Colon cancer, also called colorectal cancer or large bowel cancer is cancerous growth in areas including the colon,rectum and appendix. It has been reported that there are at least 655,000 death worldwide due to this type of cancer every year. It is the third most common form of cancer and the second cause of cancer-related death.
Symptoms
Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:
- Abdominal pain and tenderness in the lower abdomen
- Blood in the stool
- Diarrhea, constipation, or other change in bowel habit
- Intestinal Obstruction
- Narrow stools
- Unexplained anemia
- Weight loss with no known reason
Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5 mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies.
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