HTHSCI 2F03 Chapter 5: Oncological treatment of lower GI cancers
26 Dec 2020
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30% ascending colon, 10% transverse colon, 15% descending colon, 25% sigmoid colon, 20% anal. Hnpcc has higher threshold for chemotherapy, as has less metastatic potential. As surgery is the mainstay, the benefits of adjuvant chemotherapy relate to prevention of systematic relapse. Risk of relapse determined by 1) clinicopathological features 2) exclusion of deficiencies in mismatch repair 3) ?genetic profiling (in development) prognostic criteria indicate adjuvant chemotherapy. Ln status (>3 i. e. pn2: penetration of bowel wall (pt4 highly causative of peritoneal relapse, microsatellite instability, perforation/obstruction during surgery, <12 ln assessed in surgery, extramural vascular invasion (tumour cells entering veins outside of bowel wall) tumour grade. N. b. adjuvant online is an online tool that assesses the benefit of adjuvant chemo for you using such criteria as above with patient details e. g. age, ethinicity, sex etc. = dukes c and dukes b with additional features (high grade, perforation, extra-mural invasion, young age, mmr proficient)
