28 y/o woman with abdominal pain - new Dx of Colorectal Cancer
Dr. Alfred Neugut | Morning Report | 09/06/2016
Peritoneal Mets in Colorectal Cancer is a poor prognostic marker
Stage 4- previously only treated with 5-FU with high mortality at 6 months.
Newer agents such as Irinotecan/Oxaliplatin added to 5-FU and Lecuovorin now have improved prognosis - median survival closer to 30 months.
Posted 09/06/16 04:12:18 PM by Adam Faye
If pt. has WT KRAS mutation- can be considered for anti-EGFR therapy (Panitumumab) - has been shown to improve survival. Staging is the most accurate predictor of outcome in pts. with colorectal cancer.
Posted 09/06/16 04:19:47 PM by Adam Faye
Staging Colorectal Cancer:
CEA- useful for response to therapy/recurrence. In general, tumor markers better for prognosis/recurrence than diagnosis
CT Chest, Abdomen, Pelvis. Often see colorectal mets in the liver
CRC is one of the few malignancies that can be surgically removed even if there are mets (generally only if the mets are isolated to one organ system).