PMID- 20304247
OWN - NLM
STAT- MEDLINE
DCOM- 20100503
LR  - 20220410
IS  - 1474-547X (Electronic)
IS  - 0140-6736 (Linking)
VI  - 375
IP  - 9719
DP  - 2010 Mar 20
TI  - Colorectal cancer.
PG  - 1030-47
LID - 10.1016/S0140-6736(10)60353-4 [doi]
AB  - Substantial progress has been made in colorectal cancer in the past decade. 
      Screening, used to identify individuals at an early stage, has improved outcome. 
      There is greater understanding of the genetic basis of inherited colorectal 
      cancer and identification of patients at risk. Optimisation of surgery for 
      patients with localised disease has had a major effect on survival at 5 years and 
      10 years. For rectal cancer, identification of patients at greatest risk of local 
      failure is important in the selection of patients for preoperative 
      chemoradiation, a strategy proven to improve outcomes in these patients. 
      Stringent postoperative follow-up helps the early identification of potentially 
      radically treatable oligometastatic disease and improves long-term survival. 
      Treatment with adjuvant fluoropyrimidine for colon and rectal cancers further 
      improves survival, more so in stage III than in stage II disease, and 
      oxaliplatin-based combination chemotherapy is now routinely used for stage III 
      disease, although efficacy must be carefully balanced against toxicity. In stage 
      II disease, molecular markers such as microsatellite instability might help 
      select patients for treatment. The integration of targeted treatments with 
      conventional cytotoxic drugs has expanded the treatment of metastatic disease 
      resulting in incremental survival gains. However, biomarker development is 
      essential to aid selection of patients likely to respond to therapy, thereby 
      rationalising treatments and improving outcomes.
CI  - Copyright 2010 Elsevier Ltd. All rights reserved.
FAU - Cunningham, David
AU  - Cunningham D
AD  - Gastrointestinal Unit, Royal Marsden Hospital National Health Service Foundation 
      Trust, London and Surrey, UK. David.cunningham@rmh.nhs.uk
FAU - Atkin, Wendy
AU  - Atkin W
FAU - Lenz, Heinz-Josef
AU  - Lenz HJ
FAU - Lynch, Henry T
AU  - Lynch HT
FAU - Minsky, Bruce
AU  - Minsky B
FAU - Nordlinger, Bernard
AU  - Nordlinger B
FAU - Starling, Naureen
AU  - Starling N
LA  - eng
GR  - G9615910/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Biomarkers, Tumor)
SB  - IM
CIN - Lancet. 2010 Jul 31;376(9738):330; author reply 331-2. PMID: 20674717
CIN - Lancet. 2010 Jul 31;376(9738):331; author reply 331-2. PMID: 20674718
MH  - Antineoplastic Agents/therapeutic use
MH  - Biomarkers, Tumor/analysis
MH  - *Colorectal Neoplasms/diagnosis/genetics/pathology/therapy
MH  - Humans
MH  - Prognosis
RF  - 216
EDAT- 2010/03/23 06:00
MHDA- 2010/05/04 06:00
CRDT- 2010/03/23 06:00
PHST- 2010/03/23 06:00 [entrez]
PHST- 2010/03/23 06:00 [pubmed]
PHST- 2010/05/04 06:00 [medline]
AID - S0140-6736(10)60353-4 [pii]
AID - 10.1016/S0140-6736(10)60353-4 [doi]
PST - ppublish
SO  - Lancet. 2010 Mar 20;375(9719):1030-47. doi: 10.1016/S0140-6736(10)60353-4.