prognosis after surgical resection of colorectal carcinoma
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Introduction
Tumor stage is the most important prognostic factor in a patient with newly diagnosed colorectal cancer[4]
Predictors of poor outcome:
- tumor spread to regional lymph nodes
- number of regional lymph nodes involved
- tumor penetration through the bowel wall
- poorly differentiated histology
- perforation
- tumor adherence to adjacent organs
- venous invasion
- preoperative elevation of CEA titer (> 5.0 ng/mL)
- aneuploidy
- specific chromosome deletion(s)
- allelic loss on chromosome 18q
- poor performance status (best predictor of poor prognosis)
Stage 3:
- 45% 5 year survival without chemotherapy[2]
- disease-free survival improved with adjuvant chemotherapy
- survival improved with adequate lymph node dissection[3]
- reverse transcriptase, polymerase chain reaction analysis of lymph node biopsy specimens taken during surgery for resection of colon cancer may allow for identification of submicroscopic metastases of tumor to local lymph nodes
More general terms
References
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 576
- ↑ 2.0 2.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ 3.0 3.1 Chen SL and Bilchik AJ More extensive nodal dissection improves survival for stages I-III of colon cancer: A population-based study. Ann Surg 2006, 244:602 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16998369
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015