Costi R, Leonardi F, Zanoni D, Violi V, Roncoroni L. Palliative care and end-stage colorectal cancer management: The surgeon meets the oncologist. World J Gastroenterol 2014; 20(24): 7602-7621 [PMID: 24976699 DOI: 10.3748/wjg.v20.i24.7602]
Corresponding Author of This Article
Renato Costi, MD, PhD, FACS, Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Dipartimento di Scienze Chirurgiche, Università di Parma, Via Gramsci 14, 43100 Parma, Italy. renatocosti@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Topic Highlight
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World J Gastroenterol. Jun 28, 2014; 20(24): 7602-7621 Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7602
Palliative care and end-stage colorectal cancer management: The surgeon meets the oncologist
Renato Costi, Francesco Leonardi, Daniele Zanoni, Vincenzo Violi, Luigi Roncoroni
Renato Costi, Vincenzo Violi, Luigi Roncoroni, Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Dipartimento di Scienze Chirurgiche, Università di Parma, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy
Francesco Leonardi, Daniele Zanoni, Dipartimento Polispecialistico 1, Unità Operativa di Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy
Vincenzo Violi, Dipartimento di Chirurgia Generale e Specialistica, Ospedale di Vaio, Azienda Unità Sanitaria Locale di Parma, 43036 Fidenza (Parma), Italy
Author contributions: Costi R and Leonardi F designed the article; Zanoni D and Violi V collected the data; Costi R, Zanoni D and Leonardi F analysed the data; Costi R and Leonardi F wrote the paper; Violi V and Roncoroni L reviewed the paper for important intellectual contribution; Roncoroni L supervised.
Supported by University of Parma Research Funds
Correspondence to: Renato Costi, MD, PhD, FACS, Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Dipartimento di Scienze Chirurgiche, Università di Parma, Via Gramsci 14, 43100 Parma, Italy. renatocosti@hotmail.com
Telephone: +39-335-8234285 Fax: +39-521-940125
Received: October 30, 2013 Revised: February 19, 2014 Accepted: April 8, 2014 Published online: June 28, 2014
Core Tip
Core tip: Colorectal cancer is a common neoplasia with considerable morbidity/mortality. Every fifth patient presents with metastatic disease, which is usually not resectable. In asymptomatic patients, new chemotherapy regimens allow long survival and, potentially, conversion of non resectable liver metastasis in resectable ones, with a significantly improved prognosis. Obstruction is traditionally approached by colonic resection, stoma or internal by-pass, although nowadays stenting is a feasible option. Perforation is associated with the highest mortality and is mostly managed surgically, by lavage/drainage, colonic resection and/or stoma. Bleeding and other symptoms (pain, tenesmus) are managed mini-invasivally by radiotherapy, laser therapy and other transanal procedures.
