S3-Leitlinie Kolorektales Karzinom Version 1.0 - Juni 2013 AWMF-Registernummer: 021/007OL

Pox, Christian; Aretz, Stefan; Bischoff, Stephan C.; Graeven, U.; Hass, M.; Heußner, Pia; Hohenberger, Werner; Holstege, Axel; Hübner, Jutta; Kolligs, Frank T.; Kreis, Martin E.; Lux, P.; Ockenga, J.; Porschen, Rainer; Post, Stefan; Rahner, Nils; Reinacher-Schick, A.; Riemann, Jürgen F.; Sauer, Rolf; Sieg, Andreas; Scheppach, Wolfgang; Schmitt, Wolfgang; Schmoll, Hans‐Joachim; Schulmann, Karsten; Tannapfel, Andrea; Schmiegel, Wolff

doi:10.1055/s-0033-1350264

Cited by 158 publications

(111 citation statements)

References 106 publications

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“…Regular physical activity, weight reduction for overweight persons and smoking cessation are recommended after a detailed review of the literature for the prevention of CRC [4] . Although a specific diet recommendation is not given, current knowledge suggests that a high consumption of fruit and vegetable is associated with a reduced risk of colorectal cancer [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Anthocyanins Prevent Colorectal Cancer Development in a Mouse Model

et al. 2017

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BACKGROUND Colorectal cancer is the main leading cause of cancer-related deaths worldwide. Present data suggest that plant-derived anthocyanins have anti-inflammatory and chemopreventive properties. This study was aimed at evaluating the effect of an anthocyanin-rich extract from bilberries on colorectal tumour development and growth in the administration of azoxymethan (AOM)/dextran sodium sulfate (DSS) mouse model. METHODS Colonic carcinogenesis was induced by AOM and DSS 3 or 5%, respectively, in 50 female Balb/c mice. Mice received either normal food (controls) or a diet containing either 10 or 1% anthocyanin-rich bilberry extract. Colonoscopy took place at week 4 and 9 after initiation of carcinogenesis. After termination at week 9, colon samples were analysed macroscopically and microscopically. RESULTS Mice receiving 10% anthocyanins showed significantly (p < 0.004) less reduced colon length (12.1 cm [8.5-14.4 cm]) as compared to controls (11.2 cm [9.8-12.3]) indicating less inflammation. Mice fed with 10% anthocyanin-rich extract revealed significantly less mean tumour numbers (n = 1.2) compared to control (n = 14) and anthocyanin 1% treated mice (n = 10.6, p < 0.001). CONCLUSION Anthocyanins prevented the formation and growth of colorectal cancer in AOM/DSStreated Balb/c mice. Further studies should investigate the mechanisms of how anthocyanins influence the development of colorectal cancer.

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Section: Introductionmentioning

confidence: 99%

Anthocyanins Prevent Colorectal Cancer Development in a Mouse Model

et al. 2017

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“…In patients unwilling to undergo colonoscopy sigmoidoscopy or FOBT should be used alternatively. FIT with a specificity of more than 90% can be used instead of FOBT [48]. …”

Section: Summary Of Guidelinesmentioning

confidence: 99%

Controversies in Colorectal Cancer Screening

Pox¹

2014

Digestion

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Background: Colorectal cancer (CRC) is one of the most common cancers worldwide and a good candidate for screening programmes. However, there is controversy concerning which of the available screening tests should be used. Summary: There is general agreement that screening for CRC in the asymptomatic population should begin at the age of 50. Several different screening methods are available which can be separated into those that mainly detect cancers: faecal occult blood tests [guaiac (FOBT) and immunochemical (FIT)], genetic stool tests, blood tests and the M2-pyruvate kinase (M2-PK) test. Methods that detect cancers and polyps are colonoscopy, sigmoidoscopy, CT-colonography (CT-C) and colon capsule endoscopy. The only tests for which a reduction in CRC mortality compared to no screening have been proven in randomized trials are FOBT and sigmoidoscopy. Several trials suggest that FIT are superior to FOBT in terms of detection rates of cancers and advanced adenomas and possibly compliance. There is indirect evidence suggesting efficacy of colonoscopy as a screening test. The role of CT-C is controversial. There is data suggesting a good sensitivity for neoplasia >9 mm with a lower sensitivity for smaller neoplasia. However, radiation exposure is considered a major limitation in some countries. Unresolved questions include the lesion cut-off for referral to colonoscopy and work-up of extracolonic findings. For other methods, like genetic stool testing using newer markers, blood tests, capsule endoscopy and M2-PK, there is currently insufficient data on screening of the asymptomatic population. Key Messages: Colorectal screening is recommended and should be performed in the form of an organized programme. If detection of early-stage cancers is the aim of a screening programme, FIT seem to be superior to FOBT. If detection and removal of adenomas is the aim of a screening programme, endoscopic methods seem to be good alternatives. Sigmoidoscopy is easier to perform but will likely only have an effect on distal cancers. Colonoscopy is more invasive but enables inspection of the whole colon. The role of CT-C, capsule endoscopy, genetic stool tests, blood tests and M2-PK is currently unknown.

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“…Such clinical risk factors comprise T4 category, tumor perforation, surgery with complete bowel obstruction and too few lymph nodes examined (understaging, <12). Some also consider G3 grading and vascular (V1) or lymphatic invasion (L1) clinical or histopathological risk factors [11]. …”

Section: Adjuvant Therapy In Colon Cancer: Clinical and Molecular Feamentioning

confidence: 99%

Colorectal Cancer: Personalized Therapy

Leichsenring

Koppelle

Reinacher‐Schick

2014

Gastrointest Tumors

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Background: Colorectal cancer (CRC) is the second most common type of cancer in the Western world. The treatment of this disease has evolved greatly, particularly for patients with metastatic disease. The advent of combination chemotherapy plus targeted agents has led to more curative resections and improved survival rates in these patients. A deeper understanding of the mechanisms of tumorigenesis has facilitated tumor characterization, prognosis and patient stratification, bringing us one step closer towards personalized medicine. Summary: There are two main pathways of CRC development: (1) chromosomal instability, also known as the classical adenoma-carcinoma sequence, and (2) microsatellite instability, caused by a defective mismatch repair (dMMR) system. Analysis of these pathways has uncovered key prognostic and predictive biomarkers to guide patient selection and treatment strategy. This review summarizes the current treatment regimens and recent advances in the personalized therapy of CRC. Key Message: Understanding of the mechanisms of CRC pathogenesis has led to new developments in tumor characterization, patient stratification, prognosis and treatment, bringing us closer to personalized therapy. Practical Implications: In the adjuvant setting, the treatment decision is driven by clinical and histopathological factors. dMMR status is one of the most robust positive prognostic factors in resected colon cancer. More and more guidelines recommend refraining from adjuvant chemotherapy in patients with dMMR. In the metastatic setting, the introduction of effective compounds, including agents that target the epidermal growth factor receptor and vascular endothelial growth factor pathways, has significantly improved survival. The presence of wild-type KRAS and NRAS (all RAS) is a positive predictive factor for epidermal growth factor receptor antibody treatment. Therefore, analysis of all RAS status is recommended for all patients with metastatic disease prior to the initiation of first-line chemotherapy.

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S3-Leitlinie Kolorektales Karzinom Version 1.0 - Juni 2013 AWMF-Registernummer: 021/007OL

Cited by 158 publications

References 106 publications

Anthocyanins Prevent Colorectal Cancer Development in a Mouse Model

Anthocyanins Prevent Colorectal Cancer Development in a Mouse Model

Controversies in Colorectal Cancer Screening

Colorectal Cancer: Personalized Therapy

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