Rectal and colon cancer: Not just a different anatomic site.

Abstract:

:Due to differences in anatomy, primary rectal and colon cancer require different staging procedures, different neo-adjuvant treatment and different surgical approaches. For example, neoadjuvant radiotherapy or chemoradiotherapy is administered solely for rectal cancer. Neoadjuvant therapy and total mesorectal excision for rectal cancer might be responsible in part for the differing effect of adjuvant systemic treatment on overall survival, which is more evident in colon cancer than in rectal cancer. Apart from anatomic divergences, rectal and colon cancer also differ in their embryological origin and metastatic patterns. Moreover, they harbor a different composition of drug targets, such as v-raf murine sarcoma viral oncogene homolog B (BRAF), which is preferentially mutated in proximal colon cancers, and the epidermal growth factor receptor (EGFR), which is prevalently amplified or overexpressed in distal colorectal cancers. Despite their differences in metastatic pattern, composition of drug targets and earlier local treatment, metastatic rectal and colon cancer are, however, commonly regarded as one entity and are treated alike. In this review, we focused on rectal cancer and its biological and clinical differences and similarities relative to colon cancer. These aspects are crucial because they influence the current staging and treatment of these cancers, and might influence the design of future trials with targeted drugs.

journal_name

Cancer Treat Rev

journal_title

Cancer treatment reviews

authors

Tamas K,Walenkamp AM,de Vries EG,van Vugt MA,Beets-Tan RG,van Etten B,de Groot DJ,Hospers GA

doi

10.1016/j.ctrv.2015.06.007

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

671-9

issue

8

eissn

0305-7372

issn

1532-1967

pii

S0305-7372(15)00129-2

journal_volume

41

pub_type

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