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Multidisciplinary management of stage IV colon Cancer
Significant advances in systemic chemotherapy and surgical techniques have allowed a subset of patients with stage IV colorectal cancer to be suitable candidates for multimodality therapy with curative intent. Care of these patients requires multidisciplinary coordination, close monitoring of disease response, and individualized treatment plan. This review will discuss considerations for treatment planning and sequencing in patients with symptomatic and asymptomatic primary colon cancer in the setting of potentially resectable liver metastases. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Y. Nancy You, Cathy Eng, Thomas Aloia Source Type: research

Colon cancer in hereditary syndromes
Though representing less than 10% of colorectal cancers diagnosed worldwide, inherited colon cancer syndromes are important as their identification allows for screening and early interventions for both patients and their potentially affected family members. Both autosomal dominant and recessive gene mutations have been linked with these syndromes. High penetrance mutations, such as those involved in tumor suppression or mismatch repair mechanisms, lead to phenotypes with increased colorectal cancer risk. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Alexander T. Hawkins, Paul E. Wise Source Type: research

Introduction
It is an honor to serve as the guest editor for this issue of Seminars in Colon and Rectal Surgery, “Current Treatment of Colon Cancer.” I thank Dr. David Schoetz for the invitation and opportunity to oversee its content. Although colon cancer remains one of the most common cancers and causes of cancer death in the United States and throughout the world, it still is one of the most preventable and curable. Both incidence and mortality rates have improved over the last several decades. Several factors have contributed to these increased outcomes. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Matthew F. Kalady Source Type: research

Molecular genetics of colorectal Cancer
Colorectal cancer is the end result of an accumulation of destabilizing mutations and other genetic events that occur in colonocyte nuclei over many years. While each colorectal cancer is genetically unique, there are at least three distinct mechanisms by which the process occurs. The commonest is chromosomal instability, producing microsatellite stable, aneuploidy cancers. The second is DNA promoter methylation, that underlies CpG island methylation phenotype cancers, either microsatellite stable or unstable, and the third is loss of DNA mismatch repair, causing microsatellite unstable, diploid cancers. (Source: Seminars ...
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: James Church Source Type: research

Advances in colonoscopy and screening for colon cancer
Physicians have a plethora of options when choosing a diagnostic test or procedure for colon cancer screening. Clinicians are no longer limited to fecal occult blood tests and standard colonoscopy. Newer choices include advanced stool tests and imaging modalities such as computed tomography colonography. Even the “standard” colonoscope has multiple accessories, ranging from simple plastic caps to multisystem high definition imaging. Each new innovation brings with it data touting its excellence and deciding the best modality can be a daunting task. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Nathan H. Hite, David A. Margolin Source Type: research

Management of malignant polyps
Malignant polyps of the colon may be managed with endoscopic therapy or oncologic resection, with the appropriateness of each dependent on histologic features, polyp location, and patient preference. Lesions at increased risk for having nodal metastases should undergo oncologic resection. High-risk features include lymphovascular invasion, poor differentiation, and greater depth of submucosal invasion. However, while there are some clear indications for endoscopic or oncologic resection, many cases of malignant polyps fall into a gray zone where management is under debate. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Cindy Kin Source Type: research

Staging, prognosis, and survivorship in colon cancer
The American Joint Committee on Cancer released the 7th edition of their staging manual for colon cancer in 2010. The biggest changes were the subcategories added for stage II and III colon cancer, as there is a significant difference in survival based upon the tumor depth of invasion (T stage) within these two stages. The 8th edition is awaiting release in the near future. However, there continues to be a dilemma of which patients with Stage II cancer may benefit from adjuvant chemotherapy. There are guidelines that now include clinical, pathologic and genomic factors that allow us to stratify patients into high and low-r...
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Kevin Kniery, Madhuri Nishtala, Scott R. Steele Source Type: research

Surgical approach to colon cancer
Surgery remains the most definitive treatment for colon cancer. A complete colon exam is critical to localize the primary lesion and exclude other pathology in the colon that may influence the extent of resection. In the comorbid aging population, the surgeon must be able to accurately prognosticate postoperative morbidity and mortality. Enhanced recovery interventions, including minimally invasive approaches to resection offer improved short-term outcomes without oncologic compromise. Colectomy for cancer follows four oncologic principles; adequate lymphadenectomy of ≥12 lymph nodes, high ligation of the primary vessel,...
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Matthew G. Mutch, Katerina O. Wells Source Type: research

Advances in adjuvant therapy of colon Cancer
Surgical resection is the primary curative modality for colon cancer but outcomes are variable and dependent on risk of recurrence. Currently, stage and a variety of clinicopathologic risk factors are used to estimate recurrence risk. Adjuvant chemotherapy is recommended for most patients with stage III disease and high-risk patients with stage II disease to reduce the risk of recurrence and improve outcomes. Fluoropyrimidines with and without oxaliplatin have proven benefit, but there is no effect of other agents including irinotecan, anti-vascular endothelial growth factor, or anti-epidermal growth factor agents in this ...
Source: Seminars in Colon and Rectal Surgery - April 24, 2016 Category: Gastroenterology Authors: Santosh Kumar, Marcus S. Noel, Alok A. Khorana Source Type: research

Setup and positioning in robotic colorectal surgery
Preparation for robotic colorectal surgery is more complicated than open and laparoscopy approaches. The colorectal surgeon interested in robotic training should be familiar with and well prepared for robotic draping, positioning of the operating table, the patient cart, the vision cart, the surgeon console, and other operating equipment. Port placement requires more strategy than for the laparoscopic platform and differs depending on the type of robotic system utilized. Anesthesia personnel should be prepared for potential airway issues related to operating table and patient positioning. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 20, 2016 Category: Gastroenterology Authors: Anuradha R. Bhama, Robert K. Cleary Source Type: research

Set up and positioning in robotic colorectal surgery
Preparation for robotic colorectal surgery is more complicated than open and laparoscopy approaches. The colorectal surgeon interested in robotic training should be familiar with and well prepared for robotic draping, positioning of the operating table, the patient cart, the vision cart, the surgeon console, and other operating equipment. Port Placement requires more strategy than for the laparoscopic platform and differs depending on the type of robotic system utilized.Anesthesia personnel should be prepared for potential airway issues related to operating table and patient positioning. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 20, 2016 Category: Gastroenterology Authors: Anuradha R. Bhama, Robert K. Cleary Source Type: research

Introduction: Robotic colorectal surgery
The minimally invasive phase of colorectal surgery can be traced to 1991 when the first laparoscopic colectomy was reported. Since then, many natural advances have occurred to organ and disease-specific uses of minimally invasive techniques. The majority of colorectal surgeons have been trained in the use of minimally invasive techniques and it is typical to find most major institutions using these techniques to improve the short-term outcomes of patients with colorectal diseases. It is difficult to estimate the percentage use of laparoscopic techniques for routine elective cases for colectomy unless one divides the medica...
Source: Seminars in Colon and Rectal Surgery - April 18, 2016 Category: Gastroenterology Authors: James Fleshman Source Type: research

Robotic colorectal surgery: Evolution and future
The introduction of laparoscopic cholecystectomy changed the approach to abdominal surgery revealing the patient-specific advantages of minimally invasive approaches to gastrointestinal diseases. Unfortunately, inherent limitations of laparoscopy impeded widespread utilization of laparoscopic surgery in advanced procedures such as laparoscopic colectomy. Even as prospective and randomized trials demonstrated outcomes advantages for the patient, few surgeons introduced laparoscopic colectomy into their practice. (Source: Seminars in Colon and Rectal Surgery)
Source: Seminars in Colon and Rectal Surgery - April 18, 2016 Category: Gastroenterology Authors: Evan Weitman, Mona Saleh, Jacques Marescaux, Terri R. Martin, Garth H. Ballantyne Source Type: research