Display Settings:

Format

Send to:

Choose Destination
Lancet. 2010 Mar 20;375(9719):1030-47. doi: 10.1016/S0140-6736(10)60353-4.

Colorectal cancer.

Author information

  • 1Gastrointestinal Unit, Royal Marsden Hospital National Health Service Foundation Trust, London and Surrey, UK. David.cunningham@rmh.nhs.uk

Abstract

Substantial progress has been made in colorectal cancer in the past decade. Screening, used to identify individuals at an early stage, has improved outcome. There is greater understanding of the genetic basis of inherited colorectal cancer and identification of patients at risk. Optimisation of surgery for patients with localised disease has had a major effect on survival at 5 years and 10 years. For rectal cancer, identification of patients at greatest risk of local failure is important in the selection of patients for preoperative chemoradiation, a strategy proven to improve outcomes in these patients. Stringent postoperative follow-up helps the early identification of potentially radically treatable oligometastatic disease and improves long-term survival. Treatment with adjuvant fluoropyrimidine for colon and rectal cancers further improves survival, more so in stage III than in stage II disease, and oxaliplatin-based combination chemotherapy is now routinely used for stage III disease, although efficacy must be carefully balanced against toxicity. In stage II disease, molecular markers such as microsatellite instability might help select patients for treatment. The integration of targeted treatments with conventional cytotoxic drugs has expanded the treatment of metastatic disease resulting in incremental survival gains. However, biomarker development is essential to aid selection of patients likely to respond to therapy, thereby rationalising treatments and improving outcomes.

Copyright 2010 Elsevier Ltd. All rights reserved.

Comment in

  • Colorectal cancer. [Lancet. 2010]
  • Colorectal cancer. [Lancet. 2010]
PMID:
20304247
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk