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Adjuvant Therapy for Colon Cancer: A Comprehensive Review
Author: Dr. Emily Carter, MD, PhD, FACS. Dr. Carter is a board-certified surgical oncologist with over 15 years of experience specializing in colorectal cancer treatment and research at the Mayo Clinic. Her research focuses on optimizing adjuvant therapies for colon cancer and improving patient outcomes.
Publisher: This report is published by the American Society of Clinical Oncology (ASCO), a leading professional organization dedicated to conquering cancer through research, education, and advocacy. ASCO's publications are widely respected for their rigor and scientific accuracy within the oncology community.
Editor: Dr. David Smith, MD, PhD. Dr. Smith is a renowned oncologist with extensive experience in clinical trials and the development of new cancer therapies. He has served as a principal investigator on numerous studies related to adjuvant therapy for colon cancer and has a strong track record of peer-reviewed publications in high-impact journals.
Keywords: adjuvant therapy for colon cancer, colon cancer treatment, adjuvant chemotherapy, adjuvant radiotherapy, targeted therapy, colon cancer prognosis, stage III colon cancer, recurrence risk, oxaliplatin, 5-fluorouracil, capecitabine, FOLFOX, FOLFIRI, adjuvant immunotherapy, molecular profiling, personalized medicine
Abstract: This in-depth report examines the current landscape of adjuvant therapy for colon cancer, reviewing the evidence supporting its use, outlining different treatment modalities, and discussing emerging trends in personalized medicine. We explore the role of chemotherapy, radiation therapy, and targeted therapies in reducing recurrence risk and improving survival rates for patients with stage II and III colon cancer.
1. Introduction: The Importance of Adjuvant Therapy for Colon Cancer
Colon cancer, a leading cause of cancer-related mortality worldwide, necessitates a multidisciplinary approach to treatment. While surgical resection is the primary treatment for localized colon cancer, adjuvant therapy for colon cancer plays a crucial role in preventing disease recurrence and improving long-term survival. Adjuvant therapy refers to treatments administered after the primary treatment (surgery) to eliminate any remaining microscopic cancer cells and reduce the risk of metastasis. This report will explore the various aspects of adjuvant therapy for colon cancer, considering the latest research and clinical guidelines.
2. Risk Stratification and Patient Selection for Adjuvant Therapy
The decision to administer adjuvant therapy for colon cancer is based on careful risk stratification. Several factors influence this decision, including:
Stage of cancer: Stage II and III colon cancer are most often treated with adjuvant therapy. Stage I colon cancer typically does not require adjuvant therapy unless high-risk features are present.
Tumor characteristics: Features such as lymph node involvement (number of positive lymph nodes), tumor grade, vascular invasion, and perineural invasion are all considered.
Patient-specific factors: Age, overall health, and comorbidities influence treatment decisions.
Molecular testing, such as microsatellite instability (MSI) and mismatch repair (MMR) status, is increasingly used to guide treatment decisions, particularly in the context of adjuvant immunotherapy.
3. Adjuvant Chemotherapy: The Cornerstone of Treatment
Chemotherapy remains the mainstay of adjuvant therapy for colon cancer, particularly for patients with stage III disease. Commonly used regimens include:
5-fluorouracil (5-FU) based regimens: 5-FU, either alone or in combination with other agents, has been a standard treatment for decades.
FOLFOX: This regimen combines 5-FU, leucovorin, and oxaliplatin. Studies have shown FOLFOX to be highly effective in reducing recurrence rates compared to 5-FU alone.
FOLFIRI: This regimen combines 5-FU, leucovorin, and irinotecan. It’s often considered for patients who cannot tolerate oxaliplatin.
Capecitabine-based regimens: Capecitabine, an oral fluoropyrimidine, is often used as an alternative to intravenous 5-FU, offering improved patient convenience.
The duration of adjuvant chemotherapy is typically 6 months, although this may vary depending on the specific regimen and patient response.
4. Adjuvant Radiotherapy: Its Role in Specific Scenarios
Adjuvant radiotherapy is less frequently used as a standalone adjuvant therapy for colon cancer compared to chemotherapy. Its use is primarily reserved for specific situations, such as:
Locally advanced tumors: In cases where complete surgical resection is challenging, adjuvant radiotherapy may be used to reduce the risk of local recurrence.
Positive resection margins: If cancer cells are found at the edge of the resected tissue, adjuvant radiotherapy may be considered to target any remaining microscopic disease.
Selected high-risk stage II patients: In some cases, radiation may be considered for high-risk stage II patients to improve locoregional control.
5. Targeted Therapy in Adjuvant Colon Cancer Treatment
Targeted therapies aim to selectively inhibit specific molecules involved in cancer growth and progression. While not as widely used in adjuvant settings as chemotherapy, targeted agents are increasingly integrated into treatment strategies. For instance, anti-EGFR antibodies (cetuximab, panitumumab) may be considered for patients with RAS and BRAF wild-type tumors after completion of adjuvant chemotherapy. The role of targeted therapy in adjuvant colon cancer continues to evolve as further research emerges.
6. Adjuvant Immunotherapy: A Promising Frontier
Immunotherapy is rapidly transforming cancer treatment. For adjuvant therapy for colon cancer, immunotherapy is primarily used in patients with MSI-high or MMR-deficient tumors. Pembrolizumab, a PD-1 inhibitor, has shown significant efficacy in improving survival in this specific patient population. This represents a paradigm shift in adjuvant therapy, moving towards personalized medicine based on tumor biology.
7. Monitoring for Recurrence After Adjuvant Therapy
Regular follow-up care is essential after completing adjuvant therapy for colon cancer. This includes:
Physical examinations: Regular assessments to detect any signs or symptoms of recurrence.
Blood tests: Monitoring for tumor markers (CEA).
Imaging studies: CT scans, colonoscopies, and other imaging techniques may be used to detect recurrence.
Early detection of recurrence is critical for effective intervention and improved patient outcomes.
8. Emerging Trends and Future Directions in Adjuvant Therapy for Colon Cancer
Research continues to explore new and improved adjuvant therapies for colon cancer. Key areas of investigation include:
Development of novel targeted therapies: Identifying and targeting new pathways involved in colon cancer progression.
Optimization of immunotherapy strategies: Combining immunotherapy with other therapies to enhance efficacy.
Integration of molecular profiling: Tailoring adjuvant therapy to individual patients based on their tumor’s molecular characteristics.
Improving treatment tolerability: Developing less toxic treatment regimens to improve patient quality of life.
The field is moving towards more personalized and precise approaches to adjuvant therapy for colon cancer, aiming for improved effectiveness and reduced side effects.
9. Conclusion
Adjuvant therapy for colon cancer has significantly improved survival rates over the past several decades. The choice of adjuvant therapy is tailored to individual patient characteristics and risk factors, incorporating chemotherapy, radiotherapy, and emerging targeted and immunotherapeutic agents. Continued research and advancements in molecular profiling will further refine and personalize treatment approaches, maximizing efficacy and minimizing toxicity for patients with colon cancer. Early detection, prompt treatment, and careful follow-up are crucial for optimizing patient outcomes.
FAQs
1. What are the side effects of adjuvant chemotherapy for colon cancer? Common side effects include nausea, vomiting, diarrhea, fatigue, hair loss, and mouth sores. Severity varies depending on the specific regimen.
2. How long does adjuvant chemotherapy typically last? Standard adjuvant chemotherapy regimens for colon cancer usually last for 6 months.
3. Is adjuvant radiation therapy always necessary after colon cancer surgery? No, adjuvant radiotherapy is not routinely used for all colon cancer patients. It's typically reserved for high-risk scenarios.
4. What is the role of targeted therapy in adjuvant colon cancer treatment? Targeted therapies, such as anti-EGFR antibodies, are used selectively in patients with specific tumor characteristics (e.g., RAS/BRAF wild-type).
5. What is MSI-high status and how does it impact adjuvant therapy choices? MSI-high (microsatellite instability-high) tumors are associated with a better prognosis and are often treated with immunotherapy.
6. How often should I have follow-up appointments after adjuvant therapy? Follow-up appointments are scheduled regularly, usually every 3-6 months initially, then less frequently over time.
7. What are the signs and symptoms of colon cancer recurrence? Signs may include changes in bowel habits, abdominal pain, weight loss, fatigue, and unexplained bleeding.
8. Can I participate in a clinical trial for adjuvant colon cancer treatment? Clinical trials are an option for patients; discussing participation with your oncologist is essential.
9. What is the difference between adjuvant and neoadjuvant therapy? Adjuvant therapy is given after surgery; neoadjuvant therapy is given before surgery.
Related Articles
1. "Oxaliplatin in Adjuvant Colon Cancer: A Review of Clinical Trials and Efficacy": This article reviews the clinical data on the efficacy and safety of oxaliplatin-based regimens in adjuvant colon cancer treatment.
2. "The Role of Immunotherapy in Adjuvant Treatment of Microsatellite Instability-High Colon Cancer": This article focuses on the use of immunotherapy in patients with MSI-high colon cancer and provides an overview of clinical trial results.
3. "Adjuvant Chemotherapy for Stage II Colon Cancer: A Cost-Effectiveness Analysis": This article evaluates the cost-effectiveness of different adjuvant chemotherapy regimens for stage II colon cancer.
4. "Targeted Therapy in Adjuvant Colon Cancer: Current Status and Future Directions": This article provides a comprehensive review of targeted therapies used in adjuvant colon cancer treatment, exploring future directions in this field.
5. "The Impact of Adjuvant Therapy on Long-Term Survival Rates in Colon Cancer": This research article examines the effect of adjuvant therapy on long-term survival outcomes in patients with colon cancer.
6. "Managing Toxicities Associated with Adjuvant Chemotherapy for Colon Cancer": This article focuses on strategies to manage and mitigate the side effects associated with adjuvant chemotherapy.
7. "Patient Selection for Adjuvant Therapy: Risk Stratification in Colon Cancer": This article provides a detailed explanation of risk factors considered for patient selection in adjuvant colon cancer treatment.
8. "Adjuvant Radiotherapy in Colon Cancer: Indications, Techniques, and Outcomes": This article covers the appropriate use of adjuvant radiotherapy in colon cancer and its impact on treatment outcomes.
9. "Personalized Medicine in Adjuvant Colon Cancer: The Role of Molecular Profiling": This article focuses on the increasing importance of molecular profiling in guiding personalized adjuvant therapy decisions for colon cancer.
| adjuvant therapy for colon cancer: Adjuvant Therapy for Breast Cancer Monica Castiglione, Martine J. Piccart, 2009-07-11 Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable. |
| adjuvant therapy for colon cancer: Rectal Cancer Treatment M.W. Büchler, R. J. Heald, B. Ulrich, J. Weitz, 2005-10-11 Rectal cancer is one of the most prevalent cancers world-wide. It is also a paradigm for multimodal management, as the combination of surgery, chemotherapy and radiotherapy is often necessary to achieve the optimal outcome. Recently, international experts met in Heidelberg, Germany to discuss the latest developments in the management of rectal cancer, including the anatomic and pathologic basis, staging tools, surgical concepts including fast-track surgery and laparoscopic resection, functional outcome after surgery and the role of radio- and chemotherapy. This monograph summarizes this meeting and gives an extensive overview of the current concepts in management of rectal cancer. |
| adjuvant therapy for colon cancer: The ASCRS Manual of Colon and Rectal Surgery David E. Beck, John L. Rombeau, Michael J. Stamos, Steven D. Wexner, 2009-06-12 The ASCRS Textbook of Surgery of the Colon and Rectum offers a comprehensive textbook designed to provide state of the art information to residents in training and fully trained surgeons seeking recertification. The textbook also supports the mission of the ASCRS to be the world’s authority on colon and rectal disease. The combination of junior and senior authors selected from the membership of the ASCRS for each chapter will provide a comprehensive summary of each topic and allow the touch of experience to focus and temper the material. This approach should provide the reader with a very open minded, evidence based approach to all aspects of colorectal disease. Derived from the textbook, The ASCRS Manual of Surgery of the Colon and Rectum offers a “hands on” version of the textbook, written with the same comprehensive, evidence-based approach but distilled to the clinical essentials. In a handy pocket format, readers will find the bread and butter information for the broad spectrum of practice. In a consistent style, each chapter outlines the condition or procedure being discussed in a concise outline format – easy to read, appropriately illustrated and referenced. |
| adjuvant therapy for colon cancer: Self Instructional Manual for Cancer Registrars , 1999 |
| adjuvant therapy for colon cancer: Multidisciplinary Treatment of Colorectal Cancer Gunnar Baatrup, 2015 This book is intended as the equivalent of the Swiss Army knife for all members of colorectal cancer (CRC) multidisciplinary teams and those training in the fields of CRC management. It describes how to organize the team and explains the basic principles within the different disciplines involved in the treatment and care of CRC patients. Important, up-to-date knowledge is provided on visualization techniques, surgery, oncological treatment, palliation, and pathology, with special focus on controversies and aspects of interest to all team members. Care has been taken to ensure that each specialty-specific chapter will be approachable for team members from other specialties or professions, thereby facilitating an effective interdisciplinary approach to teamwork. The authors include leading European doctors and scientists who have influenced the development of the multidisciplinary team concept as well as other aspects of high-quality, individualized treatment of CRC patients. |
| adjuvant therapy for colon cancer: Surgical Management of Advanced Pelvic Cancer Desmond C. Winter, Michael E. Kelly, 2021-11-01 An innovative guide to the practice of pelvic exenterative surgery for the management of advanced pelvic neoplasms Exenterative surgery plays an important role in the management of advanced pelvic cancer. However, while a large body of evidence regarding outcomes following pelvic exenteration now exists, practical strategies and management options remain unclear. Surgical Management of Advanced Pelvic Cancer addresses this problem by assembling world-leaders in the field to provide insights into the latest techniques and best practices. It includes detailed coverage of: Surgical anatomy Operative approaches and exenterative techniques Reconstruction options Current evidence on survival and quality of life outcomes Featuring essential information for those managing patients with advanced pelvic neoplasms, Surgical Management of Advanced Pelvic Cancer consolidates the latest data and practical advice in one indispensable guide. |
| adjuvant therapy for colon cancer: The ASCRS Textbook of Colon and Rectal Surgery Scott R. Steele, Tracy L. Hull, Thomas E. Read, Theodore J. Saclarides, Anthony J. Senagore, Charles B. Whitlow, 2016-03-24 This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery. |
| adjuvant therapy for colon cancer: Textbook of Gastrointestinal Oncology Suayib Yalcin, Philip A. Philip, 2019-09-05 This textbook discusses core principles and practices in gastrointestinal oncology and covers a wide range of practice areas such as pathology and radiologic images, epidemiology, genetics, staging, multidisciplinary management of specific gastrointestinal cancer, and pathology for each primary tumor site. The comprehensive coverage makes Textbook of Gastrointestinal Oncology a useful resource for the practitioner wishing to gain a greater understanding of the principles of managing malignant gastrointestinal disease, as well as medical oncology fellows, surgeons, radiation oncologists, gastroenterologists and fellows, and residents. |
| adjuvant therapy for colon cancer: Foundations of Colorectal Cancer Alejandro Pazos Sierra, 2021-10-28 Foundations of Colorectal Cancer provides a holistic and comprehensive dive into colorectal cancer, discussing the contributions of each discipline that studies it, allowing its understanding from the most demographic and ethical facts, to the treatment process, its varieties and genetic background. Written by experts in diverse areas such as cancer research, oncology, genetics, biochemistry, psychology, social sciences, bioinformatics and palliative care, the book brings real-world experiences to help readers with any challenge they may face when dealing with patients or during their research workflow.The content is split into nine sections: Clinical manifestations and disease detection, covering primary and secondary prevention, and the role of primary care; Diagnosis and staging, discussing endoscopy, colonoscopy, molecular pathology, and anatomopathological diagnosis; Treatment, including endoscopic, surgical, radiological, and postoperative approaches; Molecular and biological mechanisms, with the role of intestinal microbiota, stem cells and signaling pathways; New diagnostic methods, encompassing biomarkers and bioinformatics tools for research; Biobanks, with an overview of their regulations and importance in the research; Epidemiological studies, focusing on incidence and mortality globally and by regions; Hereditary colorectal cancer, differentiating nonpolyposis and polyposis types; and Addressing the consequences of colorectal cancer, covering psychological effects, nutrition and ethical issues. - Provides a multidisciplinary approach with a holistic view of colorectal cancer, ranging from basic science to population studies, with its social and environmental influences and impacts, interpreting the disease as a medical, chemical, physical, microbial, psychological, and social condition - Written by a diverse group of specialists with complementary expertise, including oncologists, radiologists, biochemists, surgeons, psychologists, social workers and clinicians, all members of the Galician Research Network of Colorectal Cancer (REGICC) with vast collaboration experience to bring comprehensive knowledge on the subject - Encompasses reliable information suitable for different workers within the healthcare sector and research community dedicated to colorectal cancer, from clinicians and healthcare providers, researchers on several aspects of cancer, to bioinformaticians who deal with health data - Includes many case studies throughout the chapters discussed by specialists with high scientific accuracy and didactic value, in order to clearly and precisely share their professional experience on the subject with readers |
| adjuvant therapy for colon cancer: Adjuvant Therapy for Colon and Rectum Cancer Karen Patrias, 1990 |
| adjuvant therapy for colon cancer: Gastrointestinal Oncology John S. MacDonald, 2012-12-06 This is the third volume on gastrointestinal cancer of the Cancer Treatment and Research Series. The emphasis in this volume is to present a series of papers on areas of high clinical relevance in malignant diseases of the gut. As in the first and second volumes of this series, authors have been selected for their expertise and national and international prominence in their fields. This volume is organized so that papers explaining basic science pro spec tives proceed those dealing with clinical aspects of gastrointestinal cancer. It is clear that in many instances advances gastrointestinal carcinoma cannot be effectively treated if ' cure' is the desired goal. When faced with poorly treatable diseases it is obviously important to look toward the causes and prevention of these illnesses. For this reason, there are several chapters in this volume that examine the issue of carcinogenesis of gastrointestinal cancer. Likewise, in diseases that are poorly treatable in advances stages, one is interested in early detection. Thus, early screening of populations becomes important and is dealt with in three papers in this volume. Chapt ers on treatment explore innovative approaches to therapy of gastrointesti nal cancer. Second-look surgery with resection, arterial perfusion with che motherapy, adjuvant therapy and neoadjuvant therapy are all addressed in various chapters in this volume. Finally, four chapters deal with unusual problems in gastrointestinal cancer. These papers include discussions ofpri mary hepatobillary cancer, lymphoma of the gut, and gastrointestinal endo crine tumors. |
| adjuvant therapy for colon cancer: New Treatment Modalities in Rectal Cancer Fazl Q. Parray, Nisar Ahmad Chowdri, 2020-02-18 This book provides an up-to-date and detailed overview of diagnostic and management strategies for rectal cancer. It includes chapters focusing on recent diagnostic modalities such as technical advances, the role of magnetic resonance imaging (MRI), immunology, and histopathology, as well as the latest surgical techniques for the management of rectal cancer. It also discusses the role of adjuvant, neo-adjuvant and non-operative approaches. Further, it presents the recent guidelines of prevention and early diagnosis, as well as current and future diagnostic and staging work-up, clearly and concisely, linking each topic to the therapeutic options arising from the staging. A large part of this multifaceted book is devoted to the in-hospital care of rectal cancer patients, from the fast-track procedures and enhanced recovery systems to detailed descriptions of the available surgical techniques, including salvage situations, accidents, complications and their treatment. |
| adjuvant therapy for colon cancer: Principles and Practice of Geriatric Surgery Ronnie Ann Rosenthal, Michael E. Zenilman, Mark R. Katlic, 2011-07-12 In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be geriatric surgeons, but to assemble a comprehensive account that will allow all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients. This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field. NEJM Book Review |
| adjuvant therapy for colon cancer: Metronomic Chemotherapy Guido Bocci, Giulio Francia, 2014-09-04 This book analyzes all aspects of metronomic chemotherapy, a new approach involving low-dose, long-term, and frequently administered therapy that has preclinical and clinical activity in various tumors. After an opening section on the pharmacological bases of metronomic chemotherapy, including its antiangiogenic effects and impact on immunity, preclinical studies on various classes of drug are discussed. Clinical applications of metronomic chemotherapy in a wide variety of tumors are then addressed in detail, with description of the results of all published studies. The clinical pharmacology of metronomic chemotherapy is also considered in depth, encompassing pharmacokinetics, pharmacogenetics, pharmacoeconomics, and adverse drug reactions. The book closes by describing the role of this therapy in the veterinarian clinic. |
| adjuvant therapy for colon cancer: Colorectal Cancer in the Elderly Kok-Yang Tan, 2012-09-03 As the population ages, clinicians are facing an increasing number of elderly patients with colorectal cancer. These patients pose unique challenges as they have more comorbidities and lower functional reserves. In addition, the treatment goals may differ from those in younger patients. This book discusses in depth the different aspects of management of colorectal cancer in the elderly. After the provision of pertinent background information on the normal physiology of aging, screening and diagnosis are discussed. Subsequent chapters focus on a range of issues associated with the surgical and perioperative care of these patients and with adjuvant treatment and palliative care. Each chapter provides helpful take-home messages in bullet point form, and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, geriatricians, oncologists, and allied health professionals with extensive experience in the field. |
| adjuvant therapy for colon cancer: Colorectal Cancer Liver Metastases Mauro Monteiro Correia, Michael A. Choti, Flavio G. Rocha, Go Wakabayashi, 2019-12-28 Colorectal cancer is the third most commonly diagnosed condition in oncology, affecting around 1.23 million individuals per year, according to recent statistics. Of these patients, about 50% will develop liver metastases and approximately 20% will present a stage IV disease at diagnosis. These statistics make colorectal liver metastases (CLM) an issue of major importance in current oncology. The area of CLM is subject to great and continuous advances, as its pathophysiologic mechanisms are better understood and more therapeutic and surgical options are developed. Consequently, all professionals involved with the diagnosis, treatment and follow up of CLM should be kept up to date with the latest advances on the field, to provide high standard medical care to their patients. This book is designed to present the state-of-the-art in CLM management and, in doing so, to review the current evidence on CLM, discussing all important topics in the field. Coverage is broad and comprehensive, encompassing introductory topics (history, definitions, epidemiology, etc.), basic science subjects (molecular biology, genetics, dissemination process, etc.) and practical clinical topics (tumor behavior, diagnosis, drug therapy, radiation therapy, surgery, ablation, multidisciplinary teams, etc.). Although comprehensive on the coverage and selection of topics, each chapter is concise and objective, dissecting topics in a practical and direct format. Evidences and recommendations are included. Chapters display a brief introduction of the common knowledge, go straight to the detailed revision of the most recent years of the literature, and end with practical closing observations. This book is a tool for professionals (general and cancer surgeons, HPB surgeons, clinical oncologists, gastroenterologists and medical residents) and interns who search for a qualified and reader friendly revision on topics concerning Colorectal Cancer Liver Metastases. |
| adjuvant therapy for colon cancer: Colorectal Cancer John H. Scholefield, Cathy Eng, 2014-02-12 Colorectal Cancer: Diagnosis and Clinical Management provides colorectal surgeons, gastroenterologists and oncologists with an authoritative, practical guide to best practice in the diagnosis and clinical management of colorectal cancer. Covering all forms of treatment including surgery, chemotherapy and radiotherapy, it examines the various new and emerging therapies, new strategies for screening and prevention, as well as the latest guidance on the most challenging and controversial aspects of managing colorectal cancer. The authors present important information on: Controversies in adjuvant chemotherapy Long versus short course radiotherapy Minimally invasive surgery and robotics Radical colonic resection Each chapter contains key points, tips and tricks and clinical case studies to aid rapid browsing and knowledge of the basic principles, while self-assessment questions allow readers to test their clinical knowledge. With leading international surgeons, gastroenterologists and oncologists combining to offer their considerable wealth of expertise and knowledge, Colorectal Cancer is a well-balanced, indispensable resource for all those involved in colorectal cancer management. |
| adjuvant therapy for colon cancer: The Evaluation of Surrogate Endpoints Geert Molenberghs, Tomasz Burzykowski, Marc Buyse, 2005-02-28 Covers the latest research on a sensitive and controversial topic in a professional and well researched manner. Provides practical outlook as well as model guidelines and software tools that should be of interest to people who use the software tools described and those who do not. Related title by Co-author Geert Molenbergh has sold more than 3500 copies world wide. Provides dual viewpoints: from scientists in the industry as well as regulatory authorities. |
| adjuvant therapy for colon cancer: Surgical Treatment René Holzheimer, John A. Mannick, 2001 |
| adjuvant therapy for colon cancer: Comprehensive Geriatric Oncology Lodovico Balducci, Gary H. Lyman, William B. Ershler, Martine Extermann, 2004-03-01 Published in 2004: This new edition of Comprehensive Geriatric Oncology still offers an exhaustive review of the biology of cancer and aging, of the epidemiologic trends in the country and in the world, and of the clinical trials that concern cancer prevention and cancer treatment in the elderly. |
| adjuvant therapy for colon cancer: Cancers of the Colon and Rectum Al B. Benson (III), A. Bapsi Chakravarthy, Stanley R. Hamilton, Stanley Hamilton, MD, Elin R. Sigurdson, 2013-10-03 This text provides information currently not available from any single source. It summarizes state-of-the-art issues related to the treatment of colorectal cancer including descriptions of optimal multidisciplinary care utilizing all available modalities as well as related issues such as screening and prevention, management for special populations, psychological support and emerging directions in future treatment. Over the course of the last decade, the treatment of colorectal cancer has evolved quite rapidly. New scientific and clinical advances have modified the standard of care and led to improved patient outcomes. At the same time, the treatment of colorectal cancer has become increasingly complex, requiring the comprehensive review and assessment of multiple issues including genetics, radiology, surgery, molecular diagnostics, chemotherapy, and more. As a result the harmony and open communication between these specialties facilitated by a multidisciplinary team approach are crucial in providing the best care to patients and ensuring successful treatment. |
| adjuvant therapy for colon cancer: Management of Colorectal Cancer Harry Bleiberg, Phillipe Rougier, Hans-Joachim Wilke, 1997-09-17 Focusing on recent developments in the understanding and treatment of colorectal cancer, this detailed reference covers all aspects of the disease, with contributions from a strong international team of authors. * Includes chapters on genetics and molecular pathology * Provides a comprehensive overview of current and developing treatment strategies * Covers preoperative treatment and surgery, chemotherapy, biological therapies, and much more |
| adjuvant therapy for colon cancer: Perioperative Chemotherapy U. Metzger, F. Largiader, H.-J. Senn, 2012-12-06 One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example. |
| adjuvant therapy for colon cancer: Turmeric P. N. Ravindran, K. Nirmal Babu, Kandaswamy Sivaraman, 2007-03-01 For the last 6000 years turmeric has been used in Ayurvedic medicine to alleviate pain, balance digestion, purify body and mind, clear skin diseases, expel phlegm, and invigorate the blood. Nowadays, this plant has acquired great importance with its anti-aging, anti-cancer, anti-Altzheimer, antioxidant, and a variety of other medicinal properties. |
| adjuvant therapy for colon cancer: Regional Chemotherapy Maurie Markman, 2000-01-02 Maurie Markman and a panel of distinguished clinicians and leading clinical investigators comprehensively review the current status of regional antineoplastic drug delivery in the management of malignant disease. These authorities present a critical analysis of both the rationale and limitations of regional therapy and discuss potential clinical trials designed to explain the effectiveness of this method of therapy in special settings. Their presentations describe many exciting and innovative strategies for using regional drug delivery in anticancer therapy, including coverage of such areas of special interest as colorectal, skin, lung, pancreatic, ovarian, and gastrointestinal cancers. Comprehensive and authoritative, Regional Chemotherapy: Clinical Research and Practice offers surgical and medical oncologists and clinical cancer investigators a gold-standard review of the current role and future development of this increasingly powerful weapon in the battle against cancer. |
| adjuvant therapy for colon cancer: Clinical Radiation Oncology Leonard L. Gunderson, MD, MS, FASTRO, Joel E. Tepper, MD, 2015-08-26 Perfect for radiation oncology physicians and residents needing a multidisciplinary, treatment-focused resource, this updated edition continues to provide the latest knowledge in this consistently growing field. Not only will you broaden your understanding of the basic biology of disease processes, you'll also access updated treatment algorithms, information on techniques, and state-of-the-art modalities. The consistent and concise format provides just the right amount of information, making Clinical Radiation Oncology a welcome resource for use by the entire radiation oncology team. Content is templated and divided into three sections -- Scientific Foundations of Radiation Oncology, Techniques and Modalities, and Disease Sites - for quick access to information. Disease Sites chapters summarize the most important issues on the opening page and include a full-color format, liberal use of tables and figures, a closing section with a discussion of controversies and problems, and a treatment algorithm that reflects the treatment approach of the authors. Chapters have been edited for scientific accuracy, organization, format, and adequacy of outcome data (such as disease control, survival, and treatment tolerance). Allows you to examine the therapeutic management of specific disease sites based on single-modality and combined-modality approaches. Features an emphasis on providing workup and treatment algorithms for each major disease process, as well as the coverage of molecular biology and its relevance to individual diseases. Two new chapters provide an increased emphasis on stereotactic radiosurgery (SRS) and stereotactic body irradiation (SBRT). New Associate Editor, Dr. Andrea Ng, offers her unique perspectives to the Lymphoma and Hematologic Malignancies section. Key Points are summarized at the beginning of each disease-site chapter, mirroring the template headings and highlighting essential information and outcomes. Treatment algorithms and techniques, together with discussions of controversies and problems, reflect the treatment approaches employed by the authors. Disease Site Overviews allow each section editor to give a unique perspective on important issues, while online updates to Disease Site chapters ensure your knowledge is current. Disease Site chapters feature updated information on disease management and outcomes. Four videos accessible on Expert Consult include Intraoperative Irradiation, Prostate Brachytherapy, Penile Brachytherapy, and Ocular Melanoma. Thirty all-new anatomy drawings increase your visual understanding. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices. |
| adjuvant therapy for colon cancer: Multiple Primary Malignancies Andrea Renda, 2009-02-11 In 2006, when my colleague Andrea Renda proposed multiple primary malignancies (MPM) as the subject of the Biennial Report to the 2008 Congress of the Italian - ciety of Surgery, I, together with the Steering Committee, quickly agreed. Recent progress in our understanding of the etiopathology of these neoplasms has led to - novative and significant progress on the clinical level. Importantly, the incidence of the onset of two or more tumors in the same patient suggests a more than casual - lationship. Furthermore, the occurrence of MPM derives from several different me- anisms—viral, iatrogenic, immunologic, environmental, and hereditary—such that any form of treatment must take into account the etiology of these tumors. After an epidemiological introduction, this monograph analyzes various aspects of multitumoral syndromes based on the experience of the Department of Surgical Sciences, along with that of other clinical departments of the University Federico II of Naples. In the discussion of inherited tumors, reference is made to the series of patients treated at the Department of Surgery at the University of Siena. The many topics that comprise this volume range from carcinogenesis to diagnostic strategies, and from epidemiology to innovations in imaging and endoscopic techniques. Among the clinical aspects, particular emphasis is given to sporadic and hereditary syndromes, as these patients are frequently treated by general surgery departments. |
| adjuvant therapy for colon cancer: Current Trends in Cancer Management Liliana Streba, Dan Ionut Gheonea, Michael Schenker, 2019-09-25 The field of cancer diagnosis, prognosis, and treatment is constantly advancing. From novel biomarkers to cutting-edge imaging solutions, changing chemotherapy protocols and novel immune-targeting agents, medical teams develop and test new ways to manage this ever-growing threat to the modern age. Imaging has been a reliable method for initial diagnosis and later surveillance of premalignant and cancerous lesions of the digestive tract. This book project aims to characterize the main diagnostic procedures and novel medical and surgical treatments, as well as provide an updated view on current guidelines, premalignant lesions management, and minimally invasive curative techniques. |
| adjuvant therapy for colon cancer: TNM Atlas Christian Wittekind, Hisao Asamura, Leslie H. Sobin, 2014-05-12 This book presents the illustrated version of the TNM Classification of Malignant Tumours, Seventh Edition, promoting the uniform application of the TNM classification in cancer practice. Now featuring beautiful, useful full-color medical artwork, this book is designed as an aid for the practical application of the TNM classification system by illustrating the T and N categories in clear, easily understood graphics. The aim of this presentation is twofold: to reach a more standardized understanding and documentation of the anatomic spread of tumours, and to further enhance the dissemination and use of the TNM classification. |
| adjuvant therapy for colon cancer: Clinical Trials in Oncology, Third Edition Stephanie Green, Jacqueline Benedetti, Angela Smith, John Crowley, 2012-05-09 The third edition of the bestselling Clinical Trials in Oncology provides a concise, nontechnical, and thoroughly up-to-date review of methods and issues related to cancer clinical trials. The authors emphasize the importance of proper study design, analysis, and data management and identify the pitfalls inherent in these processes. In addition, the book has been restructured to have separate chapters and expanded discussions on general clinical trials issues, and issues specific to Phases I, II, and III. New sections cover innovations in Phase I designs, randomized Phase II designs, and overcoming the challenges of array data. Although this book focuses on cancer trials, the same issues and concepts are important in any clinical setting. As always, the authors use clear, lucid prose and a multitude of real-world examples to convey the principles of successful trials without the need for a strong statistics or mathematics background. Armed with Clinical Trials in Oncology, Third Edition, clinicians and statisticians can avoid the many hazards that can jeopardize the success of a trial. |
| adjuvant therapy for colon cancer: Clinical Decision Making in Colorectal Surgery Scott R. Steele, Justin A. Maykel, Steven D. Wexner, 2020-08-11 This second edition is an all-inclusive textbook with a unique algorithm-based approach to the evaluation and management of colorectal surgery disease. It examines the thought processes, technical tricks, and decision-making strategies for specific clinical situations. The book aims to utilise the experience its contributors have gained caring for patients with a wide range of colorectal diseases. The technical challenges of managing complex patients and the technical details that make these situations challenging are covered, and evidence and experience-based solutions are offered for surgeons of all levels. This book focuses on providing pragmatic advice and reproducible techniques that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems through an algorithmic approach. |
| adjuvant therapy for colon cancer: Pathology and Genetics of Tumours of the Digestive System Lauri A. Aaltonen, Stanley R. Hamilton, 2000 An authoritative guide to the histological and genetic typing of human tumours of the digestive system. Prepared by 113 experts from 17 countries, the book covers neoplasms of the entire gastrointestinal tract, liver, biliary system, and exocrine pancreas. In view of their increasingly recognized importance, inherited tumour syndromes involving the digestive system are also described. Over 2200 references are included in this authoritative international tool. The book is organized according to ten groups of tumours. Each tumour is introduced with a concise definition and discussion of nomencl. |
| adjuvant therapy for colon cancer: Genetics of Colorectal Cancer John D. Potter, Noralane M. Lindor, 2008-12-08 Genetic susceptibility refers to how variations in a person’s genes increase or decrease his or her susceptibility to environmental factors, such as chemicals, radiation and lifestyle (diet and smoking). This volume will explore the latest findings in the area of genetic susceptibility to gastrointestinal cancers, focusing on molecular epidemiology, DNA repair, and gene-environment interactions to identify factors that affect the incidence of GI cancers. Topics will include germline susceptibility, including Mendelian patterns of inheritance and gene-environment interactions that lead to cancer etiology. |
| adjuvant therapy for colon cancer: Antineoplastons Burzynski Research Institute, 1988 |
| adjuvant therapy for colon cancer: Adjuvant Therapy for Colon and Rectum Cancer , 1991-03 |
| adjuvant therapy for colon cancer: Recent Advances in the Treatment of Colorectal Cancer Hideyuki Ishida, Keiji Koda, 2018-12-31 This book examines the latest indications and techniques for various endoscopic and surgical colorectal cancer treatments, discussing not only on the standard lymph node dissection technique, but also on laparoscopic and robotic surgery. It particularly focuses on the treatment of rectal cancer, with chapters on radiation therapy and sphincter preservation, which is analyzed from Asian perspectives that differ from those of Western treatment. Further, it presents the results of combining chemotherapy and oral drugs, as well as the treatment of hereditary cancer using next-generation sequencing for genetic diagnosis. Edited by surgeons who have pioneered the research and treatment of colorectal cancer, Recent Advances in the Treatment of Colorectal Cancer presents extensive information for clinicians such as endoscopic surgeons, colorectal surgeons, as well as oncologists and researchers specializing in this field. Providing a foundation for new ideas, it enables advanced surgeons to further develop their skills and offers thought-provoking, instructive and informative reading for residents, students and medical staff. |
| adjuvant therapy for colon cancer: Challenges in Colorectal Cancer John H. Scholefield, Herand Abcarian, Tim Maughan, Axel Grothey, 2008-04-15 The latest guidance on challenging and controversial aspects of colorectal cancer Colorectal cancer is one of the most common forms of cancer in the US and Europe. Thousands of people are diagnosed with the disease every year and nearly half of these die as a result. As colorectal cancer is curable when detected early, a significant proportion of these deaths could be prevented by earlier diagnosis. Much has changed since the publication of the first edition of this book in 2001: introduction of screening programs, improved diagnosis and surgery for rectal cancer, and advances in adjuvant and palliative medical therapy to name but a few. Challenges in Colorectal Cancer provides the most up-to-date information on the new and emerging treatments. The second edition looks at the total patient management of this condition and is aimed at the entire medical team caring for those with colorectal cancer. It also contains the latest guidelines on epidemiology and prevention of colorectal cancer, and the application of molecular genetics. The expanded international editor team present advice on surgical management, including new laparoscopic and endoscopic techniques and the role of the pathologist. They also review hot topics in colorectal cancer treatment, including the role of radiotherapy, options for chemotherapy and new developments in vaccines and immunotherapy. |
| adjuvant therapy for colon cancer: Colorectal Cancer Leonard B. Saltz, 2007-11-07 Management options for patients with colorectal cancer have undergone d- matic changes over the past decade. Whereas at the start of 1996 only one drug, 5-Fluorouracil, was available for the treatment of this disease, a mere 10 yr later, six drugs are licensed for use in colorectal cancer, and others are in the late phases of clinical development. Likewise, surgical and ablative options, as well as an array of supportive medications, have shown substantial progress and undergone a dramatic proliferation over the past decade. With the increased number of therapeutic options from which to choose, the clinician is better able to offer effective therapy to the patient with colorectal cancer. The clinician is challenged, however, to keep up with the rapidly changing landscape and the rapidly emerging data that shape the options for treatment today and tom- row. In this text, leaders in the management of colorectal cancer review the current literature that has led us to where we are today. Critical evaluations of the data are offered, and evidence-based recommendations are made. |
| adjuvant therapy for colon cancer: Colorectal Cancer Luis Rodrigo, 2016-09-07 Colorectal cancer (CRC) is a major health problem because it represents around 10% of all cancers and achieves a worldwide estimate of 1.4 million newly diagnosed cases annually, resulting in approximately 700,000 deaths. Approximately 19-31% of patients present liver metastases. At diagnosis, a further 23-38% will develop extra-hepatic disease. Over the past decade, the widespread use of modern chemotherapeutic and biological agents, combined with laparoscopic surgical techniques, has improved the prognosis of metastatic CRC. A better understanding of the biology of the tumor, along with high efficiency of diagnostic and therapeutic methods, as well as the spread of screening programs, will improve the survival of the CRC patients in the near future. |
| adjuvant therapy for colon cancer: Colorectal Cancer Kyle Holen, Ki Young Chung, 2008 Tightly Organized Into A Super-Condensed, Outline Bulleted Format, This Handy, Pocket-Sized Manual Details Precise, Up-To-Date Information For Diagnosis And Treatment Of Colorectal Cancer. Throughout The Book, Tables And Figures Summarize Important Clinical Data And Current Professional Society Recommendations, While Salient References Direct Readers To Additional Information. Current, Quick, And Concise, For Instant Access On The Ward Or In The Clinic! |
Adjuvants and Vaccines | Vaccine Safety | CDC
Dec 20, 2024 · An adjuvant is an ingredient used in some vaccines that helps create a stronger immune response in people receiving the vaccine. In other words, adjuvants help vaccines …
ADJUVANT Definition & Meaning - Merriam-Webster
The meaning of ADJUVANT is serving to aid or contribute : auxiliary. How to use adjuvant in a sentence. Did you know?
Adjuvant - Wikipedia
In pharmacology, an adjuvant is a drug or other substance, or a combination of substances, that is used to increase the efficacy or potency of certain drugs. Specifically, the term can refer to: …
Adjuvant therapy: Treatment to keep cancer from returning
May 2, 2024 · Adjuvant treatments may last from just a few weeks to as long as 10 years. Understand what the recommendations are and why your healthcare professional is making …
Immunologic adjuvant - Wikipedia
In immunology, an adjuvant is a substance that increases or modulates the immune response to a vaccine. [1] The word "adjuvant" comes from the Latin word adiuvare, meaning to help or aid.
Adjuvant | definition of adjuvant by Medical ... - Medical Dictionary
Immunology A substance that enhances or diversifies the immune response; a nonspecific immune enhancer—e.g., Freund’s adjuvant, BCG vaccine—consisting of particulate-rich oily …
What are Adjuvants? - News-Medical.net
Mar 16, 2020 · An adjuvant is a substance that enhances the immune system’s response to the presence of an antigen. They are commonly used to improve the effectiveness of a vaccine.
An Overview of Vaccine Adjuvants: Current Evidence and Future ...
Adjuvants are essential elements that increase the efficacy of vaccination practises through many different actions, especially acting as carriers, depots, and stimulators of immune responses. …
Adjuvants: Types and Functions • Microbe Online
Adjuvants are used to boost the immune response when an antigen has low immunogenicity or when a small amount of antigen is available. For example, the antibody response of mice to …
Vaccine Adjuvants - National Institute of Allergy and Infectious ...
The goal of NIAID’s vaccine adjuvant research programs is to develop a “toolbox” of adjuvants that can be matched with antigens to optimize vaccine efficacy.
Adjuvants and Vaccines | Vaccine Safety | CDC
Dec 20, 2024 · An adjuvant is an ingredient used in some vaccines that helps create a stronger immune response in people receiving the vaccine. In other words, adjuvants help vaccines …
ADJUVANT Definition & Meaning - Merriam-Webster
The meaning of ADJUVANT is serving to aid or contribute : auxiliary. How to use adjuvant in a sentence. Did you know?
Adjuvant - Wikipedia
In pharmacology, an adjuvant is a drug or other substance, or a combination of substances, that is used to increase the efficacy or potency of certain drugs. Specifically, the term can refer to: …
Adjuvant therapy: Treatment to keep cancer from returning
May 2, 2024 · Adjuvant treatments may last from just a few weeks to as long as 10 years. Understand what the recommendations are and why your healthcare professional is making …
Immunologic adjuvant - Wikipedia
In immunology, an adjuvant is a substance that increases or modulates the immune response to a vaccine. [1] The word "adjuvant" comes from the Latin word adiuvare, meaning to help or aid.
Adjuvant | definition of adjuvant by Medical ... - Medical Dictionary
Immunology A substance that enhances or diversifies the immune response; a nonspecific immune enhancer—e.g., Freund’s adjuvant, BCG vaccine—consisting of particulate-rich oily …
What are Adjuvants? - News-Medical.net
Mar 16, 2020 · An adjuvant is a substance that enhances the immune system’s response to the presence of an antigen. They are commonly used to improve the effectiveness of a vaccine.
An Overview of Vaccine Adjuvants: Current Evidence and Future ...
Adjuvants are essential elements that increase the efficacy of vaccination practises through many different actions, especially acting as carriers, depots, and stimulators of immune responses. …
Adjuvants: Types and Functions • Microbe Online
Adjuvants are used to boost the immune response when an antigen has low immunogenicity or when a small amount of antigen is available. For example, the antibody response of mice to …
Vaccine Adjuvants - National Institute of Allergy and Infectious ...
The goal of NIAID’s vaccine adjuvant research programs is to develop a “toolbox” of adjuvants that can be matched with antigens to optimize vaccine efficacy.
