Diagnosis and treatment of T 4 stage colon cancer / 国际外科学杂志

ABSTRACT

Colorectal cancer accounts for approximately 10% of all annually diagnosed cancers and cancer deaths in the world. The prognosis of T 4 stage colon cancer is poor, and of T 4b stage is even worse. The 5-year overall survival of T 4b is only 15.8% to 27.9%. Currently, the T 4 stage colon cancer is lack of accurate T stage imaging evaluation and systemic perioperative diagnosis and treatment system. In the authors′ opinion, for imaging evaluation, computed tomography (CT) is the main technique. CT colonoscopy should be applied to the patients who are unable to explore the entire colon due to tumor obstruction in colonoscopy and the patients who are difficult to estimate via traditional CT. For perioperative diagnosis and treatment system, radical surgery and postoperative chemotherapy could be performed in the T 4a colon cancer patients; neoadjuvant chemotherapy, radical surgery and postoperative chemotherapy could be performed in the T 4b colon cancer patients; neoadjuvant radiotherapy could be performed in the patients whose tumor is fixed. Moreover, multiple disciplinary team (MDT) should be established for the complicated T 4 colon cancer patients.