Colorectal cancer diagnostic study of choice

Revision as of 20:07, 10 October 2019 by Skazmi (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to: navigation, search

Colorectal cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Colorectal cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Metastasis Treatment

Primary Prevention

Secondary Prevention

Follow-up

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Colorectal cancer diagnostic study of choice On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Colorectal cancer diagnostic study of choice

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Colorectal cancer diagnostic study of choice

CDC on Colorectal cancer diagnostic study of choice

Colorectal cancer diagnostic study of choice in the news

Blogs on Colorectal cancer diagnostic study of choice

Directions to Hospitals Treating Colorectal cancer

Risk calculators and risk factors for Colorectal cancer diagnostic study of choice

To view the staging of familial adenomatous polyposis (FAP), click here
To view the staging of hereditary nonpolyposis colorectal cancer (HNPCC), click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ; Roukoz A. Karam, M.D.[2] Saarah T. Alkhairy, M.D.; Elliot B. Tapper, M.D.

Overview

The diagnostic study of choice for colorectal cancer is colonoscopy due to its ability to visualize the tumor in its location and take biopsies from lesions in the colon.

Diagnostic Study of Choice

Study of choice

The diagnostic study of choice for colorectal cancer is colonoscopy due to its ability to visualize the tumor in its location and take biopsies from lesions in the colon.

A colonoscopy checks for polyps and other abnormalities in the entire colon and rectum. A colonoscopy has the advantage that if polyps are found during the procedure they can be immediately removed, and the tissue can also be taken for biopsy. The American Society for Gastrointestinal Endoscopy has released quality indicators for screening colonoscopy, which include:[1]

  • Documentation of prep quality
  • Photo documentation of cecal intubation
  • Withdrawal time of 6 minutes or more
  • Adenoma detection rate of greater than 25% in males and 15% in females greater than 50 years old.

A biopsy can be performed when a suspected lesion is found on colonoscopy. The biopsy specimen is examined for histologic changes and tissue differentiation. Well-differentiated lesions have a good prognosis compared to poorly and undifferentiated lesions.[1]

Colorectal Cancer Staging

  • Staging of colorectal cancer is calculated after the diagnosis has been established in order to assess treatment and prognosis.
  • Definitive staging can only be achieved after surgery has been performed and pathology reports have been reviewed.
  • The most recent revision (2017) of the tumor, node, metastasis staging system (TNM) proposed by the American Joint Committe on Cancer and the Union for International Cancer Control is widely used.
  • This staging system depends on 3 main factors including the size of the tumor (T), the degree of lymph node involvement (N), and the presence or absence of distant metastasis (M).[2]
Category Criteria
T - Primary tumor
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ (intraepithelial or invasion of lamina propria)
T1 Tumor invades the submucosa
T2 Tumor invades the muscularis propria
T3 Tumor invades through the muscularis propria into subserosa or into pericolic/perirectal tissues
T4 Tumor directly invades other organs and/or perforates visceral peritoneum
T4a Tumor perforates through the visceral peritoneum
T4b Tumor directly invades other organs
N - Regional lymph nodes
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Metastasis to one to three regional lymph nodes
N1a Metastasis to one regional lymph node
N1b Metastasis to two or three regional lymph nodes
N1c Negative regional lymph nodes, but spread into areas of fat near the lymph nodes
N2 Metastasis to four or more regional lymph nodes
N2a Metastasis to four to six regional lymph nodes
N2b Metastasis to seven or more regional lymph nodes
M - Distant metastasis
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis
M1a Metastasis to one organ/site without peritoneal metastasis
M1b Metastasis to two or more organs/sites without peritoneal metastasis
M1c Metastasis to the peritoneal surface and/or metastasis to other organs/sites

Stage grouping[2]

Stage 0 Tis N0 M0
Stage I T1-T2 N0 M0
Stage IIA T3 N0 M0
Stage IIB T4a N0 M0
Stage IIC T4b N0 M0
Stage IIIA T1-T2 N1/N1c M0
T1 N2a M0
Stage IIIB T3-T4a N1/N1c M0
T2-T3 N2a M0
T1-T2 N2b M0
Stage IIIC T4a N2a M0
T3-T4a N2b M0
T4b N1-N2 M0
Stage IVA any T any M M1a
Stage IVB any T any M M1b
Stage IVC any T any M M1c

References

  1. 1.0 1.1 Rex DK, Petrini JL, Baron TH, Chak A, Cohen J, Deal SE; et al. (2006). "Quality indicators for colonoscopy". Am J Gastroenterol. 101 (4): 873–85. doi:10.1111/j.1572-0241.2006.00673.x. PMID 16635231.
  2. 2.0 2.1 Amin, Mahul (2017). AJCC cancer staging manual. Switzerland: Springer. ISBN 9783319406176.

Linked-in.jpg