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Colon Cancer, An Issue of Surgical Oncology Clinics of North America, E-Book

Colon Cancer, An Issue of Surgical Oncology Clinics of North America, E-Book

Mark W. Arnold

(2018)

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Book Details

Abstract

This issue of Surgical Oncology Clinics of North America, guest edited by Dr. Mark Arnold, is devoted to Colon Cancer. Dr. Arnold has assembled expert authors to review the following topics: Chemotherapy for Colon Cancer; Colon Cancer: What We Eat; Colon Cancer: Inflammatory Associated Cancer; Colon Cancer: The Imaging Conundrum; Minimally Invasive Surgical Approaches to Colon Cancer; Population Screening for Hereditary Colorectal Cancer; The Economics of Colon Cancer; Clinical Trials in Colon Cancer; Advanced Colonoscopic Techniques; Surgical Treatment of Metastatic Disease; The Metastatic Lymph Node; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Colon Cancer i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword: Colon Cancer vii
Preface: Colon Cancer: The Road Traveled vii
Systemic Therapy for Colon Cancer vii
Colon Cancer: What We Eat vii
Colon Cancer: Inflammation-Associated Cancer vii
Colorectal Cancer: Imaging Conundrums viii
Minimally Invasive Surgical Approaches to Colon Cancer viii
Population Screening for Hereditary Colorectal Cancer viii
The Economics of Colon Cancer viii
Clinical Trials and Progress in Metastatic Colon Cancer ix
Maximizing the Effectiveness of Colonoscopy in the Prevention of Colorectal Cancer ix
Surgical Treatment of Metastatic Colorectal Cancer ix
Lymph Node Metastasis in Colorectal Cancer ix
SURGICAL ONCOLOGY\rCLINICS OF NORTH AMERICA\r xi
FORTHCOMING ISSUES xi
July 2018 xi
October 2018 xi
January 2019 xi
RECENT ISSUES xi
January 2018 xi
October 2017 xi
July 2017 xi
Foreword: Colon Cancer\r xiii
Preface:\rColon Cancer: The Road Traveled xv
REFERENCES xvii
Systemic Therapy for Colon Cancer 235
Key points 235
INTRODUCTION 235
LOCALLY ADVANCED COLON CANCER AND ADJUVANT CHEMOTHERAPY 236
Adjuvant Therapy for Stage II Colon Cancer 236
Microsatellite Instability High and Stage II Colon Cancer 236
High-Risk Features in Stage II Colon Cancer 237
Adjuvant Therapy for Stage III Colon Cancer 237
3 Versus 6 Months of FOLFOX for Stage III Colon Cancer 237
METASTATIC COLORECTAL CANCER 237
First- and Second-Line Chemotherapy 237
Antibody Therapy Targeting Vascular Endothelial Growth Factor Pathway 238
Antibody Therapy Targeting Epidermal Growth Factor Receptor Pathway 239
Refractory Colon Cancer 240
Immunotherapy for Microsatellite Instability-High Cancers 240
REFERENCES 241
Colon Cancer 243
Key points 243
INTRODUCTION 243
MATERIALS AND METHODS 244
Red Meat and Processed Meat 245
Fish 246
Fibers from All Sources 249
Fiber from Whole Grains and Cereals 252
Fruit and Vegetables 252
Vitamins and Minerals 255
Coffee and Tea 259
SUMMARY/DISCUSSION 259
REFERENCES 259
Colon Cancer 269
Key points 269
INTRODUCTION 269
EPIDEMIOLOGY 270
Risk Factors for Developing Carcinoma in Patients with Inflammatory Bowel Disease 270
Age at onset of disease 270
Duration of disease 271
Anatomic extent of disease 271
Histologic changes versus macroscopic changes 271
Backwash ileitis and the risk of colorectal cancer 271
Primary sclerosing cholangitis 271
Family history of colorectal cancer 272
Other factors and special considerations 272
PATHOGENESIS 272
SURVEILLANCE 274
Visible Versus Invisible Lesions and White Light Endoscopy Versus Chromoendoscopy 275
Dysplasia in Inflammatory Bowel Disease 275
Type of Lesions Detected Endoscopically 275
Histologic Interpretation 276
Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients 276
International consensus recommendations: Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Infla ... 276
Classification (nomenclature) of dysplasia in inflammatory bowel disease 276
MANAGEMENT OF COLITIS-ASSOCIATED CANCER 277
Management of Endoscopically Visible Lesions 277
Pouch Surveillance 278
Surgical Management 278
SPECIAL CONSIDERATIONS 278
Mucosectomy Versus Stapled Anastomosis and Keeping the Anal Transitional Zone 278
Rectal Cancer in Patients with Colitis 279
Risk of Cancer After Colectomy 280
PERSONALIZED MEDICINE FOR COLITIS-ASSOCIATED CANCER: 3-DIMENSIONAL HUMAN MODELS 281
Research Summary 282
FUTURE TREATMENT STRATEGIES 282
ACKNOWLEDGMENTS 282
REFERENCES 282
Colorectal Cancer: 289
Key points 289
INTRODUCTION 289
THE CONUNDRUM OF SENSITIVITY: TRANSLATING LESION DETECTABILITY FROM THE READING ROOM INTO THE OPERATING ROOM 291
THE CONUNDRUM OF SPECIFICITY: THE CONFLICT BETWEEN LESION DETECTABILITY AND SENSITIVITY 294
A SOLUTION TO BOTH CONUNDRUMS: INTRAOPERATIVE GUIDANCE 295
REFERENCES 296
Minimally Invasive Surgical Approaches to Colon Cancer 303
Key points 303
INTRODUCTION 303
EVOLUTION OF MINIMALLY INVASIVE SURGICAL TECHNIQUES IN COLON CANCER 304
PATIENT SELECTION IN MINIMALLY INVASIVE SURGERY FOR COLON CANCER 305
ADVANTAGES OF MINIMALLY INVASIVE SURGERY IN COLON CANCER 306
RIGHT COLON CANCER 306
Surgical Techniques 306
Laparoscopic right colectomy 306
Single-incision surgery for right colon cancer 308
Robotic right colectomy 308
Extent of Resection 308
LEFT COLON CANCER 309
Surgical Techniques 309
Multiport laparoscopic left colectomy 309
Releasing the splenic flexure 309
Positioning the small bowel 310
Transection of the inferior mesenteric artery and the inferior mesenteric vein 311
Mobilization of the colon 311
Transection of the mesorectum 311
Transection of the rectum 311
Exteriorization of the specimen 312
The anastomosis 312
Closing 312
Hand-assisted laparoscopic left colectomy 312
Single-incision laparoscopic left colectomy 313
Robotic left colectomy 313
Special Considerations 314
OUTCOMES 314
SUMMARY 315
REFERENCES 315
Population Screening for Hereditary Colorectal Cancer 319
Key points 319
INTRODUCTION 319
LYNCH SYNDROME 320
UNIVERSAL TUMOR SCREENING FOR LYNCH SYNDROME 320
CANCER GENETIC TESTING IN UNSELECTED COLORECTAL CANCER PATIENTS 322
IMPLICATIONS 322
SUMMARY 324
REFERENCES 324
The Economics of Colon Cancer 327
Key points 327
INTRODUCTION 327
ECONOMIC BURDEN OF CANCER 328
ECONOMIC COST OF COLORECTAL CANCER 329
FINANCIAL BURDEN ON CANCERS SURVIVORS 329
FINANCIAL BURDEN OF CANCER SURVIVORS: ADOLESCENTS AND YOUNG ADULTS 330
ECONOMIC COST OF MEDICAL ONCOLOGY 330
HIGH COST OF CANCER DRUGS 332
Medicare’s Average Sales Price 332
Policies That Mandate Cancer Drug Coverage 333
Impact of Coverage Expansion 333
Role of Genomic Sequencing 333
EARLY COLON CANCER MEASURES, QUALITY, VALUE, AND COST 333
Value 334
Value of Cancer Care in the United States 335
COLORECTAL CANCER SCREENING HEALTH LITERACY 335
Heath Care Access and Colorectal Cancer Screening 336
SURGICAL COST OF COLON CANCER 337
COST EFFECTIVENESS OF LAPAROSCOPIC VERSUS ROBOTIC VERSUS OPEN RESECTION 337
Hospital Duration of Stay and Readmission Rates 338
Cost of Readmission 339
Post Acute Care Spending After Surgery 340
END-OF-LIFE SPENDING 341
SUMMARY 345
REFERENCES 345
Clinical Trials and Progress in Metastatic Colon Cancer 349
Key points 349
INTRODUCTION 349
MUTATIONS IN THE RAS PATHWAY AND THEIR IMPLICATIONS ON CHOICE OF THERAPY 350
TUMORS 353
TARGETING THE AMPLIFIED HER2 PATHWAY 354
OTHER TARGETS 355
THE ROLE OF IMMUNOTHERAPY 356
Microsatellite Instability High Disease 356
Microsatellite Instability Low Disease or Stable Disease 357
SUMMARY 358
REFERENCES 359
Maximizing the Effectiveness of Colonoscopy in the Prevention of Colorectal Cancer 367
Key points 367
EFFECTIVENESS OF COLONOSCOPY FOR COLORECTAL CANCER PREVENTION 367
INTERVAL COLORECTAL CANCER 368
INCREASING THE ADENOMA DETECTION RATE 368
ASSISTIVE DEVICES 370
POLYPECTOMY 371
ADVANCED POLYPECTOMY 372
REFERENCES 373
Surgical Treatment of Metastatic Colorectal Cancer 377
Key points 377
MANAGEMENT OF METASTATIC COLORECTAL CANCER 377
Genetic Mutation and Sites of Metastasis 378
Perioperative Chemotherapy for Liver Metastases 379
Treatment Order with Synchronous Metastases 380
SURGICAL MANAGEMENT OF HEPATIC METASTASES 382
Indications for Resection and Outcomes 382
Technical Strategies for Resection 383
Adjuncts to Resection 385
SURGICAL MANAGEMENT OF PERITONEAL METASTASES 387
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy 387
Patient Selection and Outcomes 388
SURGICAL MANAGEMENT OF PULMONARY METASTASIS 390
SUMMARY 391
REFERENCES 391
Lymph Node Metastasis in Colorectal Cancer 401
Key points 401
INTRODUCTION 401
CONTENT 402
American Joint Committee on Cancer Lymph Node Staging 402
Required number of total lymph nodes 402
American Joint Committee on Cancer N staging definition 402
The impact of N category on prognostic stage groups 403
Tumor Deposit 403
Tumor deposit definition evolution 403
Prognostic significance of tumor deposit 405
Interpretation challenges 406
Tumor deposit versus discontinuous tumor spread 407
Tumor deposit versus totally replaced lymph node 407
Tumor deposit versus venous invasion 407
Isolated Tumor Cells and Micrometastases 408
Lymph Node Ratio 408
Neoadjuvant Treatment Effect in Rectal Cancer 409
Required number of total lymph nodes 409
Acellular mucin 410
Regression assessment after neoadjuvant therapy 410
SUMMARY 410
ACKNOWLEDGMENTS 410
REFERENCES 410