Colorectal cancer is the second most common cause of cancer death in the developed world. The last five years have seen dramatic improvements in the multidisciplinary management of this malignancy. In this volume, experts at the forefront of these advances contribute their knowledge and experience on the major advances that have occurred in diagnosis, staging, preoperative and adjuvant therapy, surgery and follow-up assessment of patients with this disease. Imaging underpins all aspects of the clinical management of colorectal cancer and has been shown to play a critical role in improving outcomes for patients. About the series Each volume in Contemporary Issues in Cancer Imaging - A Multidisciplinary Approach is edited by an expert guest editor, with contributions from all members of the multidisciplinary team, bringing together expertise from many specialties to promote the understanding and application of modern imaging in overall patient management.
Author(s): Gina Brown
Edition: 1
Year: 2008
Language: English
Pages: 272
Series-title......Page 4
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 9
Series foreword......Page 11
Acknowledgements......Page 13
Incidence and mortality......Page 15
Risk factors......Page 16
Genetics......Page 17
Pathogenesis......Page 19
Symptoms of colorectal cancer......Page 20
Clinical examination......Page 21
Referral to the multidisciplinary team process......Page 22
Screening......Page 25
References......Page 26
The rectum......Page 29
Applied anatomy of the rectum......Page 30
Pathological features of importance to the radiologist......Page 32
Surgical circumferential resection margin......Page 33
Peritoneal and extramural vascular invasion......Page 34
Low rectal cancer......Page 36
Postchemoradiotherapy changes......Page 38
The multidisciplinary team meetings......Page 40
The colon......Page 41
References......Page 44
Introduction......Page 48
Fecal occult blood testing......Page 50
Endoscopy......Page 52
CT colonography (virtual colonoscopy)......Page 54
Cancer prevention or cancer cure?......Page 55
Test characteristics: sensitivity and specificity......Page 56
Acceptability......Page 59
Safety......Page 60
Availability and cost-effectiveness......Page 62
Are results generalizable?......Page 63
Effect on disease-specific mortality......Page 69
Summary......Page 70
References......Page 71
Introduction......Page 74
Historical basis for surgery for colorectal cancer......Page 75
Surgical planes: the interaction with radiology......Page 77
The technique of total mesorectal excision......Page 78
The important steps in performing a TME......Page 79
Optimal surgical technique......Page 85
Colon cancer: the next challenge......Page 86
References......Page 87
Introduction......Page 89
Quality of life......Page 90
Fast-track surgery/Enhanced recovery programs......Page 91
Long-term outcomes and survival evidence from trials......Page 92
Specific intra-operative risks......Page 93
Rectal cancer surgery......Page 94
The procedure......Page 95
Right hemicolectomy......Page 96
Left hemicolectomy and anterior resection......Page 97
The requirements for a successful anastomosis......Page 101
Conversion from laparoscopic to open surgery......Page 103
Port-site recurrences......Page 104
Summary......Page 105
References......Page 106
Chemotherapy for advanced inoperable colorectal cancer......Page 111
Adjuvant chemotherapy for resected early stage colorectal cancer......Page 115
Neoadjuvant or preoperative treatment......Page 117
References......Page 119
Technique......Page 124
Pre- vs. postoperative radiotherapy......Page 126
Short-course preoperative radiotherapy......Page 129
Downstaging......Page 132
Sphincter preservation and changing operation......Page 133
Interval......Page 135
Non-Operative Management......Page 136
Gastro-Intestinal......Page 137
Reproductive......Page 138
Sexual......Page 139
Secondary malignancy......Page 140
Local excision......Page 141
Colon cancer......Page 142
Hepatic radiotherapy......Page 143
References......Page 144
Introduction......Page 150
Anatomy, equipment, and techniques......Page 151
Staging accuracy of ERUS......Page 154
Potential impact of ERUS on early rectal cancer management: beyond TNM......Page 157
Other techniques for assessing tumor stage: endoscopic evaluation......Page 160
ERUS and apparently benign lesions......Page 163
Early detection of locally recurrent rectal cancer......Page 164
References......Page 165
CT in local staging of colorectal cancer......Page 171
T-staging......Page 172
Anatomical considerations in staging......Page 175
N-staging......Page 182
References......Page 185
The role of imaging in surgical planning......Page 188
Anatomical considerations......Page 192
The pelvic nerve plexuses......Page 193
Cecum and ascending colon......Page 194
Sigmoid colon......Page 195
The mesorectum and peritoneal covering and mesorectal fascia......Page 196
Annular and semiannular tumors......Page 199
Polypoidal tumors......Page 204
Mucinous tumors......Page 205
Image interpretation criteria for T staging......Page 207
Spread beyond the peritoneal membrane......Page 211
Lymph node spread......Page 213
Venous spread......Page 216
Rectal cancer......Page 219
References......Page 221
Introduction......Page 226
Follow-up of patients with colorectal cancer......Page 227
Hematogenous spread......Page 228
Lymph node spread......Page 231
Prognostic factors governing outcomes after hepatic resection......Page 233
Clinical risk score......Page 234
Extrahepatic disease......Page 236
CT detection......Page 238
MRI assessment......Page 240
PET imaging......Page 241
References......Page 242
The impact of TME on local recurrence rates in rectal cancer......Page 247
Classifying patterns of local recurrence......Page 249
The impact of multimodality therapy on patterns of recurrence......Page 253
Follow-up after rectal cancer surgery for the detection of recurrence......Page 255
Conclusions......Page 257
References......Page 258
Index......Page 262
