Skip to main content
SpringerLink
Log in

Colorectal Cancer

  • Chapter
  • First Online:
Book cover Handbook of Evidence-Based Radiation Oncology

  • 2745 Accesses

Abstract

Third most frequently diagnosed cancer in the US men and women. 108,070 new cases of colon cancer and 40,740 new cases of rectal cancer in the US in 2008. Combined mortality for colorectal cancer 49,960 in 2008. Rectum begins at the rectosigmoid junction at level of S3 vertebra. It is divided into three ∼5 cm segments by transverse folds: upper, mid, lower rectum. Cancer of rectum is defined as those straddling or inferior to the peritoneal reflection. Rectal nodal drainage: superior half rectum drains to pararectal, sacral, sigmoidal, inferior mesenteric; inferior half rectum drains to internal iliacs; lower rectum and tumors extending to anal canal may drain to superficial inguinal nodes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

References

  • Andre T, Boni C, Mounedii-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004;350:2343-2351.

    Article  PubMed  CAS  Google Scholar 

  • Add Collette L, Bosset JF, den Dulk M et al. Patients with curative resection of cT3-4 rectal cancer after preoperative radiotherapy or radiochemotherapy: does anybody benefit from adjuvant fluorouracil-based chemotherapy? A trial of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group. J Clin Oncol. 2007 Oct 1;25(28):4379-4386.

    Google Scholar 

  • Add Fisher B, Wolmark N, Rockette H et al. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. J Natl Cancer Inst. 1988 Mar 2;80(1):21-29.

    Google Scholar 

  • Add Tepper JE, O’Connell MJ, Niedzwiecki D et al. Impact of number of nodes retrieved on outcome in patients with rectal cancer. J Clin Oncol. 2001 Jan 1;19(1):157-163.

    Google Scholar 

  • Bonnen M, Crane C, Vauthey JN, et al. Long-term results using local excision after preoperative chemoradiation among selected T3 rectal cancer patients. IJROBP 2004;60(4):1098-1105.

    Google Scholar 

  • Bosset J, Collette L, Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 2006;355:1114-1123.

    Article  PubMed  CAS  Google Scholar 

  • Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 2006;93:1215-1223.

    Article  PubMed  CAS  Google Scholar 

  • Folkesson J, Birgisson H, Pahlman L, et al. Sweedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol 2005;23:5644-5650.

    Article  PubMed  Google Scholar 

  • Gérard JP, Conroy T, Bonnetain F et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol. 2006 Oct 1;24(28):4620-4625.

    Article  PubMed  Google Scholar 

  • Guillem JG, Diaz-Gonzalez JA, MInsky BD, et al. cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted. J Clin Oncol 2008;26(3):368-373.

    Article  PubMed  Google Scholar 

  • Gunderson LL, Sargent DJ, Tepper JE, et al. Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol 2004;22:1785-1796.

    Article  PubMed  Google Scholar 

  • Kapiteijn E, Marijnen CAM, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001;345:638-646.

    Article  PubMed  CAS  Google Scholar 

  • Krook JE, Moertel CG, Gunderson LL, et al. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med. 1991;324(11):709-715.

    Article  PubMed  CAS  Google Scholar 

  • Moertel CG, Fleming TR, Macdonald JS, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352-358.

    Article  PubMed  CAS  Google Scholar 

  • NSABP R-02 reference: Wolmark N, Wieand HS, Hyams DM et al. Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst. 2000 Mar 1;92(5):388-396.

    Google Scholar 

  • O’Connell MJ, Martenson JA, Wieand HS, et al. Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 1994;331:502-507.

    Article  PubMed  Google Scholar 

  • Pahlman L, Glimelius B, et al. Improved survival with preoperative radiotherapy in resectable rectal cancer: Swedish Rectal Cancer Trial. N Engl J Med 1997;336:980-987.

    Article  Google Scholar 

  • Peeters KC, Marijnen CA, Nagtegaal ID et al. The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg. 2007 Nov;246(5):693-701.

    Article  PubMed  Google Scholar 

  • Quirke P, Steele R, Monson J, et al. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG C016 randomized clinical trial. Lancet 2009;373:821-828.

    Article  PubMed  Google Scholar 

  • Russell AH, Harris J, Rosenberg PJ, et al. Anal sphincter conservation for patients with adenocarcinoma of the distal rectum: long term results of Radiation Therapy Oncology Group Protocol 89-02. Int J Radiat Oncol Biol Phys 2000;46:313-322.

    Article  PubMed  CAS  Google Scholar 

  • Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004;351:1731-1740.

    Article  PubMed  CAS  Google Scholar 

  • Sebag-Montefiore D, Stephens R, Monson J, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomized trial. Lancet 2009;373:811-820.

    Article  PubMed  Google Scholar 

  • Tepper JE, O’Connell M, Niedzwiecki D, et al. Adjuvant therapy in rectal cancer: analysis of stage, sex, and local control–final report of Intergroup 0114. J Clin Oncol 2002;20:1744-1750.

    Article  PubMed  CAS  Google Scholar 

  • Thomas PR, Lindblad AS. Adjuvant postoperative radiotherapy and chemotherapy in rectal carcinoma: a review of the Gastrointestinal Tumor Study Group experience. Radiother Oncol 1988;13:245-252.

    Article  PubMed  CAS  Google Scholar 

  • Twelves C, Wong A, Nowacki MP, et al. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 2005;352:2696-2704.

    Article  PubMed  CAS  Google Scholar 

Further Reading

  • Janjan NA, Delclos ME, Ballo MT, et al. The Colon and Rectum. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 497-536.

    Google Scholar 

  • Martenson Jr JA, Willet CG, Sargent DJ, et al. Phase III study of adjuvant chemotherapy and radiation therapy compared with chemotherapy alone in the surgical adjuvant treatment of colon cancer: results of Intergroup protocol 0130. J Clin Oncol 2004;22:3277-3283.

    Google Scholar 

  • Minsky BD. Cancer of the Colon. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 885-895.

    Google Scholar 

  • Minsky BD. Cancer of the Rectum. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 897-912.

    Google Scholar 

  • Mohiuddin M, Willett CG. Colon and Rectum. In: Halperin EC, Perez CA, Brady LW, et al., editors. Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1366-1382.

    Google Scholar 

  • National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Colon Cancer. Available at:http://www.nccn.org/professionals/physician_gls/PDF/colon.pdf. Accessed on May 24, 2009.

  • National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Rectal Cancer. Available at:http://www.nccn.org/professionals/physician_gls/PDF/rectal.pdf. Accessed on May 24, 2009.

  • Tepper JE, O’Connell MJ, Petroni GR, et al. Adjuvant postoperative fluorouracil-modulated chemotherapy combined with pelvic radiation therapy for rectal cancer: initial results of Intergroup 0114. J Clin Oncol 1997;15:2030-2039.

    Google Scholar 

Download references

Acknowledgement

We thank Richard M. Krieg, M.D., for his valuable advice in the preparation of this chapter.

Author information

Authors and Affiliations

  1. Radiation Oncology, University of California San Francisco, San Francisco, CA, USA

    Marc B. Nash MD & Kavita K. Mishra MD, MPH

  2. Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    Hans T. Chung MD

Authors
  1. Marc B. Nash MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hans T. Chung MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kavita K. Mishra MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Div. Radiation Oncology, Oregon Clinic, SW. Barnes Rd. 9205, Portland, 97225, Oregon, USA

    Eric K. Hansen

  2. Department of Radiation Oncology, University of California, San Francisco, Divisadero Street, Suite H-1031 1600, San Francisco, 94143, California, USA

    Mack Roach

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag New York

About this chapter

Cite this chapter

Nash, M.B., Chung, H.T., Mishra, K.K. (2010). Colorectal Cancer. In: Hansen, E., Roach, M. (eds) Handbook of Evidence-Based Radiation Oncology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92988-0_22

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-92988-0_22

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92987-3

  • Online ISBN: 978-0-387-92988-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation