Tailored Treatment of Colorectal Cancer: Surgical, Molecular, and Genetic Considerations

Abstract

Colorectal cancer (CRC) is a complex cancer disease, and approximately 40% of the surgically cured patients will experience cancer recurrence within 5 years. During recent years, research has shown that CRC treatment should be tailored to the individual patient due to the wide variety of risk factors, genetic factors, and surgical complexity. In this review, we provide an overview of the considerations that are needed to provide an individualized, patient-tailored treatment. We emphasize the need to assess the predictors of CRC, and we summarize the latest research on CRC genetics and immunotherapy. Finally, we provide a summary of the significant variations in the colon and rectal anatomy that is important to consider in an individualized surgical approach. For the individual patient with CRC, a tailored treatment approach is needed in the preoperative, operative, and postoperative phase.

Immunological differences between colorectal cancer and normal mucosa uncover a prognostically relevant immune cell profile

“…Colorectal cancer (CRC) is one of the most commonly diagnosed cancer and the third most common cause of cancer death. 1 Despite advances in surveillance, surgery, radio-and chemotherapy, 40% of affected patients still cannot be cured.- 2,3 An improved molecular understanding of CRC and its immune microenvironment might offer novel therapeutic concepts to improve survival.…”

Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer

“…Colon cancer (CC) is the third most common cancer in the world and its incidence is expected to increase by 60% with more than 2.2 million new cases and 1.1 million cancer deaths by 2030 . Even though surgical resection is the only potentially curative therapy for CC, the factors associated with patient prognosis have not been completely understood . In particular, while several clinicopathological variables including advanced AJCC TNM stage, poor differentiated tumor grade, high carcinoembryonic antigen (CEA) level, and lympho‐vascular invasion have been associated with poor prognosis, the role of histology on prognosis is still debated .…”

Identified and Validated the Characterization of the Colorectal Cancer Tumor Immune Microenvironment

“…Colorectal cancer (CRC) remains the third most prevalent driver of cancer-associated mortality in the world [1]. At present, surgery remains the most effective treatment strategy for CRC, but 80% of patients still experience recurrence within a 3 year period [2]. Novel chemotherapeutic regimens have extended patient survival signi cantly, but rates of drug resistance remain high and lead to poor patient outcomes [3].…”