Colorectal cancer natural history

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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Elliot B. Tapper, M.D., Beth Israel Deaconess Medical Center

Complications

Complications of colorectal cancer include:

• Intestinal obstruction
• Gastrointestinal bleeding
• Cancer spread to other organs in the body
• Cancer recurrence
• Radiation therapy side effects - skin discoloration, skin burns, headache, fatigue, hair loss, nausea, vomiting, confusion
• Chemotherapy side effects - hair loss, fatigue, weakness, nausea, vomiting, risk of infection, diarrhea

Prognosis

Survival is directly related to detection and the type of cancer involved. Survival rates for early stage detection is about 5 times that of late stage cancers. CEA level is also directly related to the prognosis of disease, since its level correlates with the bulk of tumor tissue.

5 year survival rates depending upon the stage of colorectal cancer are as follows:

Stage	5 yr survival rate
Stage I	>90%
Stage IIA	65% - 75%
Stage IIB	55% - 65%
Stage IIIA	45% - 55%
Stage IIIB	30% - 45%
Stage IIIC	20% - 30%
Stage IV	<5%

Poor prognostic factors of patients with liver metastasis include

• Synchronous (diagnosed simultaneously) liver and primary colorectal tumors
• A short time between detecting the primary cancer and subsequent development of liver mets
• Multiple metastatic lesions
• High blood levels of the tumor marker, carcino-embryonic antigen (CEA), in the patient prior to resection
• Larger size metastatic lesions

References

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