Actual Differences between Colon - and Rectal Cancer

Jafarov S1,5*, Boenicke L1, Staib L2,5, Kreuser ED3,5, Zirngibl H1 and Link KH4,5,6

1Department of Surgery II, Helios University Hospital Wuppertal, Witten/Herdecke University, Germany
2Department of General/Visceral Surgery, Klinikum Esslingen, Esslingen, Germany
3Department of Hematology/Oncology, KH Barmherzige Brüder, Regensburg, Germany
4Surgical Center and Asklepios Tumor Center, Asklepios Paulinen Klinik, Wiesbaden, Germany
5FOGT, Ulm University, Germany
6Hessian and German Cancer Societies, Germany

^*Correspondance to: Sakhavat Jafarov 

 PDF  Full Text DOI: 10.25107/2474-1647.2813

Abstract

biological point of view. Up to now, both, CC and RC, are synonymously called “Colorectal Cancer” (CRC). With our experience in basic and clinical research and routine work in this field we now have come to the opinion, that the term “CRC” should definitely be questioned, and if justified, be abandoned. Materials and Methods: We analyzed the actual available data from the literature and our own results from the Ulm based study group FOGT to proof or reject our hypothesis. Results: The following evident differences were recognized: 1. Pathologically there are differences between RC and CC. 2. Surgical topography and procedures are different. 3. Multimodal Treatment (MMT) approaches are different between CC and RC. 4. RC in MMT is less sensitive to chemotherapy than CC. 5. Prognostic factors for the spontaneous course and for success of MMT are different (e.g. TS or DPD). In addition, from preclinical points of view, CC and RC differ in carcinogenesis (e.g. the risk to develop RC is 4x higher than for CC; molecular changes in carcinogenesis in CC are different from RC), and in the frequently unrecognized fact that physical activity helps to prevent CC, not RC. Discussion: CC´s and RC´s definitely are different in many clinical (and basic research) parameters such as anatomy/topography, biological behavior, surgical and multimodal treatment concepts, sensitivity to chemotherapeutic protocols within multimodal therapy and the prognostic value of various preclinical and clinical parameters. Actually there are even observations, that in palliative chemotherapy the response rates of metastases from CC (especially right hemicolon) are differing from those deriving from RC. According to our findings we can demand that CC and RC are two different tumor entities. Conclusion: “CRC” should no longer be used in translational- and clinical research and other fields of cancer classification as a single disease entity. CC is not the same as RC. CC might even be divided into right and left CC.

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Cite the article

Jafarov S, Boenicke L, Staib L, Kreuser ED, Zirngibl H, Link KH. Actual Differences between Colon - and Rectal Cancer. Clin Surg. 2020; 5: 2813..