery for rectal cancer | 43 | ||
| Summary | 43 | ||
| References | 44 | ||
| Current Practices and Challenges of Adjuvant Chemotherapy in Patients with Colorectal Cancer | 49 | ||
| Key points | 49 | ||
| Background | 49 | ||
| AC for colorectal cancer | 50 | ||
| Timing of AC: is it important? | 51 | ||
| Challenges and barriers to AC | 52 | ||
| Summary | 53 | ||
| References | 54 | ||
| Imaging in Rectal Cancer | 59 | ||
| Key points | 59 | ||
| Introduction | 59 | ||
| Relevant anatomy | 60 | ||
| Techniques and image interpretation | 64 | ||
| MRI | 64 | ||
| ERUS | 67 | ||
| Diagnostic accuracy | 71 | ||
| MRI | 71 | ||
| Depth of tumor invasion | 71 | ||
| Nodal Metastasis | 74 | ||
| Mesorectal fascia | 74 | ||
| Assessing tumor response | 76 | ||
| References | 77 | ||
| Current Controversies in Neoadjuvant Chemoradiation of Rectal Cancer | 79 | ||
| Key points | 79 | ||
| Background | 79 | ||
| Controversies: outline | 80 | ||
| The protocol of preoperative radiation: efficacy and toxicity | 81 | ||
| Whether chemotherapy is used in combination with radiation and which chemotherapy drugs are used | 81 | ||
| The optimum timing of surgery after radiation to achieve maximum downstaging | 84 | ||
| Whether radiation is used for all rectal cancers or on a selected basis only | 85 | ||
| The preferred radiation protocol for treating superficial rectal cancer being considered for local excision | 86 | ||
| Whether endocavitary radiation can be used as effective treatment | 86 | ||
| Summary | 86 | ||
| References | 87 | ||
| Controversies in Abdominoperineal Excision | 93 | ||
| Key points | 93 | ||
| Introduction | 93 | ||
| Problems related to the conventional synchronous combined APE | 95 | ||
| The new concept of APE | 97 | ||
| Surgical Considerations | 98 | ||
| Intersphincteric APE | 99 | ||
| The Perineal Part of the Intersphincteric APE | 99 | ||
| Extralevator APE | 99 | ||
| The Pelvic Dissection in ELAPE | 100 | ||
| The Perineal Part of the ELAPE | 101 | ||
| The ischioanal APE | 103 | ||
| The Perineal Part of the Ischioanal APE | 104 | ||
| What are the current controversies in APE? | 106 | ||
| Extent of Perineal Dissection and Removal of the Pelvic Floor | 106 | ||
| Positioning of the Patient for APE | 107 | ||
| Reconstruction of the Pelvic Floor | 108 | ||
| Summary | 109 | ||
| References | 109 | ||
| Management of Complete Response After Chemoradiation in Rectal Cancer | 113 | ||
| Key points | 113 | ||
| Introduction | 113 | ||
| Defining complete response | 114 | ||
| Interpreting the literature | 114 | ||
| Scenario 1: Patients Unfit for/Unwilling to Undergo Major Surgery | 114 | ||
| Scenario 2: Patients with Early Rectal Cancer | 115 | ||
| Scenario 3: Patients with Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiation and Planned Surgery | 116 | ||
| Assessing response to chemoradiation | 117 | ||
| Future studies | 119 | ||
| Summary | 121 | ||
| References | 121 | ||
| Functional Consequences of Colorectal Cancer Management | 127 | ||
| Key points | 127 | ||
| Introduction | 127 | ||
| Bowel function | 127 | ||
| Colon Cancer | 128 | ||
| Rectal Cancer | 128 | ||
| Patient Factors | 128 | ||
| Age | 128 | ||
| Gender | 129 | ||
| Preoperative function | 129 | ||
| Tumor Factors | 129 | ||
| Tumor level | 129 | ||
| Tumor stage | 129 | ||
| Treatment Factors | 129 | ||
| Open versus minimally invasive technique | 129 | ||
| TME and non-TME approaches | 130 | ||
| Reconstructive techniques | 130 | ||
| Hand-sewn versus stapled anastomosis | 130 | ||
| Restorative pouches | 130 | ||
| Diverting ileostomy | 131 | ||
| Radiotherapy | 131 | ||
| Chemotherapy | 132 | ||
| Sexual function | 132 | ||
| Colon Cancer | 132 | ||
| Rectal Cancer | 133 | ||
| Patient Factors | 133 | ||
| Age | 133 | ||
| Gender | 134 | ||
| Preoperative function | 134 | ||
| Tumor Factors | 134 | ||
| Tumor level | 134 | ||
| Tumor stage | 134 | ||
| Treatment Factors | 135 | ||
| Minimally invasive technique | 135 | ||
| TME and non-TME approaches | 135 | ||
| LAR versus APR | 135 | ||
| Ostomy | 136 | ||
| Radiotherapy | 136 | ||
| Chemotherapy | 136 | ||
| Urinary function | 137 | ||
| Colon Cancer | 137 | ||
| Rectal Cancer | 137 | ||
| Patient Factors | 137 | ||
| Age | 137 | ||
| Gender | 137 | ||
| Preoperative function | 138 | ||
| Tumor Factors | 138 | ||
| Tumor level | 138 | ||
| Tumor stage | 138 | ||
| Treatment Factors | 138 | ||
| Open versus minimally invasive technique | 138 | ||
| TME and non-TME approaches | 138 | ||
| LAR versus APR | 139 | ||
| Radiotherapy | 139 | ||
| Chemotherapy | 139 | ||
| Future directions | 139 | ||
| Improving Measurement | 139 | ||
| Bowel function measurement | 139 | ||
| Sexual function measurement | 140 | ||
| Urinary function measurement | 140 | ||
| Injury Prevention | 140 | ||
| Treating Dysfunction | 141 | ||
| Treating bowel dysfunction | 141 | ||
| Treating sexual dysfunction | 141 | ||
| Treating urinary dysfunction | 142 | ||
| Summary | 142 | ||
| References | 143 | ||
| An Approach to the Newly Diagnosed Colorectal Cancer Patient with Synchronous Stage 4 Disease | 151 | ||
| Key points | 151 | ||
| Does the patient have synchronous stage 4 cancer? | 152 | ||
| Is immediate surgery required for palliation of the primary tumor? | 153 | ||
| What is the type and extent of metastatic disease? | 154 | ||
| Approach to stage 4 CRC to the liver | 155 | ||
| Approach to stage 4 CRC to the lung | 158 | ||
| Approach to stage 4 CRC to the peritoneum | 158 | ||
| Summary | 159 | ||
| References | 159 | ||
| Index | 161 |