world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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applies to depressed, flat neoplastic<br />
lesions (type IIc) only when the diameter<br />
does not exceed 1 cm.<br />
Sporadic advanced colonic <strong>cancer</strong> is<br />
treated by segmental colectomy with a<br />
tendency to large resection. Adjuvant<br />
chemotherapy (5 FU-levamisole or 5 FUleucovorine)<br />
is recommended if lymph<br />
node invasion is confirmed and some<br />
advocate a similar indication in B2 (subserosal)<br />
tumours. Recently introduced<br />
cytotoxic drugs, such as irinotecan and<br />
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oxaliplatin, are beginning to become<br />
established in treatment regimes [15].<br />
Advanced <strong>cancer</strong> located in the rectum is<br />
treated by neo-adjuvant radiotherapy if<br />
the tumour is either T3 (showing local<br />
invasion) or N+ (positive lymph nodes).<br />
Colorectal <strong>cancer</strong> is nowadays considered<br />
to be a chemosensitive tumour; in some<br />
patients, the occurrence of liver or pulmonary<br />
metastases does not exclude a<br />
curative management based upon combined<br />
resection and chemotherapy. The<br />
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Eshleman JR, Booker S, Lynch HT, Jass JR, Green JS, Kim H,<br />
Jen J, Vogelstein B, Hamilton SR (1998) Accumulated clonal<br />
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aggressive management of operable<br />
patients is based on initial segmental liver<br />
or lung resection followed by first line<br />
chemotherapy. In inoperable patients,<br />
first and second line chemotherapy protocols<br />
are proposed and a delayed surgical<br />
resection may be considered in some<br />
cases. The five-year survival following<br />
detection and treatment of colorectal <strong>cancer</strong><br />
is around 50% (Fig. 5.36).<br />
WEBSITES<br />
Johns Hopkins Hereditary Colorectal Cancer Website:<br />
http://www.hopkins colon<strong>cancer</strong>.org/subspecialties/<br />
heredicolor_<strong>cancer</strong>/overview.htm<br />
APC gene mutation database:<br />
http://perso.curie.fr/Thierry.Soussi/APC.html