Colon cancer is one of the most common malignancies in the western world, with about 1.9 million new cases and 900,000 deaths a year worldwide. Together with breast and prostate cancer, it is one of the three most common forms of cancer. Its impact increases significantly after 55 years, which makes preventive control over colonoscopy from the age of 50, even without a family history.
Despite the improvement of diagnostic techniques, about 20% of patients already have metastases during diagnosis. Often, warning symptoms such as stool blood, unexplained anemia or changes in bowel habits are ignored. Thus, only 15% of the incidents are located in the early stages through preventive examinations.
Surgery is still the foundation stone of treatment, especially in healing efforts. The prognosis and therapeutic effects on colon cancer are shaped through a combination of factors: the collaboration of a specialized medical group, the application of modern and documented therapeutic protocols, the availability of advanced medical equipment and the right choice of proper surgical technique. This multifactorial approach is crucial for optimizing the results and long -term survival of the patient.
Total mesocolic resection (CME)
The most appropriate surgical technique is the total medium -sized resection with central vascular ligation (CVL), adapted to the position of the primary tumor and the lymph node diaspora route. This technique, by applying oncological principles, ensures radical removal of tumor and lymph nodes through anatomical levels where large vessels (need fields) are absent.
When done correctly, it is accompanied by minimal bleeding, especially in combination with minimally invasive techniques, such as robotics or laparoscopic surgery, drastically reducing the need for transfusion. CME’s advantages in reducing local relapse and increasing survival rates are documented by a wealth of studies and integrated into modern guidelines.
With the proper application of the technique, in combination with lymph node clearance, significantly higher survival rates, even in advanced stages, are achieved. Over 60% of patients with colon cancer may be completely cured.
Treatment of liver metastases
At the metastatic stage, the more frequent localization of metastases is located in the liver. Its anatomical structure in eight sections allows selective removal of lobes or parts when the liver function is sufficient. In appropriately selected patients, the resection can be done safely.
The spectrum of interventions includes both minimally invasive (laparoscopic, robotic) and open methods, depending on the extent of the disease. In cases of extensive or multiple fireplaces, multifactorial therapeutic protocols are applied, which combine systematic therapy with local oncological interventions, such as:
- Radiofrequency (RFA)
- Microwave catalysis (MWA)
- Stereotactic radiotherapy (SBRT)
Patients with limited, technically exemplary liver metastases can be submitted in a combined surgical approach: Radical resection of primary tumor (CME) and surgical or hybrid treatment of metastases. This strategy offers increased chances of healing and long -term survival.
Writes Aristotle PerrakisMD, PhD, MHBA, FACS,
Director of Clinical General, Oncology (liver – pancreas – colocial cancer) & minimally invasive surgery, Athens Medical CenterProfessor of Surgery University of Magdeburg
Regular member of the American College of Surgeons
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