Clinical Case: Mr. Herbert is tired.
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

 Natural history of colon cancer
  • Is to invade the wall of the bowel and spread to the lymph nodes.
    • regional and distant
  • Sites of distant organ metastases include:
  • The most important prognostic factor is the tumor's stage
    • In other words, the extent of tumor spread at the time of diagnosis. 
The Astler-Coller Classification of Colorectal Carcinoma (often incorrectly labeled the Dukes scheme of classification) is widely used of staging for this lesion.
 
 Stage    Histologic Features 5 year Survival
     
  A Limited to mucosa 100%
  B1 Into muscularis propria but not through it. Uninvolved nodes 67%
  B2 Through muscularis propria. Uninvolved nodes 54%
  C1 Into muscularis propria. Involved nodes 43%
  C2 Through muscularis propria. Involved nodes 23%
  D Distant spread, i.e. liver, lungs. Bad

Where does the CEA come into play?                                                         Back

  

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