Colorectal Cancer: Metastatic: The First Step ? Colon And Rectal ...

May 31st | Colon And Rectal Surgery

In the last decade, there has been a remarkable improvement in the effectiveness of chemotherapy for colorectal cancer. Firstline treatment with either FOLFOX or FOLFIRI is now giving a major response in 50% of previously untreated patients, and performs minor responses or stable disease in an additional 20% of patients.5 multiple drug combinations are also available well, and the second-line chemotherapy is more effective and more likely to impact survival. Over the last 10 years, median survival of patients with metastatic disease who are treated with chemotherapy has improved from 12-14 months to 21 months6 Although healing of chemotherapy alone remains extremely rare, effective chemotherapy associated with aggressive surgery may be an increase in the overall cure rate. Within this framework, the management of patients with advanced disease has become very complex. The purpose of this chapter is to provide a reference source for surgeons management of patients presenting with stage IV colorectal cancer. Biology of metastatic disease is defined as the metastatic spread of malignant cells from the primary tumor to a distant organ. An estimated 90% of all cancer deaths are the result of metastasis.7 The process of metastasis is an ongoing process that begins early and inefficient in tumor formation and increased metastatic tumors grow.8 themselves can go through the process and metastatic spreading to other organs. Many clinical and laboratory studies have attempted to define the complex process of metastasis formation. This is a multistep process, and failure results in the failure stage of the whole process. The process relies on the properties of tumor cells and the microenvironment of the primary and secondary sites.9, 10 A series of major events must occur.

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Tags: cancer, Colorectal, First, Metastatic, Step, The

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