Colorectal Cancer:A Clinical Guide to Therapy

Table of Contents
Preface
Contributors
Pt. 1 Background and Epidemiology
1 Biology of colorectal cancer: An overview of genetic factors 3
2 Recent developments in the epidemiology of colorectal cancer
11
Pt. 2 Prevention and Screening
3 Hemoccult as an approach to colorectal cancer screening 33
4 Screening colonoscopy 39
5 Chemoprevention of colorectal cancer 47
Pt. 3 Pathology and Prognostic Factors
6 Pathology of colorectal cancer 55
7 Sentinel lymph-node mapping in colorectal cancer 73
8 Postoperative histopathological evaluation: Implications for
prognosis 81
Pt. 4 Management of Localized Disease
9 Surgery for colon cancer 93
10 Laparoscopic left colectomy for cancer 107
11 Minimal invasive surgery for colon cancer: Where do we stand
117
12 Systemic adjuvant therapy of colon cancer 127
13 Adjuvant treatment in Dukes B2 colon cancer: No 135
14 Adjuvant treatment in Dukes B2 colon cancer: Yes 139
15 Adjuvant intraportal treatment 147
16 Adjuvant intraperitoneal chemotherapy 155
17 Management of peritoneal surface malignancy from colorectal
cancer: The surgeon`s role 161
18 Surgery for rectal cancer 173
19 Total mesorectal excision: A quality-controlled approach to
rectal cancer surgery 185
20 Conservative treatment in rectal cancer 193
21 Treatment of locally advanced primary and locally recurrent
colorectal cancer 205
22 Radiotherapy for rectal cancer: The European approach 229
23 Radiotherapy for rectal cancer: The US approach 239
24 Radio-chemotherapy in rectal cancer: When and for which
patients? 249
25 The future of radiotherapy in rectal carcinoma 257
Pt. 5 Follow-up of Colorectal Cancer
26 Which follow-up for colorectal cancer? Perhaps none 265
27 The case for CEA screening 275
28 New methods for early detection of disease recurrence 281
Pt. 6 Treatment of Other Sites
29 Cancer of the appendix and pseudomyxoma peritonei syndrome
297
30 Treatment of anal canal carcinoma 309
Pt. 7 Management of Metastatic Disease
31 Resection of liver metastases 323
32 Surgery of lung and brain metastases 335
33 Ablative technique for liver metastases 339
34 Neoadjuvant treatment of colorectal liver metastases allowing
resection 353
35 Adjuvant chemotherapy after hepatic resection for metastatic
colorectal carcinoma 359
36 Locoregional chemotherapy for metastatic colorectal cancer to
the liver 367
37 Predictive markers in the treatment of colorectal cancer 375
38 Mechanism of action of 5-fluorouracil in colorectal cancer
treatment 391
39 From the laboratory to the clinic: The limitations of
rationally
designed fluoropyrimidine-based
therapy and the problem of
apoptosis-impaired cancer cells 399
40 Pharmacogenetics of colorectal cancer chemotherapy drugs:
Implications for the pharmacokinetic adjustment of chemotherapy
419
41 The Mayo Clinic/NCCTG (North Central Cancer
Treatment Group) regimen of 5-fluorouracil and leucovorin:
Origins, activity, and future applications 431
42 The Roswell Park regimen: Weekly 5-FU and high-dose
leucovorin for colon cancer 441
43 Infusional 5-FU: The 24-hour weekly approach 453
44 Infusional 5-fluorouracil: The bimonthly approach 463
45 Infusional 5-FU in the treatment of metastatic colorectal
cancer: The 48-hour weekly approach 467
46 Infusional 5-fluorouracil: Protracted infusion 473
47 Oral fluoropyrimidines in colorectal neoplasia 483
48 5-FU in combination with DPD inhibitors 491
49 Irinotecan: Mechanism of action 499
50 Oxaliplatin: Mechanism of action and preclinical activity 507
51 Raltitrexed and the new thymidylate synthase inhibitors 519
52 New combinations in colorectal cancer 531
53 Irinotecan: Combination chemotherapy 553
54 Bimonthly leucovorin-5-fluorouracil with oxaliplatin or
irinotecan: The FOLFOX and FOLFIRI regimens 563
55 Chronomodulation of chemotherapy against metastatic
colorectal cancer 571
56 Wh