ABSTRACT
Colorectal cancer is the third most common malignancy in men and women and accounts
for 10% of all cancer deaths. The primary risk factor for colorectal cancer is advancing
age, but other factors also play a role in its development, including genetic predisposition,
smoking, alcohol consumption, obesity, and high-fat, low-fiber diet. Colon cancer
survival is primarily related to the stage of disease at diagnosis. The main screening
tests for colon cancer are fecal occult blood testing, flexible sigmoidoscopy, double-contrast
barium enema, and colonoscopy. The pre-operative evaluation should include a complete
blood count, carcinoembryonic antigen (CEA), colonoscopy, and chest radiograph. Other
preoperative evaluations are patient specific or of unproven benefit. The operative
procedure should include a bowel preparation, parenteral antibiotics, and deep venous
thrombosis prophylaxis. The procedure performed must be tailored to the location of
the colon cancer but should include complete, en bloc resection of the cancer and
its lymphatic drainage, including locally invaded structures. The bowel margins of
resection should be at least 5 cm from the tumor to minimize anastomotic recurrences.
Laparoscopic colectomy has been shown to be as safe and effective as open colectomy
for the treatment of colon cancer. The use of sentinel lymph node biopsy is feasible
but has not yet been proved clinically useful. Surveillance after surgery for colon
cancer is necessary to monitor for metastatic disease or local recurrence. Several
groups have made surveillance recommendations including office visits, colonoscopy,
and CEA monitoring.
KEYWORDS
Colon cancer - screening - colectomy
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Matthew L LynchM.D.
Department of General Surgery, Section of Colorectal Surgery
Rush University Medical Center, 1725 W. Harrison
#810, Chicago, IL 60612-3817
Email: mllynchwi@yahoo.com
