Colorectal cancer C19

Colorectal carcinoma refers to a malignant neoplasia of the colon and is one of the most common types of cancer in industrialized countries. The boundary between a colon and rectal carcinoma is 16 cm between an aboral tumour margin and the anocutaneous line.

The incidence of colorectal carcinoma varies in Europe depending on the country, but Germany has the highest incidence with over 40 cases per 100,000 inhabitants per year. Approximately 90% of colorectal carcinomas occur after the age of 40, after which the incidence doubles every 10 years.
Risk groups include patients with colorectal adenomas, people with first-degree relatives, patients with ulcerative colitis, HNPCC and hereditary polyposis syndromes.

Colorectal carcinomas are favoured by genetic factors, nutritional factors and risk diseases.
Genetic factors include familial polyposis syndrome and Lynch syndrome. Fat-rich, meat-rich and low-fibre food as well as overweight are among the favourable nutritional factors.
Risk diseases include carcinomas of the mamma, ovary and corpus uteri, colorectal adenomas, schistosomiasis and chronic inflammatory bowel diseases.
Other risk factors are high alcohol and cigarette consumption and > 40th LJ.

Rectum (50 % of cases), sigmoid colon (30 %), coecum (10 %), remaining colon (10 %
)In the case of rectal cancer, the prognosis is better the deeper the carcinoma is located. Depending on this, the rectal carcinoma is distributed over up to 3 lymphogenic metastasis routes.
In addition, haematogenic metastasis can occur via a venous outflow, resulting in liver carcinomas.

Colorectal carcinomas show no characteristic symptoms. Some patients have blood in their stool. In addition, when haemorrhoids are diagnosed, digital examinations should be performed to exclude carcinomas.
Changes in stool habits (from the age of 40), persistent bad wind odours, chronic bleeding anaemia, pain, ileus symptoms as well as persistent fatigue, fever, weight loss and reduced performance can also indicate a colorectal carcinoma.

To diagnose colorectal cancer, a rectal palpation, spiral CT or MRI and a colonoscopy are performed. Further, complementary diagnostic procedures are the search for metastases and assessment of tumor extent by means of sonography, X-ray thorax and angio-CT of the liver, tumor maker CEA and detection of mRNA of the tumor-associated antigen HL-6.

There are different therapeutic approaches to the treatment of colorectal cancer: curative surgical, neoadjuvant, adjuvant and palliative therapy.

The 5-year survival rate for rectal cancer is up to 95% in stage 1, up to 85% in stage 2, up to 55% in stage 3 and around 5% in stage 4.

The 5-year survival rate is up to 95% for a colon carcinoma in stage 1, up to 85% in stage 2, up to 65% in stage 3 and around 5% in stage 4. In general, however, the experience and diligence of the surgeon can influence the prognosis by up to 30 %, depending on the stage.