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Molecular Markers and Mutational Analysis

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Rectal Cancer

Abstract

Improvements in systemic therapies, surgical techniques, and efforts aimed at screening and early detection have led to a gradual decrease in colorectal cancer (CRC) incidence and mortality in the United States [1]. Nevertheless, CRC remains a leading cause of cancer death resulting in approximately 49,700 deaths annually [2]. Rectal cancer accounts for 30% of all newly diagnosed large bowel cancers with an estimated 39,610 new cases each year [2]. The Cancer Genome Atlas (TCGA) Project reported that the difference between cancers of the colon and rectum is largely based on anatomic location as comprehensive molecular characterization of these tumors has demonstrated that the two diseases share similar genomic alterations and are molecularly indistinguishable [3]. As with colon cancer, early-stage rectal cancer is cured in the majority of cases with multimodal therapy including surgery, radiation, and chemotherapy. However, approximately 25% of patients will present with metastatic disease at the time of diagnosis. Another 30–50% of patients with locoregional disease who undergo surgical resection with curative intent will develop recurrence. In these unresectable patients, systemic therapy plays a key role in their overall survival, and while the introduction of new cytotoxic drugs has improved outcomes, survival in this high-risk group is only approximately 20% at 5 years.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    Callisia N. Clarke

  2. Department of Gastrointestinal Medical Oncology Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    E. Scott Kopetz

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  1. Department of Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA

    George J. Chang

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Clarke, C.N., Scott Kopetz, E. (2018). Molecular Markers and Mutational Analysis. In: Chang, G. (eds) Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-16384-0_19

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