Colon cancer

Colon cancer is a common disease that affects a significant number of people, both in the United States and worldwide. Surgery is the primary treatment for patients with resectable colon cancer. Laparoscopic colectomy is an acceptable alternative to open colectomy based on results that demonstrated oncologic equivalency between the two approaches. Robotic colectomy is emerging as an alternative approach, although data on its oncologic effectiveness is lacking. Optimal surgical resection requires resecting the affected bowel with at least 5 cm proximal and distal margins, ligating primary feeding vessels, harvesting at least 12 lymph nodes, and obtaining greater than a 1 mm circumferential radial margin. Adjuvant chemotherapy is the standard of care for stage III disease, although its role in stage II disease is debatable. The status of microsatellite instability (MSI) and the use of multigene arrays are helpful in identifying patients with stage II disease who might benefit from adjuvant therapy.